Explore/Explain: Hospital Triage Copymaster 6.1 Patients’ Vital Signs: Preliminary Information Vital signs Patient
Description
Esther
Eighty-five-year-old female 105 complaining of dizziness. Has a beats/min, history of heart problems and weak suffered a moderate stroke (blood vessel in brain ruptured) 6 years ago, resulting in mild left-side paralysis.
36°C (96.8°F)
160/65 mm Hg
22 resp/min, labored
Albert
Adult male, approximately 25 100–105 years old, with a possible head beats/min injury from a motorcycle accident. Victim not wearing helmet. He is conscious, but has no feeling in his arms, legs, or torso.
37°C (98.6°F)
80/50 mm Hg
20–22 resp/min
Maria
Fifteen-year-old girl with symptoms of severe diarrhea and vomiting.
115 beats/min
40°C (104°F)
110/70 mm Hg
21 resp/min
Mark
Nineteen-year-old male with a gunshot wound to the chest. Victim is conscious, bleeding moderately, and having great difficulty breathing.
150 beats/min
37°C (98.6°F)
100/60 mm Hg
23 resp/min
Ed
Forty-one-year-old male, obviously 110 beats/min, overweight, called paramedics weak complaining of crushing chest pains. He is now unconscious.
37°C (98.6°F)
Variable
12 resp/min
Monique
Eighteen-year-old woman rescued 120 beats/min from the canyon; stung by a bee. She is dizzy, nauseous, has cracked lips, is having difficulty breathing, and has a rash on her legs and stomach.
41°C (105.8°F)
87/50 mm Hg
30 resp/min
45 Fifty-one-year-old man rescued beats/min from the canyon. He was unconscious and having seizures when brought into the emergency room.
43°C (109.4°F)
85/50 mm Hg
10 resp/min
Nelson
Heart Rate
Temperature
Blood Pressure*
Breathing Rate**
(laboredbreathing)
*mm Hg = millimeters of mercury **resp/min = respirations per minute
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Explore/Explain Copymaster 6.1
Unit 2/Chapter 6
Copyright BSCS. All rights reserved.
Explore/Explain Copymaster 6.2
Heart rate: Temperature: Blood pressure: Breathing rate:
Heart rate: Temperature: Blood pressure: Breathing rate:
Heart rate: Temperature: Blood pressure: Breathing rate:
Heart rate: Temperature: Blood pressure: Breathing rate:
Heart rate: Temperature: Blood pressure: Breathing rate:
Heart rate: Temperature: Blood pressure: Breathing rate:
Heart rate: Temperature: Blood pressure: Breathing rate:
Albert
Maria
Mark
Ed
Monique
Nelson
Vital Signs
Esther
Patient
Range of vital Signs (√ or X) Disrupted Systems
Physicians’ names: ______________________________
Copymaster 6.2 Triage Data Sheet
Treatment Priority (critical: +++; serious: ++; stable: +)
Initial Suggestions for Treatment and Explanation for Priority
Part B Modified Priority Number
Part B Explanations for Changes to Priority
Copymaster 6.3 First Priority The emergency room (ER) staff works smoothly, a team where every person knows his or her role, everyone working together toward the goal of saving lives and minimizing the damage from injury, accident, or illness. Nurses, doctors, aides, and specialists (such as anesthesiologists, psychologists, and counselors) combine their skills to maximize their effectiveness while they work as quickly as possible. In emergency medicine, you deal with challenges on a daily basis. There is always time pressure; often, you must deal with incomplete information, making life-or-death decisions based on information you have been able to collect in just a few minutes. There are many human issues related to the sudden and unpredictable nature of trauma: patients or their loved ones may be angry, grieving, depressed, or suffering from the effects of alcohol or other drugs. Through it all, you have to make your best judgments, knowing that your decisions may mean the difference between a patient living or dying. There are two possible outcomes for the first choice made by the triage team:
• If your group placed Monique as the highest priority, then your team experiences result 1. Go to result 1 now, reading the description of what happened.
• If your team selected any patient besides Monique as the first priority, then you should read result 2. Read that result now.
Result 1: Monique Gets the Initial Attention of the Staff The young woman is in terrible shape. Her heart rate is extremely high, but her breathing is shallow and her temperature is dangerously high. The staff starts an IV drip quickly to rehydrate her body and injects a dose of epinephrine to allow her to breathe more easily. She is covered with a cooling blanket, which helps bring her temperature down. Other staff members use equipment to monitor her breathing and frequently check the level of oxygen in her blood. Over the course of the next hour, her body temperature begins to come down, and as her other vital signs return to the normal range she falls into a deep, restorative sleep.
Result 2: Another Patient (besides Monique) Gets the Initial Attention of the Staff You get to work on your patient, doing everything you can to help, while other staff members monitor the patients who are still awaiting treatment. Shortly after you begin, however, a nurse reports that Monique’s condition has quickly become critical. She is having great trouble breathing, and her heart rate suddenly falls rapidly. By the time you get to her, she has gone into cardiac arrest. The team administers CPR, oxygen, and a shot of steroids, but the treatment is too late. Despite the frantic and heroic efforts of the ER team, the young woman dies in the emergency room. This is a tough night in the emergency room. Despite the diligent efforts of this highly trained medical staff, and the most modern medicine available, you and your colleagues must face the fact that some of these patients are unlikely to survive because of the extent of their injuries.
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Explore/Explain Copymaster 6.3 page 1 of 2
Patient Updates By now, the fates of three patients have already been determined:
• Nelson: No matter who your team chose to attend to first, by now Nelson has died. By the
time he arrived in the emergency room, his heart rate and blood pressure had fallen too low to be restored, his temperature was so high that brain cells were dying, and his level of dehydration was too advanced to allow treatment to be effective. One by one, his organ systems shut down as tissues were deprived of oxygen and nutrients for too long.
• Albert: The MRI and other tests confirm what you feared for this motorcycle accident
victim. Sadly, Albert has suffered a life-changing catastrophe. His spinal cord has been damaged so badly that he has virtually no chance to regain the use of his arms and legs. There is little more that you can do for him in the ER. He has been catheterized, since he no longer has control of his own urination. His prospects for survival are good, but he will require continual rehabilitation work and extraordinary modifications to his living arrangements as he adjusts to using a motorized wheelchair for mobility.
• Monique: Depending on your initial triage choice, Monique is now resting and recovering, or she, too, has died (depending on when she received treatment).
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Explore/Explain Copymaster 6.3 page 2 of 2
Copymaster 6.4 Additional Information Look at your triage priority numbers. Cross out the entries for Monique, Nelson, and Albert. Determine which of the remaining patients you have decided should receive priority treatment. Depending on your additional choices, consult the following results to determine the final outcomes of this frantic night in the ER. If your highest-priority patient (after Monique, Albert, and Nelson) is now
• Ed, then read result 1; • Mark, read result 2; or • Maria or Esther, read result 3.
Result 1: Ed Ed is suffering from a very large myocardial infarction, commonly known as a heart attack. Turning your attention to him, you work to save his life. The team inserts an IV with saline solution to keep him hydrated and make it easy to administer other medications. It inserts an endotracheal tube into his airway to keep him breathing. The team administers several procedures to collect more data: a chest X-ray and an electrocardiograph (EKG or ECG). These diagnostics show that he needs catheterization around his heart, a surgery that is scheduled immediately. The operation provides the most information for appropriate physical therapy and greatest recovery. As soon as the team wheels Ed off to surgery, your skilled staff goes to work on Mark, who is bleeding badly from the effects of the bullet that tore through his chest and punctured one of his lungs. First, the team starts an IV for hydration and then takes a chest X-ray to evaluate the extent of the damage inside his chest. As a result of this information, the team conducts emergency surgery and is able to get the bleeding under control and re-inflate his lung. This process allows Mark a maximum chance of a full recovery.
Result 2: Mark Mark is bleeding badly, the effects of the bullet that tore through his chest and punctured one of his lungs. First, the team starts an IV for hydration and then takes a chest X-ray to evaluate the extent of the damage inside his chest. As a result of this information, the team conducts emergency surgery and is able to get the bleeding under control and re-inflate his lung. This process allows Mark a maximum chance of a full recovery. Unfortunately, while you are working on Mark, Ed’s heart fails completely, and he dies while awaiting treatment.
Result 3: Maria or Esther The team makes the patient as comfortable as possible, and her vital signs slowly return to normal; she has a good chance of recovery, and in fact was not in as much danger as the other, more critical patients. Unfortunately, by making either of these patients higher priority than Ed or Mark, valuable time is lost for stabilizing either man. Consequently, both Ed and Mark fail rapidly. By the time the team provides treatment to these patients, it is too late, and each dies.
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Explore/Explain Copymaster 6.4
Explain: Self-Defense! Copymaster 6.5 Test Subject Cards
Test Subject 1
Lifestyle:
Gets moderate exercise.
Is well rested.
Has a positive mental attitude.
Is a nonsmoker.
Test Subject 2
Lifestyle:
Gets little exercise.
Has a chronic lack of sleep.
Is mildly depressed.
Is a nonsmoker.
Test Subject 3
Lifestyle:
Gets moderate exercise.
Is well rested.
Is mildly anxious.
Is a smoker.
Test Subject 4
Lifestyle:
Gets little exercise.
Gets a lot of sleep but is still fatigued.
Is mildly depressed.
Is a nonsmoker.
Has AIDS.
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Explain Copymaster 6.5
Copymaster 6.6 Scenario Cards
Scenario A
Test subject 1 was exposed to pathogen 1. Became mildly ill, but recovered completely within seven days. Was vaccinated earlier against rubella. Did not take penicillin.
Scenario B
Test subject 1 was exposed to pathogen 2. No signs of illness occurred. Was vaccinated earlier against rubella. Did not take penicillin.
Scenario C
Test subject 1 was exposed to pathogen 3. Became moderately ill, but improved within seven days; completely recovered after nine days. Was vaccinated earlier against rubella. Did not take penicillin.
Scenario D
Test subject 2 was exposed to pathogen 2. Became moderately ill, but improved within eight days; completely recovered after 12 days. Did not take penicillin.
Scenario E
Test subject 2 was exposed to pathogen 3. Became moderately ill, but symptoms lessened abruptly after three days. Took penicillin beginning on day 1 of illness.
Scenario F Test subject 3 was exposed to pathogen 2. Became moderately ill, but improved within eight days; completely recovered after 12 days. Took penicillin beginning on day 2 of illness. Scenario G Test subject 3 was exposed to pathogen 3 Became moderately ill, but improved within eight days; completely recovered after 12 days. Had rubella as a child. Did not take penicillin. Scenario H
Test subject 4 was exposed to pathogen 1. Became very ill; remained ill for weeks without obvious improvement. Took penicillin beginning on day 2 of illness.
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Explain Copymaster 6.6
Copymaster 6.7 Complete Scenario Information
Scenario A
Test subject 1 was exposed to pathogen 1. Became mildly ill, but recovered completely within seven days. Was vaccinated earlier against rubella. Did not take penicillin.
Scenario B
Test subject 1 was exposed to pathogen 2. No signs of illness occurred. Was vaccinated earlier against rubella. Did not take penicillin.
Scenario C Test subject 1 was exposed to pathogen 3. Became moderately ill, but improved within seven days; completely recovered after nine days. Was vaccinated earlier against rubella. Did not take penicillin. Scenario D
Test subject 2 was exposed to pathogen 2. Became moderately ill, but improved within eight days; completely recovered after 12 days. Did not take penicillin.
Scenario E
Test subject 2 was exposed to pathogen 3. Became moderately ill, but symptoms lessened abruptly after three days. Took penicillin beginning on day 1 of illness.
Scenario F Test subject 3 was exposed to pathogen 2. Became moderately ill, but improved within eight days; completely recovered after 12 days. Took penicillin beginning on day 2 of illness. Scenario G Test subject 3 was exposed to pathogen 3. Became moderately ill, but improved within eight days; completely recovered after 12 days. Had rubella as a child. Did not take penicillin. Scenario H
Test subject 4 was exposed to pathogen 1. Became very ill and remained ill for weeks without obvious improvement. Took penicillin beginning on day 2 of illness.
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Explain Copymaster 6.7
Elaborate: Tony’s Brain Copymaster 6.8 Personal Interview with Tony
You are worried about your friend. He has turned down three of your invitations to go out. You decide to go see him at his house. His parents are happy that you came because he is not talking to them. You go up to his room to see him. “Hey, Tony, how’s it goin’?” “Oh, OK I guess,” Tony responds without enthusiasm. “Are you sick or something? You seem kinda down.” “I don’t think I’m sick now, but do you remember last semester? I was real sick for a few days and had a high fever.” “What about your soccer injury? You hit your head pretty hard in that game six or seven weeks ago. Does that still bother you?” “Yeah, I got whacked pretty good, but the doctor said it was just a mild concussion. After two days, I didn’t feel dizzy anymore. I think my head’s OK. Until recently, I felt good. Lately, though, I’m either tired and restless or I have too much energy and can’t relax.” Tony sighs as if he, too, is bothered by his behavior. “You’re not doin’ drugs or drinking, are you?” you ask tentatively. “No way, man! You know what happened to my brother because of that stuff.” Tony displays more emotion in this response than you have seen in weeks. “So you think everything’s OK, huh?” you say, even though you don’t really believe it yourself. “Nah. I’m not worried about anything. No cares in the world. Do you want to watch a movie?” Tony says. But you notice his voice is shaking a little and he seems almost on the verge of tears as he reaches for a DVD by his bed.
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Elaborate Copymaster 6.8
Copymaster 6.9 Some Disorders of the Brain Disorder Head injury
Behavior May Include
Body Abnormalities Brain Abnormalities May Include May Include
Loss of memory
Severe headaches
Swelling
Lethargy
Neck pain
Depressed areas
Depression
Nausea
Blood clots
“Spacing out,” Dizziness resulting in Seizures periods of missing time
Disorientation Loss of memory Depression Hallucination
Treatment: May require surgery to prevent bleeding and reduce swelling. As disease progresses:
Decreased brain size
• Tremors • Loss of body
Enlarged, fluidfilled ventricles
functions
Gradual loss of memory and ability to reason
Bipolar disorder (manic-depressive illness)
Encephalitis
Tests: EEG (electroencephalogram) may show electrical activity in injured portion of brain. Spinal tap may show blood in cerebrospinal fluid.
