Download Chapter 09

MASTER TEACHING NOTES
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Detailed Lesson Plan
Chapter 9
Life Span Development
60–75 minutes
Case Study Discussion
Teaching Tips
Discussion Questions
Class Activities
Media Links
Knowledge Application
Critical Thinking Discussion
Chapter 9 objectives can be found in an accompanying folder.
These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.
Minutes
Content Outline
I.
5
10
Master Teaching Notes
Introduction
Case Study Discussion
A. During this lesson, students will learn about the stages of life span
development and how to apply this knowledge to emergency care.
B. Case Study
1. Present The Dispatch and Upon Arrival information from the chapter.
2. Discuss with students how they would proceed.
II. Life Span Development—Infancy
A. Neonate is the term referring to a child from birth to one month of age.
B. Vital signs
1. At birth
a. Respiratory rate is 40–60 breaths per minute.
b. Tidal volume is 6–8 mL/kg.
c. Heart rate is 140–160 beats per minute.
d. Average systolic blood pressure is 70 mmHg.
2. By one year of age
a. Respiratory rate is 20–30 breaths per minute.
b. Tidal volume is 10–15 mL/kg.
c. Heart rate is about 120 beats per minute.
d. Average systolic blood pressure is 90 mmHg.
C. Physiological changes
1. Physical structure
a. The head accounts for 25 percent of the weight of a neonate.
b. Weight drops during first two weeks but then is regained.
c. Infants require breast milk or formula, followed by soft foods and
then solid foods once primary teeth appear.
2. Pulmonary system
a. The airways of an infant are shorter, narrower, less stable, and
more easily obstructed than those of an adult.
PREHOSPITAL EMERGENCY CARE, 9TH EDITION
DETAILED LESSON PLAN 9

How does the age of the patient impact
your approach to him?
 What are typical concerns of children of
this age?
Video Clip
Go to www.bradybooks.com
and click on the mykit link for Prehospital
Emergency Care, 9th edition to access a
video clip addressing health supervision
during infancy.
PAGE 1
Chapter 9 objectives can be found in an accompanying folder.
These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.
Minutes
Content Outline
Master Teaching Notes
b. Infants are primary nose breathers until four weeks of age.
c. The lung tissue of infants is fragile and prone to trauma.
d. The accessory muscles are immature, and the chest wall is rigid.
3. Immune system
a. Most of a neonate’s immunity arises from antibodies received
through the placenta.
b. Passive immunity is retained through the first six months of life or as
long as breast feeding continues.
c. Childhood immunizations normally begin after birth.
4. Nervous system
a. Infants have reflexes, or instantaneous and involuntary movements,
that result from a stimulus.
b. Well-flexed extremities move equally when stimulated.
5. Skeletal system
a. Fontanelles are soft spots on the skull that allow the head to
compress in the birth canal during delivery and to allow for the
growth of the brain during infancy.
b. Fontanelles should not be pressed but will be depressed if child is
dehydrated.
c. Bones grow throughout infancy, so the EMT should know what
activities are normally present at various stages of infancy.
D. Psychosocial changes
1. Most infants will protest when separated from their care givers.
2. In an infant does not seem upset when separated from a parent, the
EMT should consider underlying causes.
3. Infants communicate all of their needs by crying.
4. Some crying can be avoided if the parent is allowed to hold the infant
during assessment.
5. By the end of infancy, a favorite toy may calm a child during
assessment, as long as the toy cannot cause an airway obstruction.
6. A calm voice during assessment will help calm both the child and the
parents.
PREHOSPITAL EMERGENCY CARE, 9TH EDITION
DETAILED LESSON PLAN 9
Discussion Question
What are the psychosocial characteristics
of infants?
PAGE 2
Chapter 9 objectives can be found in an accompanying folder.
These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.
Minutes
10
10
Content Outline
Master Teaching Notes
III. Life Span Development—Toddlers and Preschool-Age Children
A. A toddler is a child who is one to three years of age.
B. A preschooler is a child who is three to six years of age.
C. Vital signs
1. Heart and respiratory rates tend to decrease as a child ages.
2. Systolic blood pressure increases as a child ages.
D. Physiological changes
1. Physical structure
a. The bones of the musculoskeletal system continue to grow.
b. Children have their primary teeth by the end of this period.
c. Muscle mass increases, but weight gain slows down.
2. Pulmonary system
a. Terminal airways continue to branch.
b. Alveoli continue to grow in number.
3. Immune system
a. Passive immunity from mother is lost.
b. Active immunity to common pathogens develops.
4. Nervous system
a. Brain is the fastest growing part of the body.
b. Fine motor skills begin to develop.
5. It is important for the EMT to recognize what activities toddlers and
preschoolers are capable of performing.
E. Psychosocial changes
1. Language takes the place of crying as the sole form of communication.
2. Separation anxiety begins at approximately 18 months of age.
3. By age five, a preschooler can say his name and address, recall stories,
and tell stories.
