Academy’s pioneering textbook still leads the way in EMS education

When the AAOS published the very first text for emergency medical services (EMS) personnel in 1971, the book quickly set the standard for EMS education across the United States.

Now the centerpiece of an entire series of EMS educational teaching and learning resources, Emergency Care and Transportation of the Sick and Injured—also known as the “Orange Book” for its trademark orange cover—continues to serve as a driving force in EMS education with its recently published Fortieth Anniversary Edition.

Dawn of a landmark text
In 1969, Walter A. Hoyt Jr., MD, received a manuscript intended to serve as a training manual for ambulance drivers. The preliminary manuscript consisted of 60 chapters and was developed by an editorial advisory board headed by Charles A. Rockwood Jr., MD. Two years later, the finalized manuscript went to press, and a ground-breaking text was born. When the U.S. Department of Transportation adopted the first standard curriculum for emergency medical responders, it was based on the AAOS text.

With each subsequent edition of the Orange Book, the content has been updated and enhanced to reflect advances in emergency medicine and to meet the changing curriculum requirements for EMS personnel. Over the years, resources such as review manuals, companion Web sites, and field guides for handheld electronic
devices have been added.

Today, the Orange Book, which is designed to train emergency medical technicians (EMTs) in rescue and emergency care delivery, has given rise to a series of textbooks covering the entire spectrum of emergency medical response, from first responders to critical care transport paramedics. The AAOS provides continuing education texts on special topics in emergency medicine, such as airway management as well as anatomy, physiology, and assessment and treatment of trauma.

The Orange Book is used to train tens of thousands of EMS personnel every year, including military EMS personnel. Although the Academy still works with physicians and others with experience in emergency medicine to write and revise the book, it has been published by Jones and Bartlett Learning since 1997. The publisher, which sells the textbook across the country as well as internationally, has been instrumental in helping the Academy’s annual royalty revenue from the text grow to more than $1 million.

Fortieth Anniversary Edition
AAOS member Andrew N. Pollak, MD, EMT-P, who has served as series editor since the ninth edition, draws on his extensive knowledge of emergency medicine to shape the content of the Orange Book. Currently the medical director for the Baltimore County Fire Department, Dr. Pollak has been involved in EMS since 1980 when he started as a volunteer firefighter and first responder. He has also worked as a flight physician with a hospital-based aeromedical ambulance service and has been an EMT, paramedic, and EMS educator.

“The book enjoys a tremendous reputation because many current EMS instructors used earlier editions of the text when they were students,” said Dr. Pollak.

“The Orange Book and other books in the series include careful descriptions of how national standards apply to real-life situations,” he added. “We help prepare students to handle the challenges they are going to face.”

The recently published Fortieth Anniversary Edition, which is the tenth edition of the book, is based on the new National EMS Education Standards. It includes detailed case studies, practical field tips, step-by-step explanations, and visual summaries of important skills and procedures.

Interactive resources—including a companion Web site with review materials and exercises—help facilitate learning, as do the student workbook and the eBook/eWorkbook, an online resource that provides the content of the textbook and workbook in one location. Online self-study modules offer practice and simulated certification examinations using case-based questions and detailed rationales. The Instructor’s Resource Kit contains teaching tips, lecture outlines, slides, and test banks.

“The online resources enable students to explore topics in further depth and to really get a sense of how well they understand the material,” said Dr. Pollak.

Stephen J. Rahm, NREMT-P, a nationally registered paramedic who also serves as an EMS educator, author, consultant, and volunteer paramedic for a rural EMS system, has contributed to texts as well as supplemental learning and teaching tools in the Orange Book series since 2002. According to Mr. Rahm, one of the reasons the series is so successful is that its contributors draw upon a wide array of experiences in EMS.

“Many have been in the profession for a very long time,” he said. “They are very reputable educators and clinicians.”

The future of EMS education
Dr. Pollak predicts ongoing growth and continuing excellence for the Orange Book and other texts.

“This is the best-selling, most widely used EMS textbook series available,” said Dr. Pollak. “The Academy was the first to write a textbook for EMS education, and we are the best at it.

“The Academy contributes to the education of more emergency medical care providers than any other organization in the world,” he added.

Jennie McKee is a staff writer for AAOS Now. She can be reached at mckee@aaos.org

A textbook is born
“In the mid-1960s, the Federal Highway Commission mandated that the states improve their emergency medical services,” said Dr. Hoyt upon the Orange Book’s 30th anniversary in 2001. “If they failed to do so, 10 percent of the Federal Highway Grant would be withdrawn. In 1964, Sam W. Banks, MD, chairman of the newly formed AAOS Committee on Injuries, organized a series of 3-day courses for emergency medical technicians. These courses, held throughout the country, were of great value, but they did not meet all the needs of students and teachers.

“After much deliberation,” continued Dr. Hoyt, “the committee agreed that a complementary text comprehensive enough to meet the skill and knowledge requirements was needed. A further goal was to establish a core curriculum to be taught in a community college.”

Work on the text began in 1969, and a draft manuscript comprising 60 chapters was developed and submitted to an editorial advisory board headed by Dr. Rockwood. The first edition of the book was published in 1971.

“This book is a labor of love,” said Dr. Hoyt. “It’s a major, major contribution to the Academy. I give due credit to all of the various organizations that helped [American College of Surgeons, American Medical Association, National Research Council, the Red Cross, the U.S. Public Health Service, and the Department of Transportation], but also to the Academy’s early presidents and Board of Directors. We told them we needed money to do this book, and they gave us $5,000 and that money took us to where we are now—leading the way in emergency medical training.”