Special Challenges

Course overview

Objectives Explain the special populations and challenges EMS routinely faces Describe different population groups that can often pose more difficulty for EMS providers Content Information Covered 1 Abuse and neglect 1 Introduction 1 Epidemiology 2 Definitions of abuse physical emotional sexual and neglect 2 History 1 Social 2 Financial 3 Ethical 4 Other 3 Assessment 4 Management 5 Legal aspects 6 Risk profile of abuse victim 7 Risk profile of the abuser assailant 8 Documentation 2 Homelessness Poverty 1 Advocate for patient rights and appropriate care 2 Identify facilities that will treat regardless of payment 3 Prevention strategies will likely be absent increasing the probability of disease 4 Familiarity with assistance resources offered in community 5 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 6 Financial challenges for health care can quickly result from loss of a job and depletion of savings 7 Financial challenges combined with medical conditions that require uninterrupted treatment such as 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 8 In addition poor health is closely associated with homelessness where rates of chronic or acute health problems are extremely high 9 Special considerations 3 Bariatric Patients 1 Definition 2 Risk factors 3 Associated with an increased risk for the following 4 Long term health effects 5 Special considerations 6 Patient handling issues 4 Technology Assisted Dependent 5 Hospice Care and Terminally Ill 1 What is hospice 2 EMS intervention 3 DNR do not resuscitate orders 6 Tracheostomy care dysfunction 7 Technology Assisted Patients 1 Profile of patients requiring adaptive devices 2 Adaptive devices 8 Pediatrics Developmental Disabilities 1 Impaired or insufficient development of the brain that causes an inability to learn at the usual rate developmental delay 2 Causes 3 Signs of developmental delay 4 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 5 Down Syndrome 1 Features of the patient with Down syndrome 2 Cellular etiology 3 Special considerations 6 Autism 1 Features of the patient with Autism 2 Etiology 3 Special considerations 1 Caregiver interactions 2 Cognitive ability of the autistic patient 9 Emotionally impaired 1 People with emotional impairments include those with the following 1 Neurasthenia nervous exhaustion 2 Anxiety neurosis 3 Compulsion neurosis 4 Hysteria 2 Special considerations 1 Signs and symptoms that may result from emotional impairment 2 Complete history and examination 3 Prehospital management 4 Emotionally mentally impaired EMI 10 Physical Needs Challenges 1 Hearing impairments 1 Deafness 2 Sensorineural deafness 3 Hearing impairments 11 Special considerations 1 Use of hearing aids 12 Visual impairments 1 Normal vision 2 Visual impairments 13 Speech impairments 1 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 2 Speech 14 Paraplegia Quadriplegia 1 Define paraplegia 2 Define quadriplegia 3 Causes 4 Both paraplegia and quadriplegia are accompanied by a loss of sensation and may have loss of urinary and or bowel control 5 Special considerations 1 Patients with extremity and trunk paralysis may require accommodations in patient care 2 Assessment 1 Patient may have an external device to stabilize the spine 2 Ostomies 3 Priapism may be present in some male patients 3 Transport 4 Additional manpower may be needed to move special equipment and prepare patient for transport 5 Pressu