4. Children can play simple games and follow basic rules.
5. Children begin to develop friendships outside the immediate family.
6. The EMT should communicate with the child on a level he understands
by choosing phrases carefully and demonstrating equipment.
IV. Life Span Development—School-Age Children
A. School-age children are between six and 12 years of age.
B. Vital signs
1. Normal heart rates range from 70–110 beats per minute.
2. Respiratory rates range from 20–30 breaths per minute.
3. Systolic blood pressure is between 80–120 mmHg.
PREHOSPITAL EMERGENCY CARE, 9TH EDITION
DETAILED LESSON PLAN 9
Video Clip
Go to www.bradybooks.com
and click on the mykit link for Prehospital
Emergency Care, 9th edition to access a
video clip about pediatric growth and
development.
Discussion Questions
At what age should you expect pediatric
patients to experience separation
anxiety?
 What are some techniques for
establishing trust with a toddler or
preschooler?
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Knowledge Application
Given several scenarios of patients of
various ages, determine if the patient’s vital
signs should be considered normal or
cause for concern.
PAGE 3
Chapter 9 objectives can be found in an accompanying folder.
These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.
Minutes
Content Outline
Master Teaching Notes
C. Physiological changes
1. Bones increase in density and grow in size.
2. Primary teeth are replaced with permanent teeth.
3. Brain function increases.
4. Some children struggle with nocturnal enuresis.
D. Psychosocial changes
1. Develop relationships outside the home
2. Participate in social activities
3. Capable of fundamental reasoning and problem solving
4. Develop a self-concept, self-esteem, and morals
5. Understand pain, illness, death, and loss
6. Identify EMTs, firefighters, and law enforcement officers as people who
can help
10
V. Life Span Development—Adolescence
A. An adolescent is between 12 and 18 years of age.
B. Vital signs
1. Normal heart rates range from 55–105 beats per minute.
2. Respiratory rates range from 12–20 breaths per minute.
3. Systolic blood pressure is between 100–120 mmHg.
C. Physiological changes
1. Generally experience growth spurt beginning with enlarged feet and
hands, followed by extremities, followed by chest and trunk
2. Adolescents go through puberty, during which sexual organs mature.
D. Psychosocial changes
1. Experience changes that cause family conflicts, mostly revolving around
the adolescent and his parents
2. Become more argumentative and aware of the shortcomings of others
3. May participate in risky or self-destructive behaviors.
4. Want to be treated as adults, but parents’ consent is required for
medical treatment
5. Want privacy and may disclose more information when parents are not
present
6. Develop their identity
7. Increase in self-consciousness and concern about body image
8. Antisocial behavior peaking around eighth or ninth grade
9. Increased interest in opposite sex and may participate in unprotected
sexual activity
PREHOSPITAL EMERGENCY CARE, 9TH EDITION
DETAILED LESSON PLAN 9
Video Clip
Go to www.bradybooks.com
and click on the mykit link for Prehospital
Emergency Care, 9th edition to access a
video clip promoting healthy lifestyles for
school-aged children.
Weblinks
Go to www.bradybooks.com
and click on the mykit link for Prehospital
Emergency Care, 9th edition to access web
resources on developmental stages and
psychological issues related to
development.
Discussion Question
What are some of the causes of conflict
between adolescents and their parents?
PAGE 4
Chapter 9 objectives can be found in an accompanying folder.
These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.
Minutes
5
5
Content Outline
Master Teaching Notes
VI. Life Span Development—Early Adulthood
A. Early adulthood is the stage of development from 20 to 40 years of age.
B. Vital signs
1. Average heart rate is 70 beats per minute.
2. Average respiratory rate is 16–20 breaths per minute.
3. Average blood pressure is 120/80 mmHg.
C. Physiological changes
1. Peak physical condition occurs between 19 and 26 years of age.
2. After peak physical condition, physical condition begins to slow down.
3. Adults gain weight, store fat, and experience decreased muscle tone.
4. Adults’ spinal disks begin to settle.
5. Adults develop lifelong habits during this period.
D. Psychosocial changes
1. Take on more responsibility
2. Leave parents’ home
3. Develop romantic relationships, some of which lead to marriage
4. Childbirth is common.
5. More capable of dealing with stress than when younger
VII. Life Span Development—Middle Adulthood
A. Middle adulthood is the stage of development from 41 to 60 years of age.
B. Vital signs
1. Average heart rate is 70 beats per minute.
2. Average respiratory rate is 16–20 breaths per minute.
3. Average blood pressure is 120/80 mmHg.
C. Physiological changes
1. Adults become more susceptible to chronic illness and disease.
2. Cardiovascular health becomes a concern.
3. Cardiac output decreases.
4. Cholesterol levels increase.
5. Weight is gained.
6. Vision changes may require corrective lenses.
7. Hearing may decrease.
8. Women go through menopause, which is the end of menstruation and
fertility.
D. Psychosocial changes
1. May perceive problems as challenges rather than threats
2. May help younger generations
PREHOSPITAL EMERGENCY CARE, 9TH EDITION
DETAILED LESSON PLAN 9
Knowledge Application
Given several scenarios of patients of
various ages, describe special
considerations in the EMT’s approach to
the patient, based on the physical and
psychosocial characteristics of each age
group.
