NREMT EMT 4: Patient Treatment and Transport - Special Patient Populations, Pediatrics, Geriatrics, Patients with Disabilities, Bariatric, Palliative/Hospice Care, LGBTQ Considerations

Special Patient Populations: Pediatrics

What This Is

Pediatrics is caring for children from birth to 18 years old. A real-world example is when a 2-year-old child chokes on a toy. Imagine a tiny airway like a narrow straw – if it's blocked, nothing else works.

Key Steps / Core Facts

• Pediatric Airway Management: Use a pediatric mask or bag-valve-mask (BVM) device to provide oxygen. (Use a pediatric mask with a nose clip to prevent air from escaping.)
• Pediatric CPR Ratio: 30 chest compressions to 2 breaths per minute. (AVPU: Alert, Voice, Pain, Unresponsive)
• Pediatric Vital Signs: Normal temperature: 97.7°F - 99.5°F (36.5°C - 37.5°C). (Normal heart rate: 100-160 beats per minute)
• Pediatric Dose of Medication: Use 1/4 to 1/2 the adult dose. (e.g., epinephrine: 0.01-0.02 mg/kg)
• Pediatric Head Injury: Watch for vomiting, lethargy, or difficulty breathing. (Red flag: "Don't move the child unless they're in danger")
• Pediatric Burns: Use cool water to cool the burn area. (Don't use ice or ice water)
• Pediatric Allergic Reaction: Use epinephrine (e.g., EpiPen) if symptoms worsen. (Red flag: "Anaphylaxis is a medical emergency")
• Pediatric Asthma: Use a pediatric inhaler with a spacer. (Use a mask if the child can't use the inhaler)

What Laypeople Can Do

• If a child is choking, encourage them to cough or try the back blows method (5 times).
• If a child is having an allergic reaction, call 911 and administer epinephrine (if available).
• If a child is having trouble breathing, sit them up and provide oxygen (if available).

Common Mistakes

• Mistake: Not using a pediatric mask or BVM device.
• Fix: Use a pediatric mask or BVM device to provide oxygen.
• Mistake: Not calling 911 for a child's medical emergency.
• Fix: Call 911 immediately for any child's medical emergency.
• Mistake: Not using the correct dose of medication.
• Fix: Use 1/4 to 1/2 the adult dose of medication.

Quick Practice Scenarios

A 5-year-old child is having trouble breathing after a bee sting. What should you do first?

Wait for the child to calm down and then try to remove the stinger.

Answer: Call 911 and administer epinephrine (if available). Reason: Anaphylaxis is a medical emergency.

A 2-year-old child is choking on a toy. What should you do first?

Encourage the child to cough or try the back blows method (5 times).

Answer: Encourage the child to cough or try the back blows method (5 times). Reason: This can help dislodge the object.

A 10-year-old child is having a seizure. What should you do first?

Keep the child safe and turn them onto their side.

Answer: Keep the child safe and turn them onto their side. Reason: This can help prevent injury.

Special Patient Populations: Geriatrics

What This Is

Geriatrics is caring for older adults (65+ years). A real-world example is when an 85-year-old person falls and breaks a hip. Imagine a fragile bone like a delicate egg – it can break easily.

Key Steps / Core Facts

• Geriatric Airway Management: Use a soft mask or BVM device to provide oxygen. (Use a soft mask to prevent discomfort)
• Geriatric CPR Ratio: 30 chest compressions to 2 breaths per minute. (AVPU: Alert, Voice, Pain, Unresponsive)
• Geriatric Vital Signs: Normal temperature: 97.7°F - 99.5°F (36.5°C - 37.5°C). (Normal heart rate: 60-100 beats per minute)
• Geriatric Dose of Medication: Use 1/2 to 2/3 the adult dose. (e.g., epinephrine: 0.01-0.02 mg/kg)
• Geriatric Head Injury: Watch for confusion, vomiting, or difficulty breathing. (Red flag: "Don't move the patient unless they're in danger")
• Geriatric Burns: Use cool water to cool the burn area. (Don't use ice or ice water)
• Geriatric Allergic Reaction: Use epinephrine (e.g., EpiPen) if symptoms worsen. (Red flag: "Anaphylaxis is a medical emergency")

What Laypeople Can Do

• If an older adult is having trouble breathing, sit them up and provide oxygen (if available).
• If an older adult is having an allergic reaction, call 911 and administer epinephrine (if available).
• If an older adult is having trouble walking, provide a stable walking aid (e.g., cane).

