1. Life Span Development Chapter 9

2. 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

4. Infancy Neonate – A child from birth to one month of age Vital Signs At 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/minute Tidal Volume: 10-15 mL/kg Heart Rate: about 120/minute Systolic BP: 90 mmHg

5. 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

6. 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

7. 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

8. 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

9. 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

10. Physiological Changes Physical Structure: Bones continue to grow They have their primary teeth by 6 Muscle mass increases, but weight gain slows down

11. 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

12. 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

13. 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

14. 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)

15. 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

16. Adolescence 12 – 18 years of age Vital Signs; Heart Rate: 55- 105/minute Respiratory Rate: 12-20/minute Systolic BP: 100- 120 mmHg

17. 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

18. 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

19. 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 8 th or 9 th grade Increased interest in opposite sex and may participate in unprotected sexual activity

20. Early Adulthood 20-40 years of age Vital Signs; Heart Rate: 70/minute Respiratory Rate: 16- 20/minute Average BP: 120/80 mmHg

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. Questions ????