Paramedic Textbooks – Australian Students

What textbooks are best for Australian students? I think I have the answer. PERIODICALLY UPDATED. LAST UPDATED May 2017

Paramedic textbooks have problems. They’re basically retreading the same ground every year. Some of them are still harkening back to when EMS was a new concept, simply updating the bits of the text that change as time goes by. For Australia though this is even worse – Australian students are increasingly coming straight from high school into a paramedic degree with little to no clinical experience. There is no progression from EMT to Paramedic – it doesn’t exist here, you go straight to Paramedic level. All of those essential BLS skills simply never get properly developed.

Our system here in Australia has quite a few advantages though. We don’t rely on quick overviews of anatomy and physiology or pharmacology – our Bachelor degree programs instill a significant amount of knowledge over the 3 years it takes to earn that degree. Students come out knowing a significant amount of information. But as I’ve watched new students come through, it’s clear that while lots of them know the intricacies of cellular respiration or what have you, the majority struggle with things like deciding when to ventilate a patient with inadequate respirations (most don’t even know the clinical application of tidal volume to minute volume!). Some of the wisdom that the paramedic textbooks instilled has been lost – or forgotten in the rush to teach new concepts.

Many students don’t even buy textbooks – which in some ways might reflect the rapid pace that paramedicine is moving these days, but more often than not reflects an assumption that they have no value and aren’t needed. Most I talk to say “Why buy it? The university teaches me everything I need to know, and you can do the rest. That’s how this works, right?” Well, no, unfortunately – I can’t teach you everything (there’s things I don’t know) and the university can’t either (because there’s too many students and not enough time). Hence we end up with students who simply watch the lecture to pass the content, and then come on road without a real idea of what to do.

Some universities have ditched the paramedic textbook altogether, and opted to use books aimed at medical interns. Nobody’s gone so far as to make Tintinalli the primary text, but the Textbook of Adult Emergency Medicine (Cameron et. al.) is a favourite. And they’re awesome books packed full of information that ultimately makes better paramedics, just as does the reams of free online information too – but they’re useless if you have no concept of the prehospital environment, and none of those books were written for people who are staring at a patient entrapped in the wreck of their car at midnight.

My approach for determining the best textbooks to buy is simple: get a paramedic textbook, and get a medical textbook – and pretty much leave it at that for the most part, at least while you’re at university.

So, with that in mind, what do I actually recommend?

Your local protocols

If you’re going to work in Queensland, for example, it’s important you get a hold of the clinical practice manual for the Qld Ambulance Service. This is the standard expected of you on clinical placement. Clinical practice guidelines are written to provide a minimum standard of safe care, and outline what you are or aren’t allowed to do autonomously. Read them – because your mentors will expect you to know them. Fortunately most of the time these are free to access, so they won’t cost you anything.

Some Combination of EMT/Paramedic Textbook

I’ve read just about every paramedic textbook there is, and they’re all awful. Some are less awful than others, but every last one of them has some sort of problem. Compounding this fact is that many paramedic textbooks assume you’ve been an EMT first, and will omit important information (or gloss over it), and unviersities are traditionally bad at basic life support instruction. In addition to this, many are US-based textbooks which are written to cover the US DOT NREMT plan. I don’t recommend spending a lot of money on a paramedic text, because they’re not overly helpful anymore, and all you really want is something that focuses on prehospital management.

 

They also outlive their usefulness after you’ve got the basics down – after that, it’s time to move on to a medical textbook. They’re also absurdly expensive, although some of the eBook solutions are cheaper. I recommend getting them second hand, if you can – it works out cheaper and the information will be out of date anyway. Have a really, really good look around before you purchase for the best price – some of them can vary wildly in cost. If you’re in the US, you might not get a choice, since many of them come with online access codes that your program might demand.