Common Mistakes

• Mistake: Not using a soft mask or BVM device.
• Fix: Use a soft mask or BVM device to provide oxygen.
• Mistake: Not calling 911 for an older adult's medical emergency.
• Fix: Call 911 immediately for any older adult's medical emergency.
• Mistake: Not using the correct dose of medication.
• Fix: Use 1/2 to 2/3 the adult dose of medication.

Quick Practice Scenarios

An 80-year-old person is having trouble breathing after a fall. What should you do first?

Call 911 and provide oxygen (if available).

Answer: Call 911 and provide oxygen (if available). Reason: An older adult's medical emergency requires immediate attention.

A 70-year-old person is having an allergic reaction to a bee sting. What should you do first?

Call 911 and administer epinephrine (if available).

Answer: Call 911 and administer epinephrine (if available). Reason: Anaphylaxis is a medical emergency.

Special Patient Populations: Patients with Disabilities

What This Is

Patients with disabilities require special care and consideration. A real-world example is when a person with a spinal cord injury needs to be turned onto their side. Imagine a fragile spine like a delicate vase – it can break easily.

Key Steps / Core Facts

• Patient with Disability Airway Management: Use a soft mask or BVM device to provide oxygen. (Use a soft mask to prevent discomfort)
• Patient with Disability CPR Ratio: 30 chest compressions to 2 breaths per minute. (AVPU: Alert, Voice, Pain, Unresponsive)
• Patient with Disability Vital Signs: Normal temperature: 97.7°F - 99.5°F (36.5°C - 37.5°C). (Normal heart rate: 60-100 beats per minute)
• Patient with Disability Dose of Medication: Use the same dose as for adults. (e.g., epinephrine: 0.01-0.02 mg/kg)
• Patient with Disability Head Injury: Watch for confusion, vomiting, or difficulty breathing. (Red flag: "Don't move the patient unless they're in danger")
• Patient with Disability Burns: Use cool water to cool the burn area. (Don't use ice or ice water)
• Patient with Disability Allergic Reaction: Use epinephrine (e.g., EpiPen) if symptoms worsen. (Red flag: "Anaphylaxis is a medical emergency")

What Laypeople Can Do

• If a person with a disability is having trouble breathing, sit them up and provide oxygen (if available).
• If a person with a disability is having an allergic reaction, call 911 and administer epinephrine (if available).
• If a person with a disability is having trouble walking, provide a stable walking aid (e.g., cane).

Common Mistakes

• Mistake: Not using a soft mask or BVM device.
• Fix: Use a soft mask or BVM device to provide oxygen.
• Mistake: Not calling 911 for a person with a disability's medical emergency.
• Fix: Call 911 immediately for any person with a disability's medical emergency.
• Mistake: Not using the correct dose of medication.
• Fix: Use the same dose as for adults.

Quick Practice Scenarios

A person with a spinal cord injury is having trouble breathing. What should you do first?

Call 911 and provide oxygen (if available).

Answer: Call 911 and provide oxygen (if available). Reason: A person with a spinal cord injury requires immediate medical attention.

A person with a disability is having an allergic reaction to a bee sting. What should you do first?

Call 911 and administer epinephrine (if available).

Answer: Call 911 and administer epinephrine (if available). Reason: Anaphylaxis is a medical emergency.

Special Patient Populations: Bariatric

What This Is

Bariatric patients require special care and consideration due to their weight. A real-world example is when a person with obesity needs to be turned onto their side. Imagine a fragile body like a delicate balloon – it can pop easily.

