EMERGENCY: Section 8 - Special Patient Populations (2 of 2)

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?

Check the mechanical ventilator for malfunction

EMTs are dispatched for a fall. The patient, a 16-year-old female with Down syndrome, is experiencing difficulty walking and says that her fingers "feel like needles." The EMTs should suspect:

a cervical spine injury

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in:

a decreased ability to cough

As many as 40% of patients with Down syndrome have:

a heart condition

Characteristic anatomic features of Down syndrome include:

a round head with a flat occiput

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold, and his respirations are rapid and shallow. The EMT should suspect:

a systemic infection

Down syndrome is a genetic defect that occurs as the result of:

a triplication of chromosome 21

A 70-year-old man complains of a sudden onset of difficulty breathing. He has dried blood on his lips and is very anxious. His left leg is red, swollen, and painful. The EMT should:

administer high-flow oxygen

73-year-old female experienced a syncopal episode while watching TV. She is now conscious but diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect:

an aortic aneurysm

EMTs are dispatched for a patient whose central venous catheter is malfunctioning. When they arrive and assess the patient, they find bleeding from the tubing attached to the line. The EMTs should:

apply direct pressure to the tubing and transport

Because of the complexity of the older patient and the vagueness of his or her complaint, you should:

attempt to differentiate between chronic and acute problems

When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should:

attempt to resuscitate the patient

You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your most immediate action should be to:

avoid placing him in a supine position if possible and administer oxygen

When assessing or providing care to a patient with an intellectual disability, you should:

be observant for signs of fear or reluctance from the patient

As a person ages, the heart might enlarge as a result of:

chronically increased afterload

You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. You should:

determine the patient's baseline mental status

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving, and her eyes are closed. A neighbor tells you that she found the patient this way but did not move her. When you gently tap the patient, she does not respond. You should:

direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing

A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning, and the child has increasing respiratory distress. You should:

disconnect the ventilator and apply a tracheostomy collar

EMTs are dispatched to a residence for an 80-year-old woman who is ill. The patient's daughter states that her mother almost fainted after going to the bathroom and that her pulse was very slow. The patient's pulse rate is 80 beats/min and irregular, and she is conscious and alert. The EMTs should suspect that the patient:

experienced a vasovagal response

The leading cause of death in the geriatric patient is:

heart disease

By placing one hand on your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she:

is sick

In contrast to delirium, dementia:

is usually considered irreversible

Talking about an elderly patient in front of him or her to other members of the family:

might cause the patient to think that he or she has no say in making decisions

Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should:

observe for conditions that might make the residence unsafe

You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should:

open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct

EMTs are dispatched for a patient in cardiac arrest. When they arrive, they find that the patient is pulseless, apneic, and wearing an external defibrillator vest. In this situation, the EMTs should:

perform CPR and leave the vest in place

When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would most likely have to:

place blankets behind the patient's head

Sedentary behavior while healing from a hip fracture would most likely predispose the older patient to:

pneumonia

When performing your secondary assessment on an older patient who has been injured, it is important to:

recall that it will take a less severe mechanism of injury to cause significant injuries

You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if:

she became dizzy or fainted before falling

Airway management can be challenging in patients with Down syndrome because their:

teeth are misaligned, and they have a large tongue

In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because:

the body is less able to adapt the BP to rapid postural changes

When caring for a geriatric patient with a traumatic injury, it is important to consider that:

the injury might have been preceded by a medical condition.

In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:

the patient develops cardiac arrest

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and is normally alert. When you assess this patient, it is important to note that:

the patient is experiencing delirious behavior, which suggests a new health problem

A "silent" heart attack occurs when:

the usual chest pain is not present

Many older victims of physical abuse might make false statements or lie about the origin of their injuries because:

they fear retribution from the abuser

You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed four times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should:

transport the infant to the hospital and bring the apnea monitor with you

A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should:

try repositioning the hearing aid or remove it and turn down the volume

When explaining the need for a particular procedure to an elderly patient, you should:

use plain language and simple terms