Life span development refers to changes that occur from birth to death. A thorough understanding of life span development helps EMTs and paramedics appropriately treat patients of all ages.
A baby is considered a neonate from birth to 1 month. From 1 month to 1 year, a baby is considered an infant. There are many differences between treating an infant and an adult. One significant difference to keep in mind is that, typically, the younger the baby, the faster the respiratory rate and heart rate. Babies tend to be nose breathers and have smaller airways than an older child or adult, which can make them especially vulnerable to airway obstruction.
A child is considered a toddler from 1 to 3 years. A preschooler is a child from 3 to 6 years old. The heart and respiratory rates of a child of this age are slower than those in an infant, but faster than rates in an adult. Separation anxiety may be common for toddlers and language development may vary. Accidents are a top cause of death in children of this age.
Children from ages 6 to 12 are considered school age. Their vital signs are just a little faster than an adult. Peer acceptance is starting to become important to school-age children. When treating school-age children, it is important to explain procedures so children will understand what is happening. This may decrease fear and anxiety in the child and expedite treatment.
Children from 13 to 18 are considered adolescents. Medically, adolescents are often treated similarly to adults, though in some cases, medication is administered based on weight instead of age. Since adolescent development can vary greatly, it’s important to consider the child’s size and not just age. Accidents are the leading cause of death in adolescents.
Early adulthood is considered to be from age 19 to 40. During this time, adults tend to be in their peak physical shape. Vital signs tend to be similar in both early and middle adulthood. Toward the end of early adulthood, changes in the body may take place, including loss of muscle mass, increased body fat, and slowed reflexes. Unintentional injury is the leading cause of death for young adults.
Middle adulthood is considered to be from age 41 to 60. Although it can vary, middle adulthood may be the start of medical problems for some people. Diabetes, cardiovascular disease, and vision and hearing problems commonly start in middle adulthood. For adults aged 41 to 44, unintentional injuries are still the top cause of death, while cancer is the leading cause of death in middle aged adults 45 to 60.
Older adults are classified as being age 61 and older. During this stage of adulthood, chronic medical problems, such as COPD and heart disease, are more likely to develop than in the younger adult years. The leading cause of death in older adults up to age 65 is cancer. After age 65, heart disease is the top cause of death.
Terms/Concepts to Know: fontanelles, preconventional reasoning, life expectancy
A neurological emergency involves a condition related to the brain. Some neurological conditions may be life threatening. Neurological emergencies can occur in both children and adults, but are more common in adults.
The brain is divided into different segments including the cerebrum, cerebellum, and brainstem. Each segment controls different functions. Sight, swallowing, speech, movement, and even breathing are controlled by different areas of the brain. The brain also involves a complex network of nerves that carry messages from the brain to various parts of the body.
There are several neurological considerations that range from mild to life threatening. Neurological emergencies can cause many different symptoms, depending on which part of the brain is affected. Quick recognition of serious neurological emergencies is essential to improve patient outcome.
Headaches are a very common neurological condition. Headaches are usually not a sign of a serious condition, but they do sometimes indicate something significant, such as meningitis or a stroke. Pain from a headache is not generated from the brain, since the brain does not have pain receptors. The pain is felt from nearby areas, including the blood vessels, meninges, and scalp.
A stroke is a serious medical emergency that can lead to death or permanent brain damage. A stroke occurs due to an interruption of blood flow to the brain, typically because of a clot. When blood flow is interrupted, brain cells can die and temporary or permanent damage can occur. Symptoms include slurred speech, headache, and confusion. Other conditions can mimic a stroke, including hypoglycemia and a postictal state, which occurs after a seizure.
A seizure is a misfiring of electrical activity in the brain. It’s often characterized by rigid muscles and uncontrolled muscle activity. In some cases, a loss of consciousness may also develop. Epilepsy is one of the most frequent causes of seizures. Other causes of seizures can include brain tumors, drugs, and injury to the brain from trauma. Airway management is an important consideration in patients having a seizure.
Altered mental status involves a patient not thinking clearly. Many conditions can cause altered mental status including strokes, seizures, alcohol and drug use, brain injury, hyperglycemia, and brain infection. Since various causes of altered mental status are treated differently, it is essential to continue an assessment to determine the probable cause of an altered level of consciousness (ALOC).
As with any emergency, determining scene safety is the first step to treating neurological emergencies. Next, a primary survey should be done to determine if any life-threatening conditions are present. Since neurological conditions can affect breathing, airway management is a top consideration. Getting the patient’s history may also provide clues to the problem. A secondary survey should include measuring vital signs and a possible stroke assessment. Since neurological status can quickly change, reassessment should be ongoing during transport.
Many neurological conditions, such as a stroke, require treatment in a hospital. Prehospital treatment may be limited to airway management and quick transport to the appropriate facility. In some cases, such as a seizure, medication may be administered to decrease seizure activity.
Terms/Concepts to Know: stroke, seizure, CVA, ALOC, delirium, ischemia, TIA, status epilepticus