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Chapter 9 Life Span Development. National EMS Education Standard Competencies Life Span Development Integrates comprehensive knowledge of life span development.

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Presentation on theme: "Chapter 9 Life Span Development. National EMS Education Standard Competencies Life Span Development Integrates comprehensive knowledge of life span development."— Presentation transcript:

1 Chapter 9 Life Span Development

2 National EMS Education Standard Competencies Life Span Development Integrates comprehensive knowledge of life span development.

3 Introduction Humans evolve over their life span. −Paramedics must be aware of the changes that occur at each stage of life. −Paramedics may need to adjust care based on patient’s life stage.

4 Infants Age 1 month to 1 year Younger than 1 month: −Newborns −Neonates © Johanna Goodyear/ShutterStock, Inc.

5 Infants

6 Weight −Generally 6–8 pounds at birth −Lose 5–10% of body weight in week 1 −Begin weight gain during week 2 Cardiovascular system −Switch to own vasculature system

7 Infants Pulmonary system First breath inflates lungs for first time Under 1 month, nose breathers Under 6 months, prone to nasal congestion

8 Infants Pulmonary system (cont’d) −When compared to adults: Softer rib cages Horizontally oriented ribs Immature accessory muscles Larger tongue Shorter, narrower airway Fewer alveoli Fragile lungs Courtesy of Marianne Gausche-Hill, MC, FACEP, FAAP

9 Infants Renal system −Consider: Dehydration Electrolyte imbalances Immune system −Passive immunity helps protect up to 1 year Nervous system −Continues to evolve following birth −Born with: Moro reflex Palmar grasp Rooting reflex Sucking reflex

10 Infants Nervous system (cont’d) −Fontanelles allow the head to be molded. −Sleep patterns vary.

11 Infants Musculoskeletal system −Growth and epiphyseal plates help bones grow. −Muscles account for 25% of weight. −Growth charts track growth. Dental system −Teething begins at 4–7 months. Baby teeth are in by age 3 years. Permanent teeth come in around age 6.

12 Infants Psychosocial development begins at birth. −Evolves as infant interacts with and reacts to the environment

13 Infants Infants typically have their own timetable for development. −Bonding based on a secure attachment −Anxious avoidant attachment based on rejection Most infants use crying as the primary method of communicating distress.

14 Infants For infants, a reaction to a situational crisis follows three phases: −Protest phase −Despair phase −Withdrawal Infants go through trust and mistrust phase.

15 Infants Children may be: −Easy −Difficult −Slow to warm up −Let caregiver hold infants whenever possible! Courtesy of Howard E. Huth, III, BA, EMT-P.

16 Toddlers and Preschoolers Toddlers are ages 1–3 years. Preschoolers are ages 4–5 years. Vital signs −Slower pulse and respiratory rates than infants −Higher systolic blood pressure © Kevin Levit/ShutterStock, Inc.© Maxim Bolotnikov/ShutterStock, Inc.

17 Toddlers and Preschoolers Cardiovascular system −Similar to adult’s, but lacks well-developed lung musculature Immune system −Passive immunity loss leads to acquired immunity.

18 Toddlers and Preschoolers Neuromuscular system −Development of gross and fine motor skills −Brain weighs 90% of final adult weight © EML/ShutterStock, Inc.

19 Toddlers and Preschoolers Renal system −Begin bladder control Teething process may be painful and include fever. Sensory development makes tickling fun.

20 Toddlers and Preschoolers Psychosocial changes −Separation anxiety peaks. −Language development occurs. −Peer interactions result in: Learning control, following rules, competitiveness Modeling behavior Recognizing sexual differences

21 Toddlers and Preschoolers Tips for paramedic: −Always include caregiver! −Position yourself at eye level. −Explain what you are going to do. −Save the worst for last.

22 Toddlers and Preschoolers Development is a reflection of parents −Styles: Authoritarian: expects complete obedience Authoritative: balances authority with freedom Permissive: no imposition of rules −Divorce may affect self-esteem and well-being.

23 School-Age Children Ages 6–12 years old Vital signs, physical body approaching those of an adult Grow approximately 4 lbs, 2½″ per year Puberty may start as early as 10 years © Trout55/ShutterStock, Inc.

24 School-Age Children Psychosocial changes −Three stages of reasoning Preconventional: avoid punishment Conventional: obtain approval Postconventional: conscience −Self-concept develops −Self-esteem develops

25 School-Age Children Tips for paramedics: −Use same techniques as for preschoolers. −Gaining (and losing) trust is a huge issue. −Be direct, assertive, and open!

26 Adolescents (Teenagers) Ages 13–17 years Vital signs level off to adult ranges. Growth spurt Reproductive changes −Secondary sex characteristics −Hormone secretion © Jamie Wilson/ShutterStock, Inc.

27 Adolescents (Teenagers) Psychosocial changes −Family conflict related to: Privacy Self- consciousness Rebelliousness Peer pressure Self-destructive behavior © SW Productions/Jupiterimages

28 Adolescents (Teenagers) Tips for paramedics: −Provide discretion and respect to patients. −Speak with patient separately from caregivers, whenever possible. © Jones & Bartlett Learning. Courtesy of MIEMSS.

