The at-risk population includes pediatrics, geriatrics, and those taking multiple medications who are at risk of overdose or interactions. They are dependent on others for protection and care. EMS must consider challenges in assessing uncommunicative or unreliable patients and rely on caregivers for history. Proper interpretation of exams and environments is important to guide care.

1. At-Risk
Population

2. I. Who are the “at-risk” population?:
A. Pediatrics:
• Wide range in development from neonatal to young adult
• Non-verbal to highly communicative
• Organ development may change the shock response
• Injury or illness patterns may change with the development
• Dependent on someone for protection and prevention
B. Geriatric
• Indicator is patient fragility than age in years
C. Polypharmacy is most common with certain drug interactions

3. Who are the “at-risk” population?
D. Be aware of potential overdoses with medication
• Dementia
• Delirium
E. Age-related cognitive impairment
F. Loss of independence
G. Uptake of medications may have been reduced

4. II. Signs of Domestic Violence Abuse:
A. In recent studies that have been reported say, that domestic violence
wounds are most likely found in the following anatomical sites:
• Face and neck
• Arms
• Head
• Back and buttocks
• Breasts
• Abdomen(increases during pregnancy)
• Genitals
It has been found that most victims are repeatedly abused when injuries are at the
different stages of healing.

5. III. State resources for Victims
of Domestic Violence:
1. North Carolina Collation Against
Domestic Violence
a. www.nccadv.org
2. North Carolina Collation Against
Sexual Assault:
a. www.nccasa.net

6. IV. Signs of Human Trafficking
A. Bruises that are caused by
physical abuse that are in various
stages of healing.
B. Scars, mutilations or infections
due to the lack of proper medical
care.
C. Difficulties with urination, pelvic
pain, pregnancy or rectal trauma.
D. Results of forced manual labor in
unsafe conditions:
• Chronic back problems
• Hearing
• Cardiovascular
• Respiratory problems
E. Eye problems due to working or
being in a dimly lit room

7. Signs of Human Trafficking:
F. Malnourishment
G. Serious Dental Issues
H. Results of daily mental abuse,
torture, or cultural shock:
• Disorientation
• Confusions
• Phobias
• Panic attacks

8. VI. Human Trafficking Resource:
• If you feel that someone that you
are treating is being human
trafficked call the following
number below:
Federal Law Enforcement:
1-866-346-2423

9. VII. Actions and Consideration by EMS
Professionals with “at-risk” patients:
A. Challenges with Assessments:
• Unreliable historians
• Difficulty with relaying information
• Previous medical history
• Medications
• Other current therapies
• Relying on the caregivers to give out information
• Assessing the environment in which the patient was found and the need for additional
follow-up
• Verbal and nonverbal communication of the patient with the proper interpretation of
what is going on
• The interpretation of the physical examination often drives how they will care for the patient

10. Actions and Consideration by EMS
Professionals with “at-risk” patients: