Rewritten for March 2018!
Previously I’ve written posts on paramedic textbooks for Australian students. It’s gotten a bit long and it’s a bit too challenging to keep editing. So I’ve re-written it to be a lot shorter. And now that it’s March 2018 and I’ve read pretty much all of them out there, I’ve come up with what I think is the best solution for Australian students looking to educate themselves.
The Problem for Australian Students
In the US, you go to EMT-Basic school, get an EMT-B textbook, and learn from that. Then you can go on to EMT-Paramedic school, get an EMT-P textbook, and that’s the end of it. In Australia… there is no EMT-B. There’s no EMT-P. You (almost in every case) go off to do a Bachelor Degree in Paramedic Science (or similar) use a combination of textbooks, and get thrust into a scope that’s between EMT-I and EMT-P, but with the knowledge and clinical decision-making capacity above the average EMT-P.
This creates a gap. What we gain in high level knowledge, we miss out on in fundamental prehospital skills. Any idiot in the degree can figure out how to clumsily shove in an OP airway and use a bag valve mask, but few of them can really identify when to choose an OP over an NP, or the true indications of when to bag a patient or not (they know what tidal volume is, but have no idea about minute volume, nor what constitutes true respiratory failure). This is actually made worse by universities trying to crowd out prehospital care textbooks in favour of medical textbooks – textbooks written for professions that don’t have to deal with limited equipment, limited information, and uncontrolled environments.
As a result, I still believe there’s a very strong need for an independent textbook list – one with a paramedic textbook at its heart, a textbook that’s easy to read, simple to understand, and remembers the basics. Thus, I present my list.
These are the books that, in a perfect world, every student would have access to. These are the books that I found to be the most helpful during my studies and internship, and in some cases even into qualified practice. Reading them would help an Australian student significantly, in my opinion.
Nancy Caroline’s Emergency Care in the Streets (Price varies): The 8th edition of this series is remarkably good – it’s easy to read, it’s fairly comprehensive, but it’s still a little on the shallow side. That said, if you read these tomes, you’d have a good understanding of the fundamentals of paramedic practice. The 7th edition isn’t as good (and is only a fairly minor update to the 6th edition). Whatever edition you get though, they will provide you with a good foundation knowledge of paramedicine – the bare bones of what we do and how we manage patients. They’re also somewhat cheaper than they used to be, especially if you check carefully on the second hand market. The only real downside? There’s no ebook, and they’re really big books to deal with. While your lectures do cover a load of content, there’s also loads they don’t adequately cover – and a book like this will significantly improve your basic understanding of emergency conditions.
Textbook of Adult Emergency Medicine ($76 AUD): While it isn’t the most comprehensive textbook out there, it is focused on Australians and it’s easy to read. It’s also regularly one of the recommended textbooks by Australian universities. It’ll cover off on most of the important medical and trauma considerations for the Australian setting, including additional diagnostic and management approaches that you can adapt to the prehospital environment. That said, it’s still aimed at physicians – so while it’s very easy to read and will be helpful, it isn’t targeted at prehospital care and thus probably shouldn’t be your only resource. But definitely pick it up! There’s also a paediatric version (Textbook of Paediatric Emergency Medicine) which is roughly the same price; this is also a really good book but possibly of less utility, since paediatrics are a higher risk patient cohort for our purposes and transport is recommended anyway.
Resources to Consider
Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. $176 AUD. Tintinalli is a titan of emergency books, and it’s a bloody good one too. It covers pretty much everything, with lots of images, photos, and diagrams along the way. It’s not as easy to read as the above books, nor is it quite as concise (in fact, it’s pretty wordy in some areas), but it will tell you pretty much everything you need to know about emergency medicine. That said, a significant portion of it has almost zero relevance to prehospital care – because a lot of the diagnostic approaches rely on technology we simply don’t possess. For example, Tintinalli dismisses the utility of end tidal capnography because arterial blood gases are more accurate – which is true, but totally useless when your service can’t do it prehospitally. This is more of a ‘nice to know’ thing rather than an essential book.
Paramedic Principles and Practice ANZ: Honestly, this book should be mandatory for all students in the degree – the only thing that stops me from listing it as a ‘must buy’ is that it’s particularly expensive, and it isn’t quite comprehensive enough (and the money is better spent on Nancy Caroline). This isn’t so much a paramedicine fundamentals book as it is a clinical decision-making book. It steps you through a bunch of case studies for common presentations, focusing on clinical decision-making skills, which is something a lot of textbooks overlook. It then starts to modify the cases so that they deviate from the ‘textbook’ presentation, illustrating the importance of differential diagnoses in your decision-making process. It’s probably one of the best case-based learning tools out there. Unfortunately it isn’t cheap, but it’s well worth it if you can afford it.
An anatomy and physiology textbook: Really depends on how good you are with A&P – you might find it useful, or you might not. Most degree programs have a good, solid A&P program but if you’re struggling or want a good resource, a textbook will probably help. I recommend something like Principles of Anatomy and Physiology (Tortora) rather than trying to use individual books like Guyton and Hall or Gray’s Anatomy. They tend to cover everything that we need to know in the one book as opposed to two separate books. A&P forms an important, fundamental part of your job, and the more you understand, the easier it is to understand everything else.
- Lecture notes and slides: Your lectures won’t cover everything you need to know to be a good paramedic; and if you rely solely on your lecture notes, I’m sorry to say that you’re an inadequately educated student. Lectures can’t cover everything, because they’re typically only 2 hours long; that’s why they set readings. But they do provide the foundation for what you need to know, and guide you on what sort of material to learn.
- Life in the Fast Lane: This sites is fantastic for two reasons. Firstly, it has a top class ECG learning resource; once you’ve got the basics from a paramedic textbook, this is your next step for learning the rest of it. Secondly, they regularly review important new advances in the emergency medicine/critical care world, saving you the trouble of tracking down new articles yourself. If you want to learn even more, and really start delving into evidence based practice, this is where to go!
- YouTube: It sounds dumb, but there’s loads of video resource on YouTube that will help you to understand pretty much any topic you can think of. It’s especially good for learning how to perform various procedures, like IV cannulation. There are also loads of anatomy and physiology resources on YouTube as well.
- Medscape: If you want to quickly look up a medication, procedure, or condition, Medscape is a peer-reviewed resource that’s totally free. It also has apps for iOS and Android with offline databases in case you don’t have internet access. It doesn’t cover everything, but it does cover most common things. It’s one of the more trustworthy online resources.
- PubMed: You’re probably already using it if you’re a student, but it’s the go-to for clinical journal articles. Don’t neglect it once you’re out of the degree; if you want to get into evidence based practice and look into the evidence behind doing things, you’re going to have to keep using it.
- Google and Wikipedia: While neither are particularly reliable resources, they do help you with rapid background reading on different topics. If you want a quick overview of what the spleen does and how it works, or what hypertrophic cardiomyopathy is, then Wikipedia is fine – you just can’t rely on it to justify clinical decision-making. For general education though, it’s much, much faster to Google or Wiki something than trying to go through a textbook; especially once you have the fundamentals down pat.