Loss of specific mental abilities
Alzheimer’s disease
Tests and Treatment
Regions of cell death
Tests: PET scan shows impaired brain activity occurs in middle-aged to elderly people. Family history may show similar problems. Treatment: Drug therapy to improve memory helps for a small percentage of patients.
Episodes of depression followed by episodes of mania (extreme activity and excitement; often includes compulsive behavior)
Fatigue followed by nervousness and sleep disorders
Loss of awareness
Severe headaches
Uncontrollable movement
Vomiting
Reduction in size of temporal lobe or cerebrum
Tests: Family history may show similar problems. Frequently appears during late teenage years. PET scan shows depressed glucose-utilization levels. Treatment: The drug lithium helps eliminate mood swings.
Stiff neck Sensitivity of eyes to light Fever
Tests: Blood tests show elevated white blood cell counts, indicating some type of infection. Cerebrospinal fluid pressure greatly increases. Bacteria are not present.
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Elaborate Copymaster 6.9 page 1 of 2
Copymaster 6.9 Some Disorders of the Brain (continued ) Disorder Multiple sclerosis
Behavior May Include Slurred speech Lack of balance Intoxicated appearance
Body Abnormalities Brain Abnormalities May Include May Include Tingling across chest Numbness in limbs Tremors in hands (Heat increases symptoms.)
Schizophrenia
Absence of myelin from neurons Hard tissue plaques present in brain
Disjointed thinking
Enlarged, fluidfilled ventricles
Constant distraction
Reduced blood flow in front portion of cerebrum
Socially withdrawn Loss of interest in surroundings
Tests and Treatment Tests: Electrical activity in brain pathways slows. Change in antibodies found in cerebrospinal fluid.
Tests: Frequently appears during late teenage years. Family history may show similar problems. Treatment: Administer antipsychotic drugs and behavioral therapy.
Hallucinations Stroke
Disorientation Loss of memory
Paralysis of portions of body
Hemorrhages in brain
Mood changes
Tumor
Treatment: Drug therapy reduces clots.
Loss of memory
Headaches
Disorientation
Loss of consciousness
Mood changes or mood swings Loss of specific mental abilities
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Test: CT scan shows presence of blood or blood clots in brain.
Paralysis Loss of specific abilities
Growth in brain
Tests: MRI may detect tumors. Treatment: Surgery, radiation, or chemotherapy can be used to remove or shrink tumor or kill tumor cells.
Elaborate Copymaster 6.9 page 2 of 2
Copymaster 6.10 Results of the Doctors’ Investigations of Tony’s Behavior After several trips to the family doctor that produce no treatment plan, Tony’s parents take him to a psychiatrist. The psychiatrist asks Tony and his family many questions and orders a series of diagnostic tests. The doctors obtain the following information from these procedures: 1. An interview by Tony’s family doctor reveals no significant information beyond what you learned in your interview. Tony continues to report that he has no pain. Tony is aware of his surroundings but is disinterested, his speech patterns are normal, and he appears unhappy, as though his outlook is hopeless. 2. A psychiatric survey of family history reveals that Tony’s family has a history of mental illness. Tony’s great-uncle was depressed, and his great-grandmother was committed to a mental institution for a short period of time when she was a young woman. 3. Psychiatric tests reveal a high intelligence level, good reasoning abilities, good pattern recognition, and somewhat faulty short-term memory but good long-term memory. 4. A physical exam indicates good general health, normal vision, and good reflexes and sense of balance. Lab tests show no traces of drugs in Tony’s urine, but they do show a somewhat impaired immune system, as indicated by a low white blood cell count. A brain scan for physical structure (MRI) shows no abnormalities such as tumors, blood clots, or inflammations. A brain activity scan (PET scan) shows slightly depressed levels of glucose utilization.
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Elaborate Copymaster 6.10
Elaborate: What’s the Risk? Copymaster 6.11 Risk Assessment Data
Accidental Death • In 2005, approximately 117,809 Americans died in accidents. This is fifth on the list of leading causes of death.
• The total number of people killed in traffic accidents each year is equivalent to a fully
loaded 737 passenger jet crashing every day. Auto accidents are the number one killer of Americans aged one to 44 years old and teens aged 15–19 years old.
• In 2005, 45,343 people died in motor vehicle accidents in the United States. This is part of a continuous downward trend since the 1970s. The number of people dying in traffic accidents has declined, although the number of cars on the road has increased.
• The number of teens dying annually in traffic accidents increases greatly between the ages of 14 and 15: from an average of 3.6 to 25.9 deaths per 100,000 persons (2005 statistics). Most of these deaths do not involve alcohol use.
Alcohol • Sixty-one percent of all American adults drink alcohol, but 10 percent of these drinkers consume 50 percent of all the alcohol sold.
• The National Center for Health Statistics reported that in 2005 there were 21,634 alcoholinduced deaths in the United States, excluding accidents and homicides.
