Life Span Development in Emergency Medical Services

Life Span Development

NATIONAL EMS EDUCATION STANDARD COMPETENCIES

Preparatory

  • Applies fundamental knowledge of the emergency medical services (EMS) system, safety/well-being of the emergency medical technician (EMT), and medical/legal and ethical issues in the provision of emergency care.

Life Span Development

  • Applies fundamental knowledge of life span development to patient assessment and management.

KNOWLEDGE OBJECTIVES

  1. Stages of Life:

    • Infants

    • Toddlers and Preschoolers

    • School-age Children

    • Adolescents (Teenagers)

    • Early Adults

    • Middle Adults

    • Older Adults
      (Pages 254–264)

  2. Major Characteristics of an Infant's Life:

    • Physical and psychological characteristics (Pages 254–258)

  3. Major Characteristics of a Toddler's and Preschooler's Life:

    • Physical and psychosocial characteristics (Pages 258–260)

  4. Major Characteristics of a School-Age Child's Life:

    • Physical and psychosocial characteristics (Pages 260–261)

  5. Major Characteristics of an Adolescent's Life:

    • Physical and psychosocial characteristics (Pages 261–262)

  6. Major Characteristics of an Early Adult's Life:

    • Physical and psychosocial characteristics (Page 263)

  7. Major Characteristics of a Middle Adult's Life:

    • Physical and psychosocial characteristics (Pages 263–264)

  8. Major Characteristics of an Older Adult's Life:

    • Physical and psychosocial characteristics (Pages 264–268)

SKILLS OBJECTIVES

  • There are no skills objectives for this chapter.

INTRODUCTION

  • Importance of awareness as an EMT of physical and mental changes across different life stages.

  • Understanding how these changes affect patient perception and management.

  • Example: Vital signs vary significantly with age.

VITAL SIGNS

  • Younger individuals typically show faster pulse and respiratory rates.

    • Infants: Pulse rate ranges from 140 beats/min, respiratory rate 60 breaths/min.

    • For adults, same values may indicate critical conditions.

  • Blood pressure varies widely by age. Generally increases with age.

TABLE 7-1: Approximate Normal Vital Signs for Age Groups

Age Group

Pulse Rate (beats/min)

Respirations (breaths/min)

Systolic Blood Pressure (mm Hg)

Temperature (°F)

Neonate (0 to 1 month)

100 to 180

30 to 60

50 to 70

98 to 100 (37°C to 38°C)

Infant (1 month to 1 year)

100 to 160

25 to 50

80 to 100

96.8 to 99.6 (36°C to 37.5°C)

Toddler (1 to 3 years)

90 to 150

20 to 30

80 to 100

98.6 (37°C)

Preschool (3 to 6 years)

80 to 140

20 to 25

80 to 100

98.6 (37°C)

School Age (6 to 12 years)

70 to 120

15 to 20

80 to 110

98.6 (37°C)

Adolescent (12 to 18 years)

60 to 100

12 to 20

90 to 110

98.6 (37°C)

Early Adult (19 to 40 years)

60 to 100

12 to 20

90 to 130

98.6 (37°C)

Middle Adult (41 to 60 years)

60 to 100

12 to 20

90 to 130

98.6 (37°C)

Older Adult (61 years and older)

60 to 100

12 to 20

90 to 130

98.6 (37°C)

NEONATES AND INFANTS (Birth to 1 Year)

Developmental Changes

  • Neonate period: Birth to 1 month.

  • Infant period: 1 month to 1 year (see Figure 7-1).

Physical Changes

  • Weight:

    • Neonate typically weighs 6 to 8 pounds (3 to 3.5 kg). Head comprises ~25% of weight.

    • Initial weight loss of 5% to 10% within the first week due to fluid loss; begins to gain after a week.

    • Growth rate of ~1 ounce (30 g) per day; doubles by 4 to 6 months, triples by end of year.

  • Special Considerations:

    • Infants land headfirst when falling, increasing head injury risk.

Vital Signs for Infants

  • Pulse: 100 to 160 beats/min

  • Respiratory Rate: 25 to 50 breaths/min

  • Blood Pressure: 80 to 100 mm Hg

  • Temperature: 96.8 to 99.6 °F

Respiratory System

  • Neonates are primarily nose breathers; susceptible to nasal congestion.

  • Infants have larger tongues and shorter airways, increasing risk of airway obstruction.