Key Steps / Core Facts

• Bariatric Airway Management: Use a large mask or BVM device to provide oxygen. (Use a large mask to prevent discomfort)
• Bariatric CPR Ratio: 30 chest compressions to 2 breaths per minute. (AVPU: Alert, Voice, Pain, Unresponsive)
• Bariatric Vital Signs: Normal temperature: 97.7°F - 99.5°F (36.5°C - 37.5°C). (Normal heart rate: 60-100 beats per minute)
• Bariatric Dose of Medication: Use the same dose as for adults. (e.g., epinephrine: 0.01-0.02 mg/kg)
• Bariatric Head Injury: Watch for confusion, vomiting, or difficulty breathing. (Red flag: "Don't move the patient unless they're in danger")
• Bariatric Burns: Use cool water to cool the burn area. (Don't use ice or ice water)
• Bariatric Allergic Reaction: Use epinephrine (e.g., EpiPen) if symptoms worsen. (Red flag: "Anaphylaxis is a medical emergency")

What Laypeople Can Do

• If a bariatric patient is having trouble breathing, sit them up and provide oxygen (if available).
• If a bariatric patient is having an allergic reaction, call 911 and administer epinephrine (if available).
• If a bariatric patient is having trouble walking, provide a stable walking aid (e.g., cane).

Common Mistakes

• Mistake: Not using a large mask or BVM device.
• Fix: Use a large mask or BVM device to provide oxygen.
• Mistake: Not calling 911 for a bariatric patient's medical emergency.
• Fix: Call 911 immediately for any bariatric patient's medical emergency.
• Mistake: Not using the correct dose of medication.
• Fix: Use the same dose as for adults.

Quick Practice Scenarios

A bariatric patient is having trouble breathing. What should you do first?

Call 911 and provide oxygen (if available).

Answer: Call 911 and provide oxygen (if available). Reason: A bariatric patient requires immediate medical attention.

A bariatric patient is having an allergic reaction to a bee sting. What should you do first?

Call 911 and administer epinephrine (if available).

Answer: Call 911 and administer epinephrine (if available). Reason: Anaphylaxis is a medical emergency.

Special Patient Populations: Palliative/Hospice Care

What This Is

Palliative and hospice care focus on comfort and quality of life for patients with terminal illnesses. A real-world example is when a person with cancer needs pain management. Imagine a fragile body like a delicate flower – it needs gentle care.

Key Steps / Core Facts

• Palliative/Hospice Airway Management: Use a soft mask or BVM device to provide oxygen. (Use a soft mask to prevent discomfort)
• Palliative/Hospice CPR Ratio: Do not perform CPR unless the patient has a do-not-resuscitate (DNR) order. (AVPU: Alert, Voice, Pain, Unresponsive)
• Palliative/Hospice Vital Signs: Normal temperature: 97.7°F - 99.5°F (36.5°C - 37.5°C). (Normal heart rate: 60-100 beats per minute)
• Palliative/Hospice Dose of Medication: Use the same dose as for adults. (e.g., pain medication: 5-10 mg)
• Palliative/Hospice Head Injury: Watch for confusion, vomiting, or difficulty breathing. (Red flag: "Don't move the patient unless they're in danger")
• Palliative/Hospice Burns: Use cool water to cool the burn area. (Don't use ice or ice water)
• Palliative/Hospice Allergic Reaction: Use epinephrine (e.g., EpiPen) if symptoms worsen. (Red flag: "Anaphylaxis is a medical emergency")

What Laypeople Can Do

• If a patient with palliative or hospice care is having trouble breathing, sit them up and provide oxygen (if available).
• If a patient with palliative or hospice care is having an allergic reaction, call 911 and administer epinephrine (if available).
• If a patient with palliative or hospice care is having trouble walking, provide a stable walking aid (e.g., cane).

