Lecture 38 -- Patients with Special Challenges

Patients with autism: A) have extreme difficulty with complex tasks that require many steps. B) prefer to maintain eye contact with whomever is talking with them. C) often speak with speech patterns that alternate in tone and speed. D) use and understand nonverbal means of communicating messages.

A) have extreme difficulty with complex tasks that require many steps.

What does the Emergency Medical Treatment and Active Labor Act (EMTALA) dictate? All AEMTs must have a basic level of training in order to administer aid to a patient in the field. All patients are allowed the right to treatment and/or transport. All health care facilities must provide a medical assessment and treatment, regardless of the patient's ability to pay. All health care facilities must provide a medical assessment and treatment, regardless of the patient's mental or physical limitations.

All health care facilities must provide a medical assessment and treatment, regardless of the patient's ability to pay.

Autism Bipolar disorder Cerebral palsy Down syndrome _________________ is a developmental disorder characterized by impairment of social interaction.

Autism

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:

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

Cerebral palsy is characterized by poorly controlled ________ movement. Body Neck Eye Extremity

Body

In ____________________, 25-35% of children have epilepsy. Cerebral palsy Cystic fibrosis Muscular dystrophy Multiple sclerosis

Cerebral palsy

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct? In most cases, it is appropriate for the AEMT to contact medical control prior to speaking to the patient's caregiver Before performing an assessment of the patient's ABCs, the AEMT should ask the caregiver about the patient's medical condition In general, the AEMT should only speak with a certified home healthcare professional because he or she is the expert on the patient's illness Communication with a patient's caregiver or home care provider is important because they are most familiar with the patient's condition

Communication with a patient's caregiver or home care provider is important because they are most familiar with the patient's condition

Which of the following mnemonics is helpful when you are dealing with a tracheostomy tube obstruction? DOPE DUMBELS PEARRL PASTE

DOPE (Displaced, dislodged, or damaged tube; Obstructed tube [secretions, blood, mucus, vomitus]; Pneumothorax; Equipment failure [kinked tubing, ventilator malfunction, empty oxygen supply]) can help you remember the possible causes of an airway obstruction and correct the problem. PASTE (Progression, Associated chest pain, Sputum, Talking tiredness, Exercise tolerance) is an assessment for a complaint of shortness or breath or difficulty breathing.

While attempting to ventilate a patient with a tracheostomy, you meet resistance when squeezing the BVM. The patient's oxygen saturation has fallen to 84%. You should: Remove the inner cannula of the tracheostomy tube, instill 3-5 mL of normal saline down the tube, and suction the tube for up to 30 seconds Deflate the cuff on the tracheostomy tube, cover the patient's mouth and nose with a mask, and reattempt to ventilate with BVM

Deflate the cuff on the tracheostomy tube, cover the patient's mouth and nose with a mask, and reattempt to ventilate with BVM

You are at the home of an elderly man who has a tracheostomy tube and is on mechanical ventilation. His ventilator has malfunctioned. Once you disconnect the ventilator, what should you do? Deliver 100% oxygen through a nonrebreathing mask. Use a nasal cannula to deliver oxygen. Deliver oxygen using a facemask over the stoma. Transport the patient to a critical care facility immediately.

Deliver oxygen using a facemask over the stoma.

An ileostomy is a surgical procedure that creates an opening between the urethra and the surface of the body.

False An ileostomy is a surgical procedure that creates an opening between the small intestine and the surface of the body.

If the length of a tracheostomy tube cannot be determined, insert the suction device 3-4 inches deep.

False If the length of a tracheostomy tube cannot be determined, insert the suction device no more than 1 to 2 inches (3 to 6 cm) deep.

Which of the following is the best source of information when you are dealing with an autistic patient? The patient him/herself Family members/caregivers The attending doctor Medical control

Family members/caregivers

EMS personnel would MOST likely be called to the residence of a patient receiving home health care when the home care provider: Has recognized a change in the patient's health status. Has a Q specific to pt. condition Must confirm that a specific intervention is required Needs simple assistance in providing patient care

Has recognized a change in the patient's health status.

When treating a patient with spina bifida, which of the following is most likely to produce anaphylaxis? Aspirin Iodine Latex Sulfa drugs

Latex

Which of the following is true about Down syndrome? Physical features do not impede the application of a bag-mask device. Many people with Down syndrome present with tonic-clonic seizures. Down syndrome causes significant intellectual disability in 100% of all people who have it. People with Down syndrome frequently have difficulty making eye-to-eye contact and resist encouragement to do so.

Many people with Down syndrome present with tonic-clonic seizures.

In contrast to conductive hearing loss, sensorineural hearing loss is caused by: Barotrauma Nerve damage Earwax accumulation Eardrum perforation

Nerve damage

You respond to a residence for 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.

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

General care for a patient with a tracheostomy tube includes all of the following, EXCEPT: Ensuring adequate oxygenation and ventilation at all times Removing the tube if the area around it appears to be infected Suctioning the tube as needed to clear thick mucus plugs Maintaining the patient in a position of comfort when possible

Removing the tube if the area around it appears to be infected

Nerve damage to the inner ear results in what? Conductive hearing loss Sensorineural deafness Tinnitus Otitis media

Sensorineural deafness Conductive hearing loss results from faulty transmission of sound waves.

Which of the following techniques should you use when you are communicating with a patient who has autism? Exaggerate your lip movements. Speak normally and provide simple, one-step directions. Speak loudly into the patient's ear. You and your partner should talk to the patient together.

Speak normally and provide simple, one-step directions.

Patients who have a gastric tube in place may still be at increased risk of aspiration.

True

Patients with spina bifida may also have hydrocephalus, requiring a shunt.

True

The AEMT should consult medical control when caring for a terminally ill patient who: Has died and has a valid DNR order Uses a self-administering pain medication device Wishes to receive only supportive care and transport Is being cared for by anyone other than a hospice nurce

Uses a self-administering pain medication device

A patient with epilepsy is likely to have which of the following medical devices? Central venous catheter LVAD Shunt Vagus nerve stimulator

Vagus nerve stimulator A patient with epilepsy may have a vagus nerve stimulator. This device is a form of treatment used for seizures that are not controlled with anti-epileptic medications.

What is the best way to transport an obese patient? Supine Prone With the head elevated With the feet elevated

With the head elevated