Transcript Chp.-45-Powerpoint

Division 5
Special Considerations/
Operations
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Chapter 45
The Challenged Patient
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Topics
Physical Challenges
Developmental Disabilities
Pathological Challenges
Other Challenges
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Hearing Impairments
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Conductive Deafness
A blockage of the transmission of
sound waves through the external ear
canal to the middle or inner ear
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Sensorineural Deafness
Deafness caused by the inability of
nerve impulses to reach the auditory
center of the brain because of nerve
damage to either the inner ear or to
the brain
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Recognizing Deafness
Asking questions repeatedly
Misunderstood questions or
inappropriate responses
Presence of a hearing aid
Sign language or gestures
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Hearing aids come in
various shapes and sizes.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Accommodations for
Deaf Patients
Address patient face to face.
Speak slowly in a normal voice.
Reduce background noise as much as
possible.
Help find or adjust hearing aids.
Use pen and paper.
Utilize an interpreter.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Visual Impairments
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Causes
Injury
Disease
Congenital conditions
Infection
Degenerative disorders
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
When approaching a service dog,
do not pet the dog or disturb it
while it is in its harness.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Individuals who are visually impaired can
maintain active, independent lives.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Speech Impairments
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Types of Speech
Impairments
Language disorders
Articulation disorders
Voice production disorders
Fluency disorders
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Accommodations for
Speech Impairments
Never assume the person lacks
intelligence.
Form questions that require short,
direct answers.
Never pretend to understand when you
don’t.
Let the patient write answers to
questions.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Obesity
40% of people in the U.S. are obese.
Excess weight can exacerbate the
complaint for which you were called.
Obesity can lead to many serious
medical conditions.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Accommodations for
Obese Patients
Don’t dismiss signs or symptoms, such
as shortness of breath, as being a
result of obesity.
Adipose tissue presents an
obstruction—EKG electrodes may
need to be placed on the arms and
legs.
Do not compromise your health or
safety—ask for assistance when lifting
or moving a patient.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Paralysis
The patient may have a home
ventilator; be sure to keep the airway
clear and patent.
If the patient is in halo traction, be sure
to stabilize the traction before
transport.
Be aware of other assistive devices—
colostomy, canes, wheelchairs, etc.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Developmental Disabilities
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Developmentally disabled people may have
trouble communicating, but can often still
understand what you say.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remember that a person with a
developmental disability can recognize
body language, tone, and disrespect just
like anyone else. Treat them as you would
any other patient.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Developmental Disabilities
Down Syndrome
Fetal Alcohol Syndrome (FAS)
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Pathological Challenges
Arthritis
Cancer
Cerebral palsy
Cystic fibrosis
Multiple sclerosis
Muscular
dystrophy
Poliomyelitis
Previous head
injury
Spina bifida
Myasthenia
gravis
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Rheumatoid arthritis causes joints to
become painful and deformed.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Take every effort to protect cancer patients
from infection. Keep a mask on yourself and
the patient during transport and
during transfer at the hospital.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Patients with multiple sclerosis and
muscular dystrophy may use a cane to aid
ambulation. Be sure to take such devices
with you on the ambulance.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Other Challenges
Culturally diverse patients
Terminally ill patients
Patients with communicable diseases
Financial challenges
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
United States society is becoming diverse,
with the largest number of immigrants
coming from Asia and Latin America.
© Michal Heron
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
If a patient refuses care because of cultural
or religious beliefs, be sure to have the
patient sign a Refusal of Treatment and
Transportation form.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Financial Challenges
Treat the patient, not the financial
condition the patient is in.
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Homeless people sometimes refuse care,
thinking they cannot afford to pay the
medical bills. Become familiar with
public hospitals and clinics that
provide services to the needy.
© Michal Heron
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Summary
Physical Challenges
Developmental Disabilities
Pathological Challenges
Other Challenges
Bledsoe et al., Essentials of Paramedic Care: Division V
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