Weblink
Go to www.bradybooks.com
and click on the mykit link for Prehospital
Emergency Care, 9th edition to access a
web resource on the process of aging.
Teaching Tip
Ask students for examples that illustrate the
psychosocial development stages.
Critical Thinking Discussion
How do you think differences between the
age of an EMT and the age of a patient
may affect their interaction?
PAGE 5
Chapter 9 objectives can be found in an accompanying folder.
These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.
Minutes
Content Outline
3.
4.
5.
6.
7.
8.
9.
Master Teaching Notes
May question their own accomplishments
May set new goals for the remainder of their lives
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
IX. Life Span Development—Late Adulthood
10
A. Late adulthood is the stage of development 61 years of age and older.
B. Vital signs
1. Heart rate, respiratory rate, and blood pressure depend on physical and
health status.
2. Underlying diseases, poor physical conditioning, and medications can
alter vital signs.
C. Physiological changes
1. The maximum life span is 120 years for a human being.
2. Life expectancy is the average years of life remaining based on an
individual’s year of birth.
3. Cardiovascular system becomes less efficient, putting more strain on
myocardium.
a. Blood vessels thicken.
b. Functional blood volume is decreased.
4. Respiratory system is weakened.
a. Chest wall and bone structure weaken, and elasticity of the
diaphragm is diminished.
b. Diffusion of gases through the alveoli is diminished.
5. Nervous system undergoes changes.
a. Brain gets smaller and neurons are lost.
b. Sleep cycle may be disrupted.
c. Reaction time to stimuli is increased.
d. Senses may become dulled.
6. Endocrine, reproductive, and renal systems are affected.
a. Metabolism and insulin production decrease.
b. Reproductive organs atrophy.
c. Elimination of urine decreases.
d. Permanent teeth are often lost.
7. EMTs must be aware of underlying health conditions in addition to any
PREHOSPITAL EMERGENCY CARE, 9TH EDITION
DETAILED LESSON PLAN 9
Class Activity
Divide students into groups. Have all
students place cotton balls in their ears
before giving instructions in a normal voice.
Instruct students in each group to take turns
putting on the gardening gloves; smear a
small amount of petroleum jelly on the
reading glasses, and then try to thread a
needle while wearing the gloves and
glasses. After ten minutes, ask students to
discuss their experience with the task.
Explain that you have simulated some of
the effects of aging, such as loss of
sensation, stiffness of joints in the hands,
and cataracts.
Video Clip
Go to www.bradybooks.com
and click on the mykit link for Prehospital
Emergency Care, 9th edition to access a
video on challenges and techniques
involved in notifying a family about a
serious condition or death of a loved one.
Discussion Question
How do psychosocial concerns change
through early, middle, and late adulthood?
PAGE 6
Chapter 9 objectives can be found in an accompanying folder.
These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.
Minutes
Content Outline
Master Teaching Notes
emergency situation.
8. Psychosocial changes
a. Wisdom is attributed to age in some cultures.
b. Some adults in this stage are cared for by family.
c. Some adults in this stage are isolated and alone.
d. Leaving a long-established home is often required.
e. Difficult decisions often center on financial burdens and
requirements.
f. Independence must often be given up.
g. The loss of loved ones and friends must be acknowledged.
XI. Follow-Up
10
You have an elderly patient who does not
want to leave his home despite the fact that
he is ill and needs to go to the hospital.
What might explain his reluctance? What
are some ways you can address the
patient’s reluctance to leave his home?
Case Study Follow-Up Discussion
A. Answer student questions.
B. Case Study Follow-Up
1. Review the case study from the beginning of the chapter.
2. Remind students of some of the answers that were given to the
discussion questions.
3. Ask students if they would respond the same way after discussing the
chapter material. Follow up with questions to determine why students
would or would not change their answers.
C. Follow-Up Assignments
1. Review Chapter 9 Summary.
2. Complete Chapter 9 In Review questions.
3. Complete Chapter 9 Critical Thinking.
D. Assessments
1. Handouts
2. Chapter 9 quiz
PREHOSPITAL EMERGENCY CARE, 9TH EDITION
Critical Thinking Discussion
DETAILED LESSON PLAN 9

What could you say to the patient before
asking personal questions to minimize
his potential embarrassment?
 What kind of conversation starters could
be used with a patient of this age to put
them at ease during transport?
Class Activity
Alternatively, assign each question to a
group of students and give them several
minutes to generate answers to present to
the rest of the class for discussion.
Teaching Tips

Answers to In Review and Critical
Thinking questions are in the appendix
to the Instructor’s Wraparound Edition.
Advise students to review the questions
again as they study the chapter.
 The Instructor’s Resource Package
contains handouts that assess student
learning and reinforce important
information in each chapter. This can be
found under mykit at
www.bradybooks.com.
PAGE 7
PREHOSPITAL EMERGENCY CARE, 9TH EDITION
DETAILED LESSON PLAN 9
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