Special Challenges
Information Covered:
- Abuse and neglect
- Introduction
- Epidemiology
- Definitions of abuse (physical, emotional, sexual) and neglect
- History
- Social
- Financial
- Ethical
- Other
- Assessment
- Management
- Legal aspects
- Risk profile of abuse victim
- Risk profile of the abuser/assailant
- Documentation
- Introduction
- Homelessness/Poverty
- Advocate for patient rights and appropriate care
- Identify facilities that will treat regardless of payment
- Prevention strategies will likely be absent, increasing the probability of disease
- Familiarity with assistance resources offered in community
- It is estimated that 41 million Americans and one-third of people living in poverty have no health insurance, and insurance coverage held by many others would not carry them through a catastrophic illness
- Financial challenges for health care can quickly result from loss of a job and depletion of savings
- Financial challenges combined with medical conditions that require uninterrupted treatment (e.g., TB, HIV/AIDS, diabetes, hypertension, mental disorders) or that occur in the presence of unexpected illness or injury, can deprive the patient of basic health care services
- In addition, poor health is closely associated with homelessness, where rates of chronic or acute health problems are extremely high
- Special considerations
- Bariatric Patients
- Definition
- Risk factors:
- Associated with an increased risk for the following:
- Long-term health effects
- Special considerations
- Patient handling issues
- Technology Assisted/Dependent
- Hospice Care and Terminally Ill
- What is hospice?
- EMS Intervention
- DNR (do not resuscitate) orders
- Tracheostomy care/Dysfunction
- Technology Assisted Patients
- Profile of patients requiring adaptive devices
- Adaptive devices
- Pediatrics Developmental Disabilities
- Impaired or insufficient development of the brain that causes an inability to learn at the usual rate (developmental delay)
- Causes
- Signs of developmental delay
- Accommodations that may be necessary when providing patient care include allowing adequate time for obtaining a history, performing assessment and patient management procedures, and preparing the patient for transport
- Down Syndrome
- Features of the patient with Down syndrome:
- Cellular etiology
- Special considerations
- Autism
- Features of the patient with Autism:
- Etiology
- Special considerations
- Caregiver interactions
- Cognitive ability of the autistic patient
- Emotionally impaired
- People with emotional impairments include those with the following:
- Neurasthenia (nervous exhaustion)
- Anxiety neurosis
- Compulsion neurosis
- Hysteria
- Special considerations
- Signs and symptoms that may result from emotional impairment
- Complete history and examination
- Prehospital Management
- Emotionally/mentally impaired (EMI)
- People with emotional impairments include those with the following:
- Physical Needs/Challenges
- Hearing Impairments
- Deafness
- Sensorineural deafness
- Hearing impairments
- Hearing Impairments
- Special considerations
- Use of hearing aids
- Visual Impairments
- Normal vision
- Visual impairments
- Speech impairments
- Speech impairments include disorders of language, articulation, voice production, or fluency (blockage of speech), all of which can lead to an inability to communicate effectively
- Speech
- Paraplegia/Quadriplegia
- Define Paraplegia
- Define Quadriplegia
- Causes:
- Both paraplegia and quadriplegia are accompanied by a loss of sensation and may have loss of urinary and or bowel control
- Special considerations
- Patients with extremity and trunk paralysis may require accommodations in patient care
- Assessment
- Patient may have an external device to stabilize the spine
- Ostomies
- Priapism may be present in some male patients
- Transport
- Additional manpower may be needed to move special equipment and prepare patient for transport
- Pressure that would be appreciated by patients with normal sensation may not be recognized in patients with these
- Patients with Communicable Diseases
- Overview
- Special considerations
- Terminally Ill Patients
- Overview
- Special considerations
- Mental Needs/Challenges
- Mental illness refers to any form of psychiatric disorder
- Psychose
- Neuroses
- Special considerations
- If the patient appears to be paranoid or shows anxious behavior, ask the patient's permission before beginning any assessment or performing any procedure
- These patients experience illness and injury like all other patients
- Specific Challenges Created by Chronic Conditions
- Arthritis
- Cancer
- Cerebral Palsy (CP)
- Cystic Fibrosis (CF) (mucoviscidosis)
- Multiple Sclerosis (MS)
- Muscular Dystrophy
- Poliomyelitis (polio)
- Previously head-injured patients
- Special considerations
- Spina Bifida
- Myasthenia Gravis
- Autoimmune disorder in which muscles become weak and tire easily
- Damage occurs to muscle receptors that are responsible for transmitting nerve impulses, commonly affecting muscles of the eyes, face, throat, and extremities
- Rare disease that can begin suddenly or gradually
- Can occur at any age, but usually appears in women between age 20 and 30, and in men between 70 and 80 years of age
- Classic signs and symptoms include:
- Drooping eyelids, double vision
- Difficulty in speaking
- Difficulty in chewing and swallowing
- Difficult extremity movement
- Weakened respiratory muscles
- Affected muscles become worse with use, but may recover completely with rest
- May be exacerbated by infection, stress, medications, and menstruation
- Can often be controlled with drug therapy to enhance the transmission of nerve impulses in the muscles
- Special considerations
- Accommodations required for care vary based on the patient's presentation
- In most cases, supportive care and transport will be all that is required
Content Creator: James Stone
CAPCE Course Number: 20-EMTP-F3-1311
NJ Course Number: 141116
Total CE Hours: 1
Level: Basic
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.