Special Populations Mosby items and derived items 2007
![Special Populations Mosby items and derived items © 2007, 2004 by Mosby, Inc. , Special Populations Mosby items and derived items © 2007, 2004 by Mosby, Inc. ,](https://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-1.jpg)
Special Populations Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Outline • Patients with Disabilities • Critically Ill/Injured Patients Mosby items and derived items Outline • Patients with Disabilities • Critically Ill/Injured Patients Mosby items and derived items](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-2.jpg)
Outline • Patients with Disabilities • Critically Ill/Injured Patients Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc. • Chronically Ill Patients • Geriatric Patients
![Disabilities • Physical impairments that interfere with one or more major life activities Mosby Disabilities • Physical impairments that interfere with one or more major life activities Mosby](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-3.jpg)
Disabilities • Physical impairments that interfere with one or more major life activities Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Examples of Disabilities • Impaired vision • Impaired hearing • Severe arthritis • Paralysis Examples of Disabilities • Impaired vision • Impaired hearing • Severe arthritis • Paralysis](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-4.jpg)
Examples of Disabilities • Impaired vision • Impaired hearing • Severe arthritis • Paralysis or impaired mobility Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Special Considerations • Don’t make physical contact with a person who is visually impaired Special Considerations • Don’t make physical contact with a person who is visually impaired](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-5.jpg)
Special Considerations • Don’t make physical contact with a person who is visually impaired without first telling him/her what you are going to do • It may be difficult to exchange information with persons who have impaired hearing or speech Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Special Considerations • Extra patience and assistance may be required in allowing patients time Special Considerations • Extra patience and assistance may be required in allowing patients time](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-6.jpg)
Special Considerations • Extra patience and assistance may be required in allowing patients time to comply with your requests • If at all possible, do not separate a person with disabilities from his/her service animal Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Impaired Hearing • The patient may become frustrated if you are unable to understand Impaired Hearing • The patient may become frustrated if you are unable to understand](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-7.jpg)
Impaired Hearing • The patient may become frustrated if you are unable to understand him/her, or he/she is unable to understand you • The patient may be able to read your lips – Write messages on paper or understand your gestures or facial expressions Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Impaired Vision • The unfamiliar sounds brought into the environment by an emergency may Impaired Vision • The unfamiliar sounds brought into the environment by an emergency may](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-8.jpg)
Impaired Vision • The unfamiliar sounds brought into the environment by an emergency may be frightening and confusing • Talk with the patient about your actions – Speak in a normal voice Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Impaired Mobility • Injuries may occur due to unawareness of painful stimuli or because Impaired Mobility • Injuries may occur due to unawareness of painful stimuli or because](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-9.jpg)
Impaired Mobility • Injuries may occur due to unawareness of painful stimuli or because of inability to move away from the harmful stimulus • Whenever possible, allow the patient to keep any assistive devices to maintain independence Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Chronically Sick Patients • Prone to decompensation under conditions of physiological or psychological stress Chronically Sick Patients • Prone to decompensation under conditions of physiological or psychological stress](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-10.jpg)
Chronically Sick Patients • Prone to decompensation under conditions of physiological or psychological stress • Some may be cared for in or by a hospice organization Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![DNR • Be aware of local policies concerning “Do Not Resuscitate” orders Mosby items DNR • Be aware of local policies concerning “Do Not Resuscitate” orders Mosby items](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-11.jpg)
DNR • Be aware of local policies concerning “Do Not Resuscitate” orders Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![• Geriatric refers to the elderly, those over 65 years of age • • Geriatric refers to the elderly, those over 65 years of age •](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-12.jpg)
• Geriatric refers to the elderly, those over 65 years of age • The elderly are the fastest growing group in the US population • There are many stereotypes and myths about the elderly Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![• Physical and mental changes take place with age, for the most part • Physical and mental changes take place with age, for the most part](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-13.jpg)
• Physical and mental changes take place with age, for the most part these are subtle until age is well-advanced • Dementia is not a consequence of aging, it is a disease-related process Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![• Medications may have side effects that cause physical and cognitive changes Mosby • Medications may have side effects that cause physical and cognitive changes Mosby](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-14.jpg)