• In 2007, about half of high school students in the United States had at least one drink in
the past month, and at least three-quarters of seniors had tried alcohol. This trend has been declining slightly since 1999.
• In 2007, 26 percent of high school students reported being heavy drinkers (five or more drinks at a sitting in the past month), down from 33 percent in 1997.
• Alcohol is involved in about 5,000 teen deaths annually, including traffic accidents,
injuries, suicides, and homicides. In 1998, 21 percent of the fatally injured drivers aged 15–20 had blood alcohol concentrations of at least 0.10 grams per deciliter. However, overall drunk-driving fatalities among teens fell by 63 percent between 1982 and 2006.
• Seven percent of all drinkers experience moderate levels of alcohol dependence (includes
three or more of the 13 dependence indicators, such as impairment of control, morning drinking, increased tolerance). People who begin drinking at an early age are more likely to become dependent on alcohol at some point in their lifetimes.
• Ten percent of all drinkers experience moderate levels of consequences of drinking, such as problems with a spouse, job, or school.
• More than 22 million people aged 12 or older reported drinking and driving during the
year 2000. However, 72 percent of Americans report having served as a designated driver or have been driven home by one.
• Forty-two percent of all Americans know someone killed or injured by a drunk driver. • The incidence of fetal alcohol syndrome has been estimated at from 1 in 600 to 1 in 1,000 live births. This disorder includes a range of mental retardation, growth deficiency, and facial deformity symptoms and results from exposure of the fetus to alcohol.
• Alcohol use by the mother contributes to low-birth-weight infants, which is a primary cause of high neonatal death rates.
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Elaborate Copymaster 6.11 page 1 of 6
Cancer Skin Cancer
• By age 18, the average American has reached the maximum recommended Sun exposure for his or her lifetime.
• About 50 percent of teenagers and 45 percent of those under 35 intentionally try to tan. Among adults, 56 percent report using some form of Sun protection, but the use of Sun protective behaviors fell between 2003 and 2005.
• In 2004, about 1.3 million cases of skin cancer were diagnosed. There are three types. Basal and squamous cell carcinomas are treatable when caught early. Malignant melanoma is more difficult to treat, but it can be cured if detected early.
• Approximately 75 percent of skin cancer deaths are caused by melanoma. The incidence of melanoma has almost tripled in the last three decades. Melanoma is the most common type of cancer in women aged 25–29.
• According to the American Cancer Society (2007), skin cancer is the most common of all
cancers. It accounts for nearly half of all cancers in the United States. It can affect people with all shades of skin color. More than 1 million cases of non-melanoma skin cancer are found in the U.S. each year. The American Cancer Society estimates that about 59,000 new melanomas will be diagnosed in the U.S. each year.
Breast Cancer
• Breast cancer kills an estimated 40,000 women each year in the United States. • A woman’s lifetime risk of developing breast cancer is now estimated at 1 in 8. • Breast cancers can be detected early by physical self-examination or mammogram. About 70 percent of women over the age of 40 are screened with a mammogram.
• Thirty to 90 percent of breast cancers can be cured depending on age and the stage when it was first diagnosed. Breast cancer survival rates have risen dramatically since the 1970s.
Lung Cancer
• Lung cancer kills about 46,000 women and 85,000 men each year in the United States. More than 87 percent of lung cancers are thought to be caused by smoking.
• Approximately 4,000 nonsmokers die each year because of lung cancer. Most of these result from exposure to secondhand smoke, the smoke from the cigarettes of nearby smokers.
• The incidence of lung cancer has been declining slightly since 1991. Colon and Rectal Cancer
• Approximately 138,000 people are diagnosed with colon and rectal cancer every year, and 60,000 die. Fatalities from these cancers have fallen steadily over the last 30 years.
• Colon and rectal cancers typically affect those over age 50. The incidence of these cancers has been declining slightly over the last two decades.
Prostate Cancer
• In the United States, prostate cancer is the second-leading cause of cancer death among men, though fatalities have been declining strongly since 1993.
• In 2008, an estimated 186,000 men were diagnosed with prostate cancer and approximately 28,670 will have died.
• Men over age 40 should have regular prostate cancer exams because the survival rate is very high for patients diagnosed early.
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Elaborate Copymaster 6.11 page 2 of 6
Cervical Cancer
• Cervical cancer is most frequently diagnosed among women under the age of 50. It is estimated that 11,000 new cases were diagnosed in 2008. One in 145 women will be diagnosed with cervical cancer in their lifetimes.
• The Pap test has made it possible to detect this cancer early, and successful treatment has resulted in a sharp decline in the number of deaths.
• Cervical cancer has been linked with infection by the human papillomavirus. A vaccine
against this virus became available in 2006 and is being recommended for girls and women under the age of 25.
• Women are more likely to develop cervical cancer if they began having sex before the age of 18; have had many sexual partners; or have had many pregnancies, beginning at a young age.
