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Objectives
• Define Infancy• Discuss Toddlers and Pre-school age
children• Define School-Age children• Discuss Adolescence• Define Early Adulthood• Discuss Middle Adulthood• Define Late Adulthood
Infancy
Neonate – A child from birth to one month of age
Vital SignsAt Birth:• Respiratory: 40-60
breaths per minute• Tidal Volume: 6-8
mL/kg• Heart Rate:
140-160/minute• Systolic BP: 70 mmHg
By one year;Respiratory: 20-30/minuteTidal Volume: 10-15 mL/kgHeart Rate: about
120/minuteSystolic BP: 90 mmHg
Physiological Changes
Physical Structure;• Head is 25% of weight
(neonate)• Weight drops during first 2
weeks but is regained• Infants require breast milk or
formula, followed by soft foods and then to solid food after primary teeth have arrived
Pulmonary System;• Airways of infants are
shorter, narrower, less stable, and more easily obstructed
• Primarily nose breathers to 4 weeks
• Lung tissue is fragile and prone to trauma
• Accessory muscles are immature, the chest wall is rigid
Physiological Changes
Immune System;• Neonate’s arises from
antibodies received through the placenta
• Passive immunity is retained through the first 6 months or as long as breast feeding continues
• Childhood immunizations normally begin after birth
Nervous System;• Infants have reflexes, or
instantaneous and involuntary movements, that result from a stimulus
• Well-flexed extremities move equally when stimulated
Physiological Changes
Skeletal System;• Fontanelles are soft spots on the skull that allow the
head to compress in the birth canal during delivery and allow for the growth of the brain during infancy
• Fontanelles should not be pressed but will be depressed if child is dehydrated
• Bones grow throughout infancy, so EMT’s should know what activities are normally present at various stages of infancy
Psychosocial Changes
• Most infants will protest when separated from their care givers
• If infant does not seem upset from the separation, the EMT should consider underlying causes
• Infants communicate through crying• Some crying can be avoided if the parent is allowed
to hold the infant during assessment• At end of infancy, a favorite toy may calm a child
during assessment, as long as the toy cannot cause an airway obstruction
• A calm voice during assessment will help calm both child and parent
Toddlers and Pre-school Age
Toddlers: between 1 to 3 years of age
Pre-schooler: 3 – 6
Vital Signs:• Heart & Respiratory
rates tend to decrease as child ages
• Systolic BP: increases as child ages
Physiological Changes
Physical Structure:• Bones continue to
grow• They have their
primary teeth by 6• Muscle mass
increases, but weight gain slows down
Physiological Changes
Pulmonary System;• Terminal airways
continue to branch• Alveoli continue to grow
in number
Immune System;• Passive immunity from
mother is lost• Active immunity to
common pathogens develops
Nervous System;• Brain is the fastest
growing part of the body
• Fine motor skills begin to develop
Make certain to recognize what activities toddlers and preschoolers are capable of performing
Psychosocial Changes
• Language takes place of crying as communication• Separation anxiety begins at 18 months• At age 5, preschoolers can say name and address,
recall stories, and tell stories• Children can play simple games and follow basic
rules• Begin to develop friendships outside the immediate
family• EMT’s should communicate with the child on a level
they understand by choosing phrases carefully and demonstrating equipment
School-Age Children
Between 6-12 years old
Vital Signs;• Heart Rate:
70-110/minute• Respiratory rate: 20-
30/minute• Systolic BP: 80-120
mmHg
Physiological Changes
• Bones increase indensity and grow in size
• Primary teeth are replaced with permanent teeth
• Brain functions increase
• Some children struggle with nocturnal enuresis (wet the bed)
Psychosocial Changes
• Develop relationships outside the home• Participate in social activities• Capable of fundamental reasoning and
problem-solving• Develop a self-concept, self-esteem, and
morals• Understand pain, illness, death, and loss• Identify EMT’s, firefighters, and police officers
as people who can help
Adolescence
12 – 18 years of age
Vital Signs;• Heart Rate: 55-
105/minute• Respiratory Rate:
12-20/minute• Systolic BP: 100-
120 mmHg
Physiological Changes
• Generally experience growth spurt beginning with enlarged feet and hands, followed by extremities, followed by chest and trunk
• Go through puberty, during which sexual organs mature
Psychosocial Changes
• Experience changes that cause family conflicts, mostly revolving around the adolescent and their parents
• Become more argumentative and aware of the shortcomings of others
• May participate in risky or self-destructive behaviors
• Want to be treated as an adult, but parent’s consent is required for medical treatment
Psychosocial Changes
• Want privacy and may disclose more information when parents are not present
• Develop their identity• Increase in self-consciousness and concern
about body image• Antisocial behavior peaking around 8th or 9th
grade• Increased interest in opposite sex and may
participate in unprotected sexual activity
Early Adulthood
20-40 years of age
Vital Signs;• Heart Rate: 70/minute• Respiratory Rate: 16-
20/minute• Average BP: 120/80
mmHg
Physiological Changes
• Peak physical condition occurs between 19-26 years of age
• After peak condition, physical condition begins to slow down
• Adults gain weight, store fat, and experience decreased muscle tone
• Adults’ spinal disks begin to settle• Adults develop lifelong habits during
this period
Psychosocial Changes
• Take on more responsibility
• Leave parents home
• Develop romantic relationships, some of which lead to marriage
• Childbirth is common
• More capable of dealing with stress than when younger
Middle Adulthood
41 – 60 years of age
Vital Signs;
Avg. Heart Rate: 70/minute
Avg. Respiratory Rate: 16-20/minute
Avg. BP: 120/80 mmHg
Physiological Changes
• Adults become more susceptible to chronic illness and disease
• Cardiovascular health becomes a concern• Cardiac output decreases• Cholesterol levels increase• Weight is gained• Vision changes may require corrective lenses• Hearing may decrease• Women go through menopause, which is the
end of menstruation and fertility
Psychosocial Changes
• May perceive problems as challenges rather than threats
• May help younger generation• May question their own accomplishments• May set new goals for remainder of life• May delay seeking help for health issues• May be burdened by financial commitments• May experience empty-nest syndrome• May take care of grown children and/or elderly
parents• May become grandparents
Late Adulthood
61 years and older
Vital Signs;
Heart Rate, Respiratory Rate, and BP depend on physical and health status
Underlying diseases, poor physical conditioning, and medications can alter vital signs
Physiological Changes
• Maximum life span is 120 years for humans
• Life expectancy is the average years of life remaining based on an individual’s year of birth
• Cardiovascular system becomes less efficient, putting more strain on myocardium– Blood vessels thicken– Functional blood volume decreases
Physiological Changes
Respiratory System is weakened;
• Chest wall and bone structure weaken, and elasticity of the diaphragm is diminished
• Diffusion of gases through the alveoli is diminished
Nervous system undergoes changes;
• Brain gets smaller and neurons are lost
• Sleep cycle may be disrupted
• Reaction time to stimuli is increased
• Senses may become dulled
Physiological Changes
Endocrine, reproductive, and renal systems are affected
• Metabolism and insulin production decrease• Reproductive organs atrophy• Elimination of urine decreases• Permanent teeth are often lost
EMT’s must be aware of underlying health conditions in addition to any emergency situation
Psychosocial Changes
• Wisdom is attributed to age in some cultures• Some adults in this stage are cared for by
family, and some are isolated and alone• Leaving a long-established home is often
required• Difficult decisions often center on financial
burdens and requirements• Independence must often be given up• The loss of loved ones andfriends must be
acknowledged