• Medications may have side effects that cause physical and cognitive changes Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Decreased Compensation • The circulatory system does not respond as it did when the Decreased Compensation • The circulatory system does not respond as it did when the](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-15.jpg)
Decreased Compensation • The circulatory system does not respond as it did when the patient was younger • The respiratory system is less able to provide for increased ventilation needs Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-16.jpg)
Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![• Risk factors for poor health – Age over 75 – Living alone • Risk factors for poor health – Age over 75 – Living alone](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-17.jpg)
• Risk factors for poor health – Age over 75 – Living alone – Cognitive impairment – Immobility – Recent loss of significant other – Recent hospitalization – Incontinence of urine or feces Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![The Elderly • Cardiovascular disease is the leading cause of death in the elderly The Elderly • Cardiovascular disease is the leading cause of death in the elderly](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-18.jpg)
The Elderly • Cardiovascular disease is the leading cause of death in the elderly • Trauma also plays a significant role in morbidity and mortality – Falls – Motor vehicle crashes Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Communication • Address by his or her title and last name – For example: Communication • Address by his or her title and last name – For example:](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-19.jpg)
Communication • Address by his or her title and last name – For example: Mr. Jones or Mrs. Smith • Avoid nicknames like “Buddy” • Do not speak about the patient to others in as if the patient is not there Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Communication • Don’t assume hearing impairment • Allow time for the patient to answer Communication • Don’t assume hearing impairment • Allow time for the patient to answer](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-20.jpg)
Communication • Don’t assume hearing impairment • Allow time for the patient to answer • Verify the information privately, if necessary, with a family member Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Initial Assessment • Poorly fitting dentures may interfere with management of airway and ventilation Initial Assessment • Poorly fitting dentures may interfere with management of airway and ventilation](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-21.jpg)
Initial Assessment • Poorly fitting dentures may interfere with management of airway and ventilation • Curvature of the spine may make cervical stabilization difficult • Respiratory failure occurs more easily in the elderly Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![History • Speak clearly; don’t shout • Allow the patient time to answer • History • Speak clearly; don’t shout • Allow the patient time to answer •](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-22.jpg)
History • Speak clearly; don’t shout • Allow the patient time to answer • Don’t become impatient • Focus the patient on what happened today – or recently – not a history of events over the past several years Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Physical Examination • Allow the patient time to move • Be aware of decreased Physical Examination • Allow the patient time to move • Be aware of decreased](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-23.jpg)
Physical Examination • Allow the patient time to move • Be aware of decreased sensitivity to pain • Be gentle in handling Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Abuse of the Elderly • May take many forms – Financial – Physical – Abuse of the Elderly • May take many forms – Financial – Physical –](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-24.jpg)
Abuse of the Elderly • May take many forms – Financial – Physical – Emotional – Neglect • The abuser may be anyone with access to the patient Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Abuse of the Elderly • Risk factors of being abused – Female, over age Abuse of the Elderly • Risk factors of being abused – Female, over age](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-25.jpg)
Abuse of the Elderly • Risk factors of being abused – Female, over age 75 – Multiple chronic medical conditions – Incontinence – Impaired sleep patterns – Dementia & behavioral issues – Dependence on others – Abuser has circumstances of household conflict, financial, or other problems Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Abuse of the Elderly • The elderly may be reluctant to admit or report Abuse of the Elderly • The elderly may be reluctant to admit or report](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-26.jpg)
Abuse of the Elderly • The elderly may be reluctant to admit or report abuse due to fear of retribution by the abuser • Follow local policies regarding reporting of suspected abuse Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Summary • As a EMS provider, you will encounter patients who have special needs Summary • As a EMS provider, you will encounter patients who have special needs](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-27.jpg)
Summary • As a EMS provider, you will encounter patients who have special needs • Knowing a few basic techniques in caring for them, along with having empathy for the patient, will increase your effectiveness in caring for these patients Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
![Questions? Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an Questions? Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an](http://slidetodoc.com/presentation_image_h2/ab309c831f5dfd209464f3cc2b64d035/image-28.jpg)
Questions? Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.
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