Developmental Disability
The term developmental disability means:
refers to a group of conditions that may impair development in the area's of physical ability, learning, language, development, or behavioral coping skills.
The most common sensory disabilities are:
vision loss and hearing loss
Some physical disabilities that patients with Down Syndrome can have are:
congenital heart defects
thyroid conditions
hearing and vision problems
enlarged tongue
A stoma is:
An opening through the patients anterior neck providing a pathway directly into the persons trachea where a tracheostomy tube can be placed.
You respond to a home in a rural community for shortness of breath. Inside you find a mother and her 3 children. She tells you that her youngest has asthma and he has been having difficulty breathing for 2 days. She tells you that he needs a breathing treatment and that he is out of his inhaler and she cannot afford to get him another one. She is requesting that you give him a breathing treatment but she doesn't want him transported. You should:
1. Treat the family with respect at all times and understand what a difficult position this must be for the mother.
2. Tell her that if the child has been like this for 2 days he should go to the hospital and be seen.
3. Tell her that you cannot give him a breathing treatment. You would need to call for an ALS unit which is going to be delayed due to high call volume
4. Offer to transport the child so that they can treat him at the hospital.
Intellectual disability means:
a subset of developmental disability where patients have significant limitations in both intellectual functioning and skills needed for daily living.
Your visually impaired patient states that they will not go to the hospital without their service dog. But you are unsure if you can bring the dog into the hospital. What should you do?
Call medical control or your supervisor and ask. But in most places service dogs are welcome. And if that is the only way to get your patient to go to the hospital then do it.
Two common causes of physical disability are:
Cerebral palsy
Spina Bifida
A common problem with patients who have indwelling homecare devices such as tracheostomy tubes, gastrostomy tubes, and indwelling catheters is:
Blockage of the tube by secretions, food or foreign objects
One of the most common intellectual disabilities is:
Autism
You are called to a local veterans club for a person who is acting strange. Upon arrival you find a young (mid 30's) male, lying on the floor. The bartender tells you that he comes in several times a week, his moods vary but today is different than normal. He has been angry, trying to pick a fight with people and telling them that he is tired and wants to take a nap. Then he laid down on the floor and refused to get up. They tell you that they know he is a combat veteran and you can see scars on his head. You recognize that this could be due to a :
Traumatic head injury
Though patients with Cerebral Palsy and Spina Bifida may have physical disabilities there cognitive state can be:
Normal
It varies in Cerebral Palsy from mild to severe, so ask there caregiver before assuming.
An infection or blockage in the shunt
The prevalence of autism in the US is:
1 in 40 individuals it is 3-4x more common in males and more common in those who have a sibling with the condition.
When approaching an elderly patient who is awake does not respond to your questions some possible reasons could be:
Hearing disorder
dementia
Paralysis can be caused by:
Spina bifida
stroke
trauma
birth defects
You respond to a senior daycare center for a male with chest pain. Upon arrival you find an 88 year old male patient who says that his chest hurts but nothing more. You are unable to get any other information from him about his chest pain, due to his advanced dementia , but a few minutes into speaking with him he jumps as if shocked and then holds his chest. You suspect he has:
An internal pacemaker or defibrilator that has just gone off.
You are called to a residence for an unknown medical condition. Upon arrival you are met by a teenager who states that her younger brother is not acting right and her parents are at work and she does not know what to do. She tells you that he has autism and is non verbal but is usually calm. Today he is acting out, taking all his clothes off, hitting his head against the wall and rocking. You recognize that these could be signs that the patient is:
In pain.
Patients with Down's syndrome have a:
genetic chromosomal defect resulting from a triplication of chromosome 21.
That is why it is also known as trisomy 21
When caring for an obese patient it is important to remember that:
Not all obese patients can just diet to loose weight
They may be embarrassed and sensitive about how they look
You may need extra lifting help to get them in and out of the ambulance, plan for that early if possible.
You are called to a residence to assist the hospice nurse on scene. When you get there you find a 57 year old female patient in a hospital bed in her living room with her family in attendance. The hospice nurse states that she has stage 4 cancer and is in the final stages of dying and that for the last 15 min she has been unable to get a pulse or blood pressure. Before calling the patient she wanted you there in case the family changes there mind and wants the patient rescusitated as they are not taking this well. Your next steps should be:
1. Treat the family with respect and the patient with dignity at all times
2. Confirm that the patient is pulseless, and apneic
3. Inform the family of the patients death
4. Initiate CPR if that is what they request, even though a DNR is present.