Eating Disorders and Obesity
• Thirteen percent of all American high school students are obese, an increasing trend despite the fact that half of all students are trying to lose weight.
• Obesity is a major contributor to the top killer in the United States, cardiovascular disease, as well as to adult-onset diabetes, the sixth-leading cause of death in Americans.
• The percentage of students consuming the recommended amounts of fruits, vegetables, and milk is less than 20 percent, and this percentage has been declining since 1999. Only a little over a third of American high schoolers meet the recommended levels of physical activity.
• The National Institute of Mental Health (2007) estimates that in their lifetime, 0.5 percent to 3.7 percent of females suffer from anorexia, and 1.1 percent to 4.2 percent suffer from bulimia. Over 3 percent of women and 2 percent of men reported having a binge-eating disorder, a cause of obesity, at some point in their lives.
• Anorexia is increasing among the eight- to 11-year-old age bracket. More than half of all
tweens and teens report wanting to lose weight, even though girls gain on average 18 kg (40 lb) during normal adolescent development.
• Teenagers without eating disorders consume 2,000–3,000 calories per day; a teenager with bulimia might consume 3,400 calories in a four-hour binge.
• Without treatment, up to 20 percent of people with eating disorders die, but with treatment, 98 percent survive.
Hearing Loss
• In 2005, 31 million Americans suffered from hearing loss. Fifteen of every 1,000 individuals under the age of 18 have some type of hearing impairment.
• One-third of all hearing loss is caused by loud noises. (Eighty decibels or louder will cause damage.)
• A typical rock concert is 110 decibels. Heart Disease
• Heart disease is the number one cause of death among Americans. • More than 61 million Americans have some form of cardiovascular disease. • Each day, more than 2,600 Americans die because of heart disease.
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Elaborate Copymaster 6.11 page 3 of 6
• According to the American Heart Association (2004), nearly twice as many women in the United States die of heart disease and stroke as from all forms of cancer.
• Males have a 1 in 3 chance of having a heart attack before age 60. • The estimated cost for treating heart disease is $329 billion per year. • The primary risk factors are being overweight, smoking, increasing age, high cholesterol,
high blood pressure, excess fat in the diet, diabetes, being male, a sedentary lifestyle, and a family history of heart disease.
• Stress and depression increase the risk of cardiovascular disease. • People with type A personalities (competitive, intense striving for achievement, quick
temper, and impatient) have a twofold greater incidence of coronary heart disease than nontype A personalities.
Seat Belts
• Seat belt use has been rising among teens. In 2007, only 11 percent of American high school students rarely or never used their seat belts when riding in a car.
• In 2007, 28,933 occupants of passenger vehicles were killed in motor vehicle accidents. • In 2006, seat belts saved an estimated 15,383 passenger vehicle occupants over five years old.
• In 2007, 82 percent of Americans wore seat belts regularly. • You are far more likely to be killed if you are thrown clear than if you remain in the vehicle during an accident. Less than one-half of 1 percent of all accidents involve fire, so fear of needing time to escape is a poor reason to avoid using seat belts.
Sex and Sexually Transmitted Diseases
• Nearly half of all American teenagers have had sex, though this trend has been declining slightly since 1991.
• In 2007, 35 percent of American high school students reported being currently sexually
active. One in 8 females aged 15–19 becomes pregnant each year. Teen pregnancy rates are higher in the United States than in most other Western countries.
• Engaging in sexual behavior places people at risk for sexually transmitted diseases (STDs). • STDs affect more than 12 million Americans yearly. • Every year in the United States, 1 in 7 teenagers contracts an STD. • The use of condoms among American high school students has risen from 46 percent to 62 percent between 1991 and 2007, though male teens report using condoms less frequently as a relationship continues. Only 35 percent of sexually active teens report always using a condom.
• About 22 percent of American high school students report that they drank alcohol or used drugs the same time they last had sex.
Herpes
• Herpes simplex virus is a latent (hidden) virus that lives in nerve cells without causing
symptoms until some stressor (such as illness, lack of sleep, or drug abuse) causes it to become active. The two predominant forms can cause oral or genital sores, can be spread during sex, and persist as lifelong infections.
• There are 500,000–1,000,000 new cases of genital herpes every year.
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Elaborate Copymaster 6.11 page 4 of 6
HIV
• The human immunodeficiency virus (HIV), which causes acquired immunodeficiency
syndrome (AIDS), has infected at least 1.3 million Americans and has caused the death of at least 525,000 since it was first identified in 1981.
• About 40,000 Americans contract HIV each year. As many of 25 percent of people infected with HIV in the United States do not know that they carry the virus. In recent years, an increasing percentage of cases are identified in black and Hispanic populations.
• About 66 percent of the U.S. population between the ages of 15 and 44 have been tested for HIV at least once. The cost of treating an HIV-infected individual runs about $18,000 per year.