29 Early Adults Ages 18–40 years Vital signs remain constant. Body functions at optimal level between ages 19–25. Accidents are common cause of death. © Rubberball Productions

30 Early Adults Psychosocial changes −Work, family, and stress are main focus Want to “settle down” Seek and find love −One of the most stable life periods, with less psychological problems than other stages

31 Middle Adults Ages 41–60 years. Physical changes: −Vision/hearing loss −Cardiovascular disease −Lower metabolism −Cancer rates increase Menopause/bone density loss, fractures © Photodisc

32 Middle Adults Psychosocial changes −Focus on meeting life goals “Empty nest” syndrome Financial worries related to retirement May see crisis as a challenge, not a threat

33 Late Adults Ages 61+ −Life expectancy approximately 78 years Vital signs depend on: −Overall health status −Medical conditions −Medications © Photodisc

34 Late Adults Cardiovascular system −Atherosclerosis leads to blood vessel blockage. May lead to aneurysms −Hearts are less able to deal with exercise or disease due to: Decreased pulse rate Declining cardiac output Inability to elevate cardiac output

35 Late Adults Cardiovascular system (cont’d) −Vascular system becomes stiff due to: Increased diastolic blood pressure Decreased cardiac output Impeded blood flow Reduced elasticity of peripheral vessels Reduced ability to compensate for changes

36 Late Adults Respiratory system −Changes make breathing more difficult: Larger airway; smaller alveoli Reduced lung elasticity; increased use of intercostal muscles Rigid chest as ribs calcify to sternum Decrease in intercostal muscle strength

37 Late Adults Respiratory system (cont’d) −Changes in mouth and nose leave airway less protected. Difficult to clear secretions Cough and gag reflexes decline Less responsive to smoke and dust due to decline in cilia

38 Late Adults Respiratory system (cont’d) −Weakening of smooth muscles may lead to: Collapse Inspiratory wheezing Low flow rates

39 Late Adults Respiratory system (cont’d) −Vital capacity only 50% of younger adult’s Loss of respiratory muscle mass Increased stiffness of thoracic cage Decreased surface area for air exchange −Residual volume increases causing air to hamper gas exchange in alveoli.

40 Late Adults Endocrine system −Diabetes related to weight gain −Males lose penis rigidity; females experience atrophy of uterus and vagina

41 Late Adults Renal system −Functional changes of the kidneys: Declining filtration function Decreasing kidney mass Declining number of nephrons −Decreased response to hemodynamic stress

42 Late Adults Gastrointestinal system −Decreased sense of taste, weaker teeth −Decreased saliva production −Slower gastric motility −Diminishing acid secretion −Decreased ability to extract nutrients −Fecal incontinence

43 Late Adults Nervous system −Central nervous system changes: Brain weight loss of 10%–20% Loss of 5%–50% neurons Loss of 20% frontal lobe synapses Slower motor and sensory neural networks −Change to biphasic sleep patterns

44 Late Adults Nervous system (cont’d) −Brains have increased risk for injury. Smaller brain may lead to movement. Bridging veins may tear.

45 Late Adults Nervous system (cont’d) −Peripheral nervous system changes: Diminished sensation Diminished proprioception Deteriorated nerve endings

46 Late Adults Sensory changes: −Vision changes Pupils less responsive to light Diminished visual acuity Restricted ocular movement Increased distortions Decreased ability to focus at close range Decreased peripheral vision

47 Late Adults Sensory changes (cont’d) : −Hearing changes Loss of high-frequency hearing Deafness −Loss of taste bud sensation and olfactory perception

48 Late Adults Psychosocial changes −Up until five years preceding death, most late adults retain high-level brain function Terminal drop hypothesis

49 Late Adults Psychosocial changes (cont’d) −95% live at home. −May live in assisted living facility −Financial concerns related to health care −Patients face own mortality © Jones & Bartlett Learning. Courtesy of MIEMSS.

50 Summary Developmental stages of life include infant, toddler, preschool age, school age, adolescence, early adulthood, middle adulthood, and late adulthood. Each developmental stage is marked by different physical and psychological changes and characteristics. The vital signs of toddlers and preschoolers differ somewhat from those of an infant.

51 Summary From ages 6 to 12 years, the school-age child’s vital signs and body gradually approach those observed in adulthood. The vital signs of adolescents begin to level off within the adult ranges. Vital signs do not vary greatly through adulthood; however, the vital signs of late adults do vary depending on each person’s health.

52 Summary Infants develop at a startling rate. Two important points regarding an infant’s airway are that an infant’s tongue can more easily occlude the airway, and the lungs are fragile. Infants are classified as an easy child, difficult child, or slow to warm up. Their primary means of communication is crying.

53 Summary Toddlers and preschoolers learn to speak and express themselves. Toilet training is usually accomplished around age 28 months. A child’s development is affected by the parenting style employed by his or her parents. Parenting styles include authoritarian, authoritative, and permissive.

54 Summary School-age children develop self-esteem and reasoning abilities and receive their permanent teeth. Adolescents undergo significant reproductive development, focus on creating their self-image, are self-conscious, and may engage in self-destructive behavior.

55 Summary Early adults focus on work and family. The body should function at an optimal level. Middle adults focus on achieving life goals. Medical problems become more common. Late adults undergo significant physical changes. They also focus on their mortality.

56 Credits Chapter opener: © digitalskillet/ShutterStock, Inc. Backgrounds: Blue—Courtesy of Rhonda Beck; Gold—Jones & Bartlett Learning. Courtesy of MIEMSS; Red—© Margo Harrison/ShutterStock, Inc; Purple—Courtesy of Rhonda Beck. Unless otherwise indicated, all photographs and illustrations are under copyright of Jones & Bartlett Learning, courtesy of Maryland Institute for Emergency Medical Services Systems, or have been provided by the American Academy of Orthopaedic Surgeons.


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