Physical Disability, Terminally Ill and Non-Urgent Emergencies

Question 1

What are the two categories of physical disabilities?

Answer 1

• Acquired
• Hereditary/congenital

Question 2

What are some causes of acquired physical disabilities?

Answer 2

• Accident/trauma
• Infection or disease
• Side effect of a medical condition

Question 3

Define hereditary disability.

Answer 3

The passing on of traits from parents to offspring, biological inheritance, genetics.

Question 4

Define congenital disability.

Answer 4

A disease of physical abnormality present from birth.

Question 5

What is the definition of obesity according to BMI?

Answer 5

Obesity is classified as a BMI > 30.

Question 6

What is severe obesity classified as?

Answer 6

A BMI > 40.

Question 7

What health issues are associated with obesity?

Answer 7

• NIDDM
• HTN
• Fatty liver disease
• Cancers
• Infertility
• GERD
• Osteoarthritis
• Sleep apnea

Question 8

What is Bariatrics?

Answer 8

A branch of medicine that deals with the treatment of obesity.

Question 9

What is Obesity Hypoventilation Syndrome?

Answer 9

When obese individuals fail to breathe quickly or deeply enough, causing low oxygen levels and high blood CO2 levels.

Question 10

What condition may increase the risk of right-sided heart failure?

Answer 10

Obesity Hypoventilation Syndrome.

Question 11

What are common causes of intellectual disabilities?

Answer 11

• Genetic conditions
• Problems during pregnancy
• Problems at birth
• Exposure to diseases and toxins

Question 12

What is Down Syndrome?

Answer 12

A genetic disorder caused by an extra whole or partial third copy of chromosome 21.

Question 13

What are some physical features associated with Down Syndrome?

Answer 13

• Small chin
• Slanted eyes
• Flat nasal bridge
• Relatively large tongue

Question 14

What is Cerebral Palsy?

Answer 14

A group of disorders that affect a person’s ability to move and maintain balance.

Question 15

What are the types of Cerebral Palsy?

Answer 15

• Spastic CP
• Dyskinetic CP
• Ataxic CP
• Mixed CP

Question 16

What is Multiple Sclerosis?

Answer 16

A CNS disorder characterized by myelin sheath degeneration of brain and spinal cord.

Question 17

What is Uhthoff’s Phenomena?

Answer 17

Sensitivity to increased body temperature in multiple sclerosis patients.

Question 18

What is AIDS?

Answer 18

Acquired Immunodeficiency Syndrome, a disease caused by the HIV virus that attacks the body’s immune system.

Question 19

What are the three phases of HIV?

Answer 19

• Acute
• Chronic
• AIDS

Question 20

What is the treatment for HIV?

Answer 20

Highly active antiretroviral therapy slows the progression of the disease.

Question 21

What is Meningitis?

Answer 21

Acute inflammation of the meninges covering the brain and spinal cord.

Question 22

What are Kernig’s and Brudzinski’s signs?

Answer 22

Clinical signs used to assess meningitis.

Question 23

What is Tetanus?

Answer 23

A life-threatening infection caused by the neurotoxin from Clostridium tetani.

Question 24

What are the symptoms of Tetanus?

Answer 24

• Muscle spasm
• Painful muscle stiffness
• Jaw cramping
• Trouble swallowing
• Headache
• Chills/fever
• Seizures

Question 25

What is Toxic Shock Syndrome?

Answer 25

A life-threatening condition caused by bacterial toxins, often related to menstruation and retained tampons.

Question 26

What are the treatment options for Tetanus?

Answer 26

* Tetanus Immunoglobulin * Antibiotics * Benzodiazepines and Magnesium sulfate for muscle spasms

Question 27

What is a Personal Directive?

Answer 27

A legal document allowing you to name trusted individuals to make decisions on your behalf if you lack mental capacity.

Question 28

What options can be explained to patients other than emergent transport to the hospital?

Answer 28

* Community Paramedics * Palliative Care Community Team ## Footnote These alternatives may be more suitable depending on the patient's condition.

Question 29

What is a Personal Directive?

Answer 29

A legal document naming agents trusted to make decisions on behalf of a patient lacking mental capacity ## Footnote It specifies areas of decision-making authority.

Question 30

What must a health care practitioner do in a medical emergency if a Personal Directive is in place?

Answer 30

Inform the agent(s) of the circumstances as soon as possible ## Footnote This applies if the patient is unable to make decisions.

Question 31

What does DNR stand for?

Answer 31

Do Not Resuscitate ## Footnote It defines the patient’s resuscitation status.

Question 32

What is required for a DNR document to be validated by a paramedic?

Answer 32

* Confirm identity of patient * Check names on DNR * Verify date * Ensure it is notarized ## Footnote Validation is essential before following DNR instructions.

Question 33

What is the focus of Resuscitative Care?

Answer 33

To prolong or preserve life using any medical or surgical means ## Footnote This includes resuscitation and admission to Intensive Care.

Question 34

What does Medical Care aim to achieve?

Answer 34

To cure or manage an illness without resuscitative or life support measures ## Footnote This is suitable when such measures are not expected to work.

Question 35

What is the aim of Comfort Care?

Answer 35

Optimal symptom control and maintenance of function when cure is no longer possible ## Footnote Transfer to a hospital may occur for better symptom management.

Question 36

What conditions indicate that resuscitation should not be initiated?

Answer 36

* Goals of Care Designation present * Obvious non-survivable conditions * Confirmed drowning with submersion time > 90 minutes ## Footnote These conditions help determine the appropriateness of resuscitation efforts.

Question 37

When must resuscitation be continued?

Answer 37

* Return of spontaneous circulation at any point * Cardiac arrest witnessed by EMS * Organized electrical activity on ECG * One or more defibrillations delivered ## Footnote These factors indicate potential for survival.

Question 38

What is the Flatline Protocol used for?

Answer 38

To confirm asystole vs. fine v-fib ## Footnote It includes checking lead attachment and increasing amplitude.

Question 39

What factors should be determined when assessing a non-urgent patient?

Answer 39

* History * Vitals * Chief Complaint * Past medical history * Risk factors * Age and gender ## Footnote These factors help assess the urgency of the condition.

Question 40

What is the role of Community Paramedics?

Answer 40

To provide short-term treatments for low-acuity illnesses in the community ## Footnote They focus on vulnerable and marginalized populations.

Question 41

What are some treatments provided by Community Paramedics?

Answer 41

* Advanced pharmacology * Palliative care * Transfusion medicine * Urinary catheterization * Suturing and wound care * CVAD/PICC line access * Point of care testing * Blood draws ## Footnote These treatments address various health needs in the community.

Question 42

Who ultimately decides whether a patient is transported to the hospital?

Answer 42

The patient’s decision maker, typically a family member ## Footnote Their wishes should guide transport decisions.

Question 43

What can hypercalcemia cause in a patient?

Answer 43

Confusion and other symptoms ## Footnote It can be a complication of bone cancer.