  • Nancy Caroline’s Emergency Care in the Streets: This venerable/hated tome has been around forever, and it’s one of the most expensive on the list. People either love it or hate it – some hate it because it has some of the most simplistic language of the lot (god damn Sidney Sinus bullshit!), but with that said it’s probably the most approachable of all of the paramedic textbooks. This is especially important for Australian paramedic students who have zero prehospital experience (coming fresh from high school into the degree program). It also doesn’t forget the important BLS concepts that other textbooks gloss over (because it’s assumed you’re already an EMT). Prices vary wildly – if you want it, I’d strongly recommend only getting it second hand or at a price under $250. One of my recommended books, particularly if you only want to buy a single textbook and have little to no prehospital experience. PS: The 5th edition was the last good edition – if it wasn’t so out of date, I’d just recommend tracking down a copy of it!
  • Paramedic Care: Principles and Practice: This one isn’t mentioned all that often in Australia, but it’s an excellent series of books that covers off on a lot of content. It’s very well written and fairly concise. It’s also available on the Amazon Kindle store as a series of separate books for reasonable prices. If you wanted an eBook, this is probably the best you can get. That said, it doesn’t have much to say on BLS topics – it sort of glides over them which some might find a little confusing. Otherwise it’s an excellent set of books and one that I strongly recommend. The layout is a little off though – they’ve shoved a lot of shock recognition/management into the pathophysiology section for some reason. Note: It’s split into a couple of different books, all of them different prices. Don’t get the first and last books – they’re useless, focus on the clinical ones.
  • Essentials of Paramedic Care: Basically a distilled version of the above. Avaialble on Amazon Kindle as an eBoook, this one only costs about $60 AUD, making it the cheapest book of the lot. That said, it’s based on an older version of Paramedic Care, and it does omit some useful information. The core of it though is fully intact and it’s still an excellent textbook. If you want the cheapest possible option, I guess this is it.
  • Emergency and Trauma Case for Nurses and Paramedics: This Australian book shows up on quite a few mandatory textbook lists, but it’s probably the worst of the lot. The bulk of the book is an overly academic, long-winded and yet confused discussion of emergency care, predominately aimed at in-hospital nursing care. There’s very little for paramedics. What information is provided for paramedics is presented in the most ridiculously confused manner possible. You won’t find a good systematic assessment approach here. It’s a mess of a book that probably won’t teach anybody anything. Don’t get it. Don’t care if it’s recommended, it’s not worth it. And no, the second edition is just the same as the first!
  • Prehospital Emergency Care: This is an EMT book, and at $106 AUD it isn’t cheap, but it does fill a significant BLS-skills gap that most universities overlook. It has a lot of good, fundamental prehospital care information that your degree might skip over. It won’t discuss IV access, fluids, ECG monitoring or pharmacology, but it does provide a solid foundation in BLS from which you can build off. If your degree is particularly good, you might find this answers a lot of ‘silly’ prehopsital care questions. Physical copies are usually more expensive, and again it’s only a basic book so you can’t expect too much from it, but it’s something to consider.
  • Mosby’s Paramedic Textbook: Sometimes seen as Sanders’ Paramedic Textbook (mostly in the UK), this isn’t really a bad book but it has an annoying habit of asking a question and never giving an answer. I had this one for my paramedic degree and I didn’t really find it all that useful. It’s not a bad book but you can typically find better books out there. It falls somewhere between Paramedic Care (which is more detailed) and Caroline (which is easier to grasp). This happy medium isn’t particularly great though. I’d probably just get one of the others instead.

So what should you get? Whatever you want, to be honest, it’ll hardly make a difference in the long run. I’ve read pretty much every paramedic text out there, and they’re all pretty much the same. Some are better than others, but mostly they talk about the same concepts (since they follow the NREMT plan). If you want a very easy to understand book, get Caroline provided you can find it cheaply (sub-$200 AUD would be ideal). If you want an eBook, get the Paramedic Care series.

Medical Textbooks

Since paramedic textbooks are pretty much awful, I strongly recommend getting a good medical textbook and reading that instead. They require more knowledge in order to read them properly, but your university degree gives you a solid foundation in phyisology, so you can read them (and Google what you don’t understand, at least). By reading these books you’ll have a much better understanding of patient assessment and management principles. I’d strongly recommend getting one in favour of a paramedic text.

There are two textbooks that I can recommend:

  • Textbook of Adult Emergency Medicine (Cameron et. al.) is the most popular at Australian universities and it’s an easy to read book, and tends to be fairly concise. However it does miss out on a few topics and sometimes oversimplifies things. Also it doesn’t cover paediatrics at all. Finally, it has a significant lack of photos/images – and it could really use some. With all that said, it is very easy to read and doesn’t have such a heavy reliance on diagnostic toys, making it suitable for the prehospital environment… and it’s Australian, and written primarily for Australian healthcare professionals. If you want a nice, easy to read emergency medical reference guide, this is it. There’s also a paediatric version, too.
  • Tintinalli’s Emergency Medicine: A Comprehensive Study Guide (Tintinalli et. al.) is one of the most popular emergency medicine texts, period. It covers pretty much anything and everything, with loads of photos and diagrams, and also goes over various procedures. It’s the whole lot from cradle to grave. It does require a bit more background reading to get the most out of it, and it’s very much geared towards the ED intern, but it covers the lot. It’s also easy to find. Costs about the same as both the adult and paediatric textbooks above.

Whichever you decide to choose is up to you (or your university, I guess). Cameron’s books are easier to read and much more to the point than Tintinalli’s books, but they’re in need of some illustrations and are completely silent on procedures. Tintinalli’s book is by far the most comprehensive and will tell you pretty much anything you want to know – but it’s nowhere near as easy to read, and has a very heavy focus on using extra diagnostic or monitoring tools that we don’t have access to in the prehospital environment.

