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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 37

Patients With Special Challenges

Learning objectives (13)

  1. Contrast hospice and palliative care with curative care — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  2. Demonstrate different strategies to communicate effectively with a patient who has a hearing impairment — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  3. Describe home care, the types of patients it serves, and the services it encompasses — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  4. Describe the different types of visual impairments and the special patient care considerations required when providing emergency medical care for visually impaired patients, depend — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  5. Describe the various types of hearing aids worn by patients; include strategies to troubleshoot a hearing aid that is not working — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  6. Describe the various types of hearing impairments and the special patient care considerations required when providing emergency medical care for hard-of-hearing patients, including — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  7. Discuss the issues of poverty and homelessness in the United States, their negative effects on a person’s health, and the role of EMTs as patient advocates — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  8. Explain the responsibilities of EMTs when responding to calls for terminally ill patients who have do not resuscitate (DNR) orders — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  9. Explain the special patient care considerations required when providing emergency medical care to bariatric patients; include the best way to move bariatric patients — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  10. Explain the special patient care considerations required when providing emergency medical care to patients who have cerebral palsy, spina bifida, or paralysis — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  11. Explain the special patient care considerations required when providing emergency medical care to patients who rely on a form of medical technological assistance, including the fol — Knowledge/skills objective (printed page 1392); confirm wording in your course copy.
  12. Explain the special patient care considerations required when providing emergency medical care to patients with intellectual disabilities, including patients with autism spectrum d — Knowledge/skills objective (printed page 1391); confirm wording in your course copy.
  13. Give examples of patients with special challenges EMTs may encounter during a medical emergency — Knowledge/skills objective (printed page 1391); confirm wording in your course copy.

Vocabulary (13)

Tracheostomy
A surgically created opening in the front of the neck into the trachea, often connected to a tube to facilitate breathing.
Stoma
A surgically created opening that connects an internal body cavity to the surface — examples include tracheostomy and colostomy stomas.
Gastrostomy tube (G-tube)
A tube placed through the abdominal wall into the stomach for long-term feeding or medication delivery.
Indwelling urinary catheter (Foley)
A flexible tube inserted into the bladder to continuously drain urine, often used long-term.
Central venous access (port / PICC)
Long-term intravenous access placed into a large central vein for medications, fluids, or repeated blood draws.
Mechanical ventilator
A device that delivers breaths to a patient who cannot breathe adequately on their own.
CPAP
Continuous positive airway pressure — noninvasive ventilatory support commonly used for sleep apnea and acute pulmonary edema.
Sensory impairment
Reduced or absent vision, hearing, or other sensory function affecting communication and orientation during patient care.
Hospice care
Comprehensive end-of-life care focused on comfort, dignity, and quality of life rather than curative treatment.
Do Not Resuscitate (DNR)
A medical order indicating that CPR should not be performed if the patient stops breathing or the heart stops.
POLST / MOLST
Physician/Medical Orders for Life-Sustaining Treatment — portable medical orders that travel with the patient and specify care preferences in serious illness.
Bariatric patient
A patient with severe obesity who often requires specialized equipment, additional providers, and modified handling techniques.
Autism spectrum disorder
A developmental condition affecting communication, social interaction, and sensory processing; requires patient-specific communication strategies.

Sequence practice (2 puzzles on Quiz Me)

Tracheostomy in respiratory distress

Order EMT actions when a patient with a tracheostomy is in respiratory distress.

  1. Position the patient upright; provide reassurance
  2. Suction the tracheostomy with sterile technique for no more than 10 seconds at a time
  3. If the inner cannula is reusable, ask the caregiver to remove and clean it per their normal routine
  4. If the tube is dislodged or fully obstructed, prepare to ventilate via the stoma with a BVM and mask
  5. If you cannot ventilate through the stoma, attempt mouth-to-stoma rescue breaths while occluding the mouth and nose
  6. Transport while continuing ventilation support
Encountering a DNR / POLST in the field

Order EMT steps when finding a DNR or POLST document.

  1. Read the document carefully — verify it is valid and applies to this patient
  2. Identify what is and is not authorized (e.g., comfort care, no CPR)
  3. Provide all care that is not refused — oxygen, positioning, pain control per scope
  4. Document the document's presence and your actions thoroughly
  5. When in doubt, contact medical control

Quick fire sample (13 of 13 on Quiz Me)

A surgically created opening in the front of the neck into the trachea, often connected to a tube to facilitate breathing.
  1. Hospice care
  2. Bariatric patient
  3. Tracheostomy
  4. Indwelling urinary catheter (Foley)
A surgically created opening that connects an internal body cavity to the surface — examples include tracheostomy and colostomy stomas.
  1. Mechanical ventilator
  2. Sensory impairment
  3. POLST / MOLST
  4. Stoma
A tube placed through the abdominal wall into the stomach for long-term feeding or medication delivery.
  1. Indwelling urinary catheter (Foley)
  2. Mechanical ventilator
  3. Central venous access (port / PICC)
  4. Gastrostomy tube (G-tube)
A flexible tube inserted into the bladder to continuously drain urine, often used long-term.
  1. Central venous access (port / PICC)
  2. Sensory impairment
  3. Stoma
  4. Indwelling urinary catheter (Foley)
Long-term intravenous access placed into a large central vein for medications, fluids, or repeated blood draws.
  1. Gastrostomy tube (G-tube)
  2. Central venous access (port / PICC)
  3. Do Not Resuscitate (DNR)
  4. Mechanical ventilator
A device that delivers breaths to a patient who cannot breathe adequately on their own.
  1. Indwelling urinary catheter (Foley)
  2. Mechanical ventilator
  3. Central venous access (port / PICC)
  4. Gastrostomy tube (G-tube)
Continuous positive airway pressure — noninvasive ventilatory support commonly used for sleep apnea and acute pulmonary edema.
  1. POLST / MOLST
  2. CPAP
  3. Autism spectrum disorder
  4. Mechanical ventilator
Reduced or absent vision, hearing, or other sensory function affecting communication and orientation during patient care.
  1. Tracheostomy
  2. Sensory impairment
  3. Indwelling urinary catheter (Foley)
  4. Stoma
Comprehensive end-of-life care focused on comfort, dignity, and quality of life rather than curative treatment.
  1. Hospice care
  2. POLST / MOLST
  3. Do Not Resuscitate (DNR)
  4. Sensory impairment
A medical order indicating that CPR should not be performed if the patient stops breathing or the heart stops.
  1. Gastrostomy tube (G-tube)
  2. Autism spectrum disorder
  3. Do Not Resuscitate (DNR)
  4. POLST / MOLST
Physician/Medical Orders for Life-Sustaining Treatment — portable medical orders that travel with the patient and specify care preferences in serious illness.
  1. Central venous access (port / PICC)
  2. Autism spectrum disorder
  3. Do Not Resuscitate (DNR)
  4. POLST / MOLST
A patient with severe obesity who often requires specialized equipment, additional providers, and modified handling techniques.
  1. Mechanical ventilator
  2. Gastrostomy tube (G-tube)
  3. Bariatric patient
  4. Stoma
A developmental condition affecting communication, social interaction, and sensory processing; requires patient-specific communication strategies.
  1. Bariatric patient
  2. Mechanical ventilator
  3. Autism spectrum disorder
  4. CPAP

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/37/print/. Answers are not marked on this sheet.