  • Ribcage is less rigid; leads to diaphragmatic breathing.

  • Barotrauma risk in infants if ventilations are forceful.

Neurological Development

  • Reflexes:

    • Moro reflex, palmar grasp reflex, rooting reflex, sucking reflex.

  • Fontanelles provide information on dehydration and intracranial pressure (closure of posterior fontanelle by 3 months, anterior by 9 to 18 months).

Psychosocial Development

  • Communication primarily through crying.

  • Bonding with caregivers leads to secure attachment versus anxious-avoidant attachment.

  • Trust vs. Mistrust Stage:

    • Quality of care during this stage influences trust development from birth to around 18 months.

    • Inconsistent or unresponsive care can lead to mistrust.

Notable Ages for Psychosocial Changes

Age

Characteristic

2 months

Recognizes familiar faces; tracks objects.

6 months

Can sit upright; begins cooing and babbling.

12 months

Walks with assistance; knows name.

TODDLERS (1 to 3 Years) AND PRESCHOOLERS (3 to 6 Years)

Physical Changes

  • Musculature and lung development progress, although not fully matured.

  • Loss of passive immunity leads to frequent viral infections.

  • Transition from gross motor to fine motor skills.

  • Toilet training typically completed by 28 months (psychologically ready between 18 to 30 months).

Psychosocial Changes

  • Challenge: Autonomy vs. Shame and Doubt.

  • Dependency on parents remains strong, leading to attachment needs.

  • Separation anxiety peaks between 10 to 18 months.

  • Social interaction with peers increases, influencing behavior and development.

SCHOOL-AGE CHILDREN (6 to 12 Years)

Physical Changes

  • Typical growth: Gain ~4 pounds (2 kg) and grow ~2.5 inches (6 cm) yearly.

  • Permanent teeth replace baby teeth; increased brain activity.

Psychosocial Growth

  • Moral reasoning evolves through preconventional, conventional, and postconventional reasoning.

  • Development of self-concept and self-esteem, influenced by peer relationships.

ADOLESCENTS (12 to 18 Years)

Physical Changes

  • Vital signs stabilize; growth spurt in muscle and bone begins.

  • Secondary sexual development and maturation of reproductive systems.

Psychosocial Changes

  • Independence-seeking behavior; conflict with parents common.

  • Heightened self-consciousness and peer influence on behavior.

  • Risk behaviors and various social pressures peak in this age group.

EARLY ADULTS (19 to 40 Years)

Physical Changes

  • Vital signs remain stable; peak physical condition is from age 19 to 25.

  • Decreasing metabolism and muscle strength over time.

Psychosocial Changes

  • Focus on family, career, and lifestyle choices; relatively stable psychological state.

MIDDLE ADULTS (41 to 60 Years)

Physical Changes

  • Increased susceptibility to health issues (vision/hearing loss, cardiovascular concerns, menopause).

  • Physical changes visible but manageable through health.

Psychosocial Challenges

  • Navigating career pressures, family adjustments (e.g., empty nest syndrome), and caring for aging parents.

OLDER ADULTS (61 Years and Older)

Physical Changes

  • Life expectancy increased; health management through medications common.

  • Age-related physiological changes require careful consideration in patient assessment.

Cardiovascular System

  • Changes include atherosclerosis, decreased cardiac output, and evidence of aging in the vascular system leading to stiffness.

Respiratory System

  • Changes in lung function and increased susceptibility to pulmonary illness.

Endocrine and Digestive Systems

  • Decreased hormone production, diminished gastrointestinal function affecting nutrition.

Renal System

  • Reduction in kidney size and filtration capabilities.

Neurological Changes

  • Brain weight decreases; functions slow down, including significant changes to sleep patterns.

Psychosocial Issues

  • Common in older age include isolation, worries about finances and mortality.

  • Important to create supportive environments to help manage challenges.

VITAL VOCABULARY

  • Adolescent: A young person age 12 to 18 years.

  • Atherosclerosis: A disorder involving bloodstream blockage due to the buildup of cholesterol and calcium.

  • Barotrauma: Injury caused by pressure to enclosed body surfaces.

  • Middle Adult: Adults aged 41 to 60 years.

  • Older Adult: Adults aged 61 and over.

REFERENCES

  • Various sources including governmental guidelines and statistics regarding aging and health trends in the U.S.