So, which do I recommend? I lean towards Cameron’s books, only because they’re Australian and are easy to read. Both the adult and kids book together is less than Tintinalli (at least in eBook form), and realistically learning procedures and techniques is probably better done by attending classes or watching YouTube videos. They aren’t as complete as Tintinalli, but they’re easier to read for sure. If you do come across a cheap Tintinalli (or by some other means) it’s worth getting it though, and Tintinalli is more widely known than Cameron’s books. Tintinalli just has way more information and is the more complete reference guide – but it’s on the border of overkill for paramedics.

 

Other Recommended Texts

There are lots of textbooks out there, on a wide variety of topics. The ones above are what I’d consider the minimum for most people – the bare essentials to get by provided you pay attention in class. If you can afford extra books though, I’d recommend you consider some of the following books if they take your fancy or if you think you’ll get some use out of them. None of them are essential, but they’re nice to have.

  • If you really want a book on paramedic proceudres, Manual of Clinical Paramedic Procedures (Gregory et. al.) is an excellent book. Learning the actual procedures from university is by far the best (as well as watching videos about them) but this book offers extra information and guidance on how (and when!) to do a lot of different advanced tasks. Not essential, but not bad to have if you think you’ll get any benefit from it. Might be useful especially given the lack of information in Cameron’s book on emergency procedures.
  • Assessment Skills for Paramedics (Blaber & Harris) is a fairly short book all about assessment of various patient groups (grouped by body system). It’s UK-focused with an ABCDE approach (which doesn’t match Australian practice) but it does have a lot of useful information on how to assess various patients with particular complaints. Not essential, but possibly useful if you want to work on your assessment skills.
  • A decent toxicology handbook (even better as an eBook!) is invaluable in the field. These books will allow you to quickly look up the relevant clinical signs and symptoms, toxic doses, and treatment guides for all manner of agents (from meds to illicit drugs to envenomations). Well worth having a copy of. Toxicology Handbook 3 Ed. (Murray et. al.) is available on most ebook platforms for a relatively small outlay, and is a fantastic resource.
  • The Oxford Handbook of Emergency Medicine is another good ebook resource. Aimed at ED physicians, it contains some very quick guides on a lot of common presentations that aren’t covered by paramedic textbooks. It’s kind of like a really quick, easy to read Tintinalli or Cameron, except without the depth.
  • Paramedic Principles and Practice ANZ (Johnson et. al.) is another useful textbook that actually focuses quite nicely on common scenarios facing Australian paramedics. It’s great at helping you make decisions and perform assessments, and goes into quite a bit of detail on what topics it does cover. That’s also the issue – it doesn’t cover a lot of topics. Hypoglycaemia is covered, but hyperglycaemia is ignored, for example. While it’s an excellent book to help you along, I wouldn’t rely upon it. If this ever developed into a paramedic textbook the likes of Nancy Caroline’s tome, it’d probably be the best paramedic textbook ever written.

Other useful hints for textbooks/resources

  • I typically don’t recommend physiology or pathophysiology books, nor do I recommend pharmacology books, because the information we typically need to know is adequately covered by lectures or looking up stuff online. There are lots of recommended textbooks out there for these topics if you really want one, but paying attention in class and looking it up online will do the job too (and it’s usually faster).
  • Medscape is a fantastic free online resource that allows you to look up conditions, medications, and procedures. It doesn’t contain everything (and sometimes things are named oddly and aren’t easily found by a text search) but it does cover off on a lot of things, and provides more up to date information than any textbook could hope to provide. Get it on your smartphone and keep it with you.
  • Googling things is fine – so long as you don’t rely on it. Textbooks become outdated pretty much as soon as they’re printed, so they aren’t the be-all and end-all of information. By all means Google for explanations, but as with anything assess the source to see if it’s credible, and compare it with what else you know. Google’s a great tool to augment your studies, particularly if you don’t understand something.
  • YouTube and Kahn Academy are awesome. There’s more information on ECGs than you could ever hope for. Same with watching how to do various procedures.
  • FOAMed resources are abundant these days (see Life in the Fast Lane, FOAMed on Reddit, and the RAGE podcast) and contain the latest in clinical care. Content ranges from bleeding edge techniques and research to case studies and advice from senior clinicians. If you want to know how we’ll be treating patients in the future, this is where to learn it. That said the barrier for entry is fairly high – without basic background knowledge, it’ll sail over your head.

In summary:

  • Textbooks are invaluable for the paramedic degree – your lecturers can’t teach you everything, and they become useful as your knowledge improves
  • Online resources help augment your learning
  • Consider an EMT textbook to help with your understanding of the fundamentals of prehospital care, because most paramedic textbooks assume you’ve done this already and will gloss over it
  • Get a good medical textbook (Cameron or Tintinalli), it’ll prove useful for when you continue on into a graduate position and into the profession proper
  • Get a good ECG book (one that focuses on rhythm identification, not one that spends ages talking about the minute details of electrophysiology – worry about that later)

 

Good luck!

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