• Worldwide, at least 33 million people are estimated to be living with HIV/AIDS. Of these, 30.8 million are adults, 15.5 million are women, and 2 million are children. Twenty-five million worldwide have died from the infection.
• Worldwide, an estimated 2 million people died of AIDS in 2007, down from 3 million in 2001.
• Thirty percent of infants born to HIV-infected mothers also are infected. • Worldwide, more than 70 percent of all people infected with HIV contracted it through
heterosexual sex. Homosexual sex and intravenous drug use account for most of the other cases.
Smokeless Tobacco
• According to the Centers for Disease Control and Prevention, as many as 20 percent of high school boys and 2 percent of high school girls use smokeless tobacco. Overall, 8 percent of high school students used smokeless tobacco in 2007.
• There are more than 30,000 new cases of oropharyngeal (mouth-throat) cancer annually.
About 75 percent of oropharyngeal cancers are directly attributable to the use of tobacco. Only about 50 percent of these people are alive five years after diagnosis.
• Quitting smokeless tobacco is difficult because of the high concentration of nicotine. Smoking
• Eighty million packs of cigarettes are smoked each day by 50 million American smokers, making up 21 percent of the population.
• More than 3,000 teenagers start smoking every day (about 1,100,000 per year), and girls are more likely to smoke than boys (20 percent versus 16 percent). Half of high schoolers have tried smoking.
• Cigarette smoking among high school students in the United States declined from 35
percent to 20 percent between 1999 and 2007. The percentage of smokers varies by racial and cultural background. In 2007, 11.6 percent of smokers were black, 23.2 percent were white (non-Hispanic), and 16.7 percent were Hispanic.
• Cigarette smoke contains about 4,000 chemicals, including DDT, arsenic, and formaldehyde. At least 43 of these chemicals are known to cause cancer.
• After smoke has been inhaled, the lungs retain 70–90 percent of the compounds contained by the smoke.
• Approximately 400,000 Americans die prematurely each year because of smoking. This is more than the number of deaths due to cocaine, heroin, alcohol abuse, auto accidents, homicide, and suicide combined.
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Elaborate Copymaster 6.11 page 5 of 6
• Of every 100 regular smokers in the United States, one will be murdered, two will die in
traffic accidents, and 25 will be killed by tobacco use. The Journal of the American Medical Association reported that “cigarette smoking is the single most preventable cause of premature death in the United States.”
• Eighty-seven percent of lung cancers in men, and more than 75 percent of lung cancers in
women, are caused by smoking. Only 13 percent of the people diagnosed with lung cancer are alive five years later.
Suicide
• In 2005, suicide was ranked number 11 as the most frequent cause of death in the United States.
• In 2005, suicide was ranked third as the leading cause of death for 15–19-year-olds. Seven percent of all high schoolers made one suicide attempt in 2007.
• Nearly 15 percent of all high school students reported seriously considering attempting suicide in 2007.
• Seventy-nine to 85 percent of suicide victims suffer from alcoholism, depression, or both.
Other mood disorders, including bipolar disorder and anxiety, increase a person’s likelihood of attempting suicide by as much as 20 times more than a person without a mood disorder.
• The majority of suicides in the United States involve firearms. Studies have demonstrated that easy access to firearms contributes to successful suicides.
• The attempt on one’s own life is often an impulsive act; a person prevented from committing suicide may never be suicidal again.
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Elaborate Copymaster 6.11 page 6 of 6
Copymaster 6.12 Taking Risks: A Self-Evaluation Controllable Risks Seat belts
Hearing loss
Smoking
Smokeless tobacco
Alcohol
Drunk driving
Risk Level
Your Risk
Wear
Never
10
Sometimes
4
Always
0
10
4
0
5
3
1
Exposure to loud noises
>5 times/year
5
2–5 times/year
3
Never
1
Smoke
>1 pack/day
20
½–1 pack/week
15
<½ pack/week
10
Don’t smoke
20
15
10
0
12
9
6
0
20
15
9
0
0
Dip or chew
>3 times/day
12
1–3 times/day
9
2–3 times/week
6
Never
0
Drink
>15 drinks/week
20
10–15 drinks/week 15
3–9 drinks/week
9
<3 drinks/week
0
Drive drunk
>5 times/year
30
1–5 times/year
24
Never
30
24
0
30
24
0
0
Ride with drunk driver
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
>5 times/year
30
1–5 times/year
24
Never
0
Elaborate Copymaster 6.12 page 1 of 2
Copymaster 6.12 Taking Risks: A Self-Evaluation (continued) Controllable Risks Skin cancer
Risk Level Intentionally tan
>30 days/year
20
6–30 days/year
15
0–5 days/year
10
Fair-skinned Sexually transmitted diseases
Your Risk
20
10
15
10
10
Unprotected sex (including oral sex)
6 times/year
15
1–5 times/year
12
0 times/year
15
12
0
0
IV drug use
9
Protected sex
2
Abstinence
0
9
2
0
Your risk score: _________
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Elaborate Copymaster 6.12 page 2 of 2
Evaluate: Health Care Proposal Copymaster 6.13 Health Care Proposal Rubric Criteria
Could Be Improved
Needs Substantial Improvement
Health care proposal shows thorough understanding of how homeostasis in the human body may be disrupted by external and internal factors.
