Special Needs Patients

Question 1

How to be kind

Answer 1

• treat patients with respect
• don’t make assumptions
• don’t look down on patients for their disabilities
• ask someone else if you’re unfamiliar with a certain disability or problem

Question 2

Definition: impairment

Answer 2

• any loss or abnormality in psychological, physiological, or anatomical function or structure

Question 3

Definition: disability

Answer 3

• limitation or lack of the ability to perform an activity at what is considered “normal” capacity; results from an impairment

Question 4

Definition: handicap

Answer 4

• a disadvantage for a given individual that limits fulfillment of a “normal” role; results from impairment and disability

Question 5

Developmental Disabilities

Answer 5

• usually appear early in life and impact development

- examples: ASD, Down Syndrome, cerebral palsy

Question 6

Autism Spectrum Disorder (ASD)

Answer 6

• social impairment, communication issues
• reparative behavior, interests, and activities
• early onset (usually < 2 years old)
• spectrum refers to a wide scale of severity

Question 7

Down Syndrome

Answer 7

• a chromosomal disorder aka trisomy 21
• S/Sx:
• • physical: decreases muscle tone in infancy, flat nose, small ears and mouth, upward slanting eyes, large protruding tongue, heart defects
• • mental: impulsive, short attention span, slow learning

Question 8

Cerebral Palsy

Answer 8

• neurological disorder that appears early in life
• permanently affects body movement or muscle coordination
• associated with communication difficulty, vision problems, and learning disabilities
• can also occur from brain damage due to infection or head trauma
• appts. 1/4 have epilepsy

Question 9

What can we do?

Answer 9

• determine baseline function/mental status (ask anyone who knows the patient, never assume)
• build rapport, introduce yourself, stay calm, explain thoroughly
• transport with family/friend or someone else the patient is comfortable with

Question 10

Sensory Disabilities I - Types

Answer 10

• Sight (blindness and other visual impairments)

- Hearing (deafness and other hearing impairments)

Question 11

Sensory Disabilities II - Types

Answer 11

• Speech Disorder

- Language disorder

Question 12

Sight (blindness and other visual impairments)

Answer 12

• Sensory Disabilities I
• commonly will have glasses, cane, service dog
• verbalize everything

Question 13

Hearing (deafness and other hearing impairments)

Answer 13

• Sensory Disabilities I
• face patient, speak slowly and clearly at an adequate volume, write things down, nonverbal communication
• use family member or friend that can better communicate

Question 14

language disorder

Answer 14

• Sensory Disabilities II

- difficulty understanding others or sharing ideas/thoughts/feelings

Question 15

speech disorder

Answer 15

• Sensory Disabilities II

- difficulty with verbal communication due to inability to produce speech sounds correctly or fluently

Question 16

Physical Disabilities - Types

Answer 16

• Paralysis
• Spina Bifida
• Bariatrics

Question 17

Paralysis

Answer 17

• hemiparesis: one sided weakness
• paraplegic: paralysis of lower extremities (lumbar, 5)
• quadriplegic: all extremities paralyzed; section?; usually causes impairments in other areas too (bladder, sexual organs, breathing); sedentary lifestyle
• document CMS

Question 18

Spina Bifida

Answer 18

• incomplete closure of spinal column: part of spinal column is exposed; closed with surgery
• S/Sx: lower extremity weakness/paralysis, bladder control problems, back pain, difficulty with “executive function” (planning, organizing, problem solving, etc)
• may have a shunt due to hydrocephalus (overproduction of CSF causing increased ICP)
• shunt is an opening that allows fluid to move

Question 19

Bariatrics

Answer 19

• obesity
• puts someone at risk for many disease/problems (diabetes, hypertension, stroke, heart disease)
• be careful when lifting; call for additional manpower
• some morbidly obese patients may require a bariatric stretcher and ambulance to transport

Question 20

Tracheostomy

Answer 20

• tube placed in surgical opening (stoma) in the neck
• creates an airway
• some patients breath spontaneously, some require ventilation
• suction if necessary with french catheter
• BVM: connect BVM directly to tube, use adult BVM with peds mask and cover the nose if only a stoma

Question 21

Pacemaker

Answer 21

• implanted under patient’s skin to regulate heart rate
• AICD = automated implanted cardioverter defibrillator; pacemaker that can monitor heart rate and adjust its rate and strength of electrical signals

Question 22

LVAD

Answer 22

• left ventricle assist device
• battery operated mechanical pump
• patient will have no heartbeat
• cant get a true BP
• can’t do compressions with an LVAD; still use an AED if patient is not breathing
• signal for ALS and call med control
• ask family/freinds who know how LVAD works if possible

Question 23

IV Access

Answer 23

• cannot transport a patient with an active IV if you are an EMT-B
• can transport with saline lock (nothing attached)

Question 24

Gastrostomy Tube

Answer 24

• feeding tube that goes directly into the stomach
• for patients who cannot ingest food, fluids, and medication by mouth
• can become dislodged and cause nausea, abdominal discomfort, and vomiting

Question 25

Foley Catheter

Answer 25

• a thin sterile tube inserted into the bladder through the urethra to drain urine
• can we transport with this?

Question 26

Colostomy Bags

Answer 26

• surgeries that create an opening between the surface of the body and the colon (colostomy) or the small intestine (ileostomy)
• allows for elimination of waste into an external bag that must be changed frequently

Question 27

Mastectomies

Answer 27

• only safe to take blood pressure in some cases
• how to know:
• • ask patient if they know it’s safe
• • trust your patient
• • if they don’t know, ask if they’ve had their lymph nodes removed
• • if yes, don’t take a BP
• • if no, it’s safe
• • if they don’t know, don’t take it