Common Mistakes

• Mistake: Not using a soft mask or BVM device.
• Fix: Use a soft mask or BVM device to provide oxygen.
• Mistake: Not calling 911 for a patient with palliative or hospice care's medical emergency.
• Fix: Call 911 immediately for any patient with palliative or hospice care's medical emergency.
• Mistake: Not using the correct dose of medication.
• Fix: Use the same dose as for adults.

Quick Practice Scenarios

A patient with palliative care is having trouble breathing. What should you do first?

Call 911 and provide oxygen (if available).

Answer: Call 911 and provide oxygen (if available). Reason: A patient with palliative care requires immediate medical attention.

A patient with hospice care is having an allergic reaction to a bee sting. What should you do first?

Call 911 and administer epinephrine (if available).

Answer: Call 911 and administer epinephrine (if available). Reason: Anaphylaxis is a medical emergency.

Special Patient Populations: LGBTQ+ Considerations

What This Is

LGBTQ+ patients require special care and consideration due to their unique needs. A real-world example is when a transgender patient needs to be treated with respect and dignity. Imagine a person like a delicate flower – they need gentle care.

Key Steps / Core Facts

• LGBTQ+ Airway Management: Use a soft mask or BVM device to provide oxygen. (Use a soft mask to prevent discomfort)
• LGBTQ+ CPR Ratio: 30 chest compressions to 2 breaths per minute. (AVPU: Alert, Voice, Pain, Unresponsive)
• LGBTQ+ Vital Signs: Normal temperature: 97.7°F - 99.5°F (36.5°C - 37.5°C). (Normal heart rate: 60-100 beats per minute)
• LGBTQ+ Dose of Medication: Use the same dose as for adults. (e.g., epinephrine: 0.01-0.02 mg/kg)
• LGBTQ+ Head Injury: Watch for confusion, vomiting, or difficulty breathing. (Red flag: "Don't move the patient unless they're in danger")
• LGBTQ+ Burns: Use cool water to cool the burn area. (Don't use ice or ice water)
• LGBTQ+ Allergic Reaction: Use epinephrine (e.g., EpiPen) if symptoms worsen. (Red flag: "Anaphylaxis is a medical emergency")

What Laypeople Can Do

• If an LGBTQ+ patient is having trouble breathing, sit them up and provide oxygen (if available).
• If an LGBTQ+ patient is having an allergic reaction, call 911 and administer epinephrine (if available).
• If an LGBTQ+ patient is having trouble walking, provide a stable walking aid (e.g., cane).

Common Mistakes

• Mistake: Not using a soft mask or BVM device.
• Fix: Use a soft mask or BVM device to provide oxygen.
• Mistake: Not calling 911 for an LGBTQ+ patient's medical emergency.
• Fix: Call 911 immediately for any LGBTQ+ patient's medical emergency.
• Mistake: Not using the correct dose of medication.
• Fix: Use the same dose as for adults.

Quick Practice Scenarios

An LGBTQ+ patient is having trouble breathing. What should you do first?

Call 911 and provide oxygen (if available).

Answer: Call 911 and provide oxygen (if available). Reason: An LGBTQ+ patient requires immediate medical attention.

An LGBTQ+ patient is having an allergic reaction to a bee sting. What should you do first?

Call 911 and administer epinephrine (if available).

Answer: Call 911 and administer epinephrine (if available). Reason: Anaphylaxis is a medical emergency.

Last-Minute Exam Cram

• Normal vital sign ranges: temperature (97.7°F - 99.5°F), heart rate (60-100 beats per minute), blood pressure (90-120 mmHg)
• Drug doses: epinephrine (0.01-0.02 mg/kg), pain medication (5-10 mg)
• Mnemonics: AVPU (Alert, Voice, Pain, Unresponsive), SAMPLE (Size, Allergies, Medications, Past medical history, Last meal)
• Assessment sequences: head-to-toe assessment, vital sign assessment
• Common "trick" questions: Agonal breathing is NOT normal breathing – start CPR
• Always call 911 for a medical emergency
• Never move a patient unless they're in danger
• Always use the correct dose of medication