Health care proposal shows general understanding of how homeostasis in the human body may be disrupted by external and internal factors.
Proposal shows clear understanding that humans are subject to many health risks that are frequently affected by their own behavior.
Proposal shows basic understanding that humans are subject to many health risks that are frequently affected by their own behavior.
Health care proposal includes brief explanations or uses some incorrect statements that make it difficult to see evidence of the writer’s understanding of how homeostasis in the human body may be disrupted.
Explanation: Explanation for proposal, including specific evidence to support ideas
Health care proposal uses 3 or more specific references to research data that explain why the proposed treatment program is needed.
Health care proposal uses at least 2 specific references to research data that explain why the proposed treatment program is needed.
Health care proposal uses no specific references to research data. Or it uses references incorrectly to explain why the proposed treatment program is needed.
Explanation: Explanation for homeostasis, including specific evidence to support ideas
Health care proposal uses specific examples. It thoroughly explains which organs or regulatory systems will be most directly affected by the care provided by the treatment.
Health care proposal uses few specific examples. It generally explains which organs or regulatory systems will be most directly affected by the care provided by the treatment.
Health care proposal uses no specific examples. Or it incorrectly explains which organs or regulatory systems will be most directly affected by the care provided by the treatment.
Proposal uses specific examples and thorough explanations to describe the homeostatic disruption and the proposed treatment.
Proposal uses a few specific examples and general explanations to describe the homeostatic disruption and the proposed treatment.
Concept: Showing understanding of the big picture in this chapter
Excellent
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Proposal shows little understanding or uses incorrect assumptions about how humans are subject to many health risks that are frequently affected by their own behavior.
Proposal uses no specific examples or it uses incorrect explanations to describe the homeostatic disruption and proposed treatment.
Evaluate Copymaster 6.13 page 1 of 2
Copymaster 6.13 Health Care Proposal Rubric (continued ) Criteria
Excellent
Could Be Improved
Needs Substantial Improvement
Explanation: Explanation for risk assessment, including specific evidence to support ideas
Health care proposal uses research data to explain how common the illness or injury is that will benefit from its services.
Health care proposal uses little research data to explain how common the illness or injury is that will benefit from its services.
Health care proposal uses no research data to explain how common the illness or injury is that will benefit from its services.
Proposal uses few examples and general explanations for how the proposed treatment program will meet the peoples’ needs.
Proposal does not use examples. Or it gives incorrect explanations for how the proposed treatment program will meet the peoples’ needs.
Proposal uses specific examples and thorough explanations for how the proposed treatment program will meet the peoples’ needs. Description of the illness or injury to be treated uses research data and examples to explain the roles that behavior and choice play in a person’s risk of being affected by this ailment. Explanation: Explanation for ethical analysis, including specific evidence to support ideas
Description of the illness or injury to be treated doesn’t include any research data to explain the roles that behavior and choice play in a person’s risk of being affected by this ailment.
Health care proposal uses research data to identify and explain an ethical dilemma that is associated with the proposed treatment.
Health care proposal uses little research data to identify and explain an ethical dilemma that is associated with the proposed treatment.
Health care proposal uses no research data, or it incorrectly interprets data to identify and explain an ethical dilemma that is associated with the proposed treatment.
The writer states his or her own concerns regarding that dilemma.
The writer briefly states his or her own concerns regarding that dilemma.
Proposal includes an ethical analysis using the 6 steps outlined in the essay Ethical Analysis.
Proposal includes an ethical analysis that briefly refers to the 6 steps outlined in the essay Ethical Analysis.
The writer’s statement about his or her own concerns regarding that dilemma does not make sense.
Writer explains his or her own decision as a result of that analysis. Presentation
Description of the illness or injury to be treated doesn’t use research data or examples effectively to explain the roles that behavior and choice play in a person’s risk of being affected by this ailment.
Answers are easy to read. Grammar and punctuation are used correctly, making it easy to understand what was meant.
Unit 2/Chapter 6 Copyright BSCS. All rights reserved.
Writer’s decision is briefly related to that analysis. Answers are fairly easy to read.
Proposal includes an overly brief ethical analysis. Writer’s decision is not related to the analysis steps outlined in the essay Ethical Analysis. Answers are difficult to read.
Grammar and punctuation are frequently used incorrectly. Grammar and punctuation are generally Often, it is difficult to be sure used correctly. Sometimes what was meant. it is difficult to be sure what was meant.
Evaluate Copymaster 6.13 page 2 of 2
