Think-Ability: Responding to Patients with Disabilities

Pulling up on an emergency call for a 30-year-old male in respiratory distress may be a routine call for many EMTs and Paramedics today.

However, what happens when a victim has cognitive disabilities that make communication difficult and the patient becomes agitated? Or when we find an unconscious child with parents who are deaf and unable to communicate efficiently?

As emergency responders, we're often taught to expect the unexpected, take charge, and do whatever needs to be done to resolve the situation appropriately. When it comes to people with disabilities, it becomes "yet another" issue that we need to take into consideration. Unfortunately, disability issues are often clouded by misinformation or lack of exposure.

Part of this series will explore how to respond to different scenarios involving patients with disabilities. Other columns will look at issues involving disability and the people who work in the emergency services field.

In this initial column, we'll explore some general thoughts about people with disabilities and then identify some resources where you can get more information as a first responder.

First, let's put some some facts out there:

• There are 54 million people with disabilities in the United States today
• This represents approximately 20 percent of the population.
• The percentages are higher in the South with West Virginia having the highest at 24.4%
• African-Americans and Native Americans also have higher disability rates at 24.3% but Asians have the lowest rates at 16.6%.

It stands to reason that people with disabilities may need our services as first responders more often than those without. While hard statistics are hard to come by, the anecdotal evidence seems to bear this out.

The next question: just who are all these disabled folks anyway? The strict definition of a disability is a physical, sensory, mental or cognitive impairment that limits one's ability to participate in basic activities such as walking, reaching, lifting, climbing, etc.. Unfortunately, in this day and age of expanding waistlines and the baby boomers qualifying for AARP membership, it becomes readily apparent that the government's definition of "disabled" is overly broad. Instead, for this column, we'll focus on more traditional disabilities: cognitive disabilities, hearing and vision impairments, and folks who have mobility impairments.

Let's go over some rules of thumb when working with people with disabilities. Of course, these "rules" cannot apply in every situation but they're a good guide to follow.

• Always ask the person the best way to assist them. The answer (or lack thereof) will usually give you a significant understanding of any disabilities you may be facing.
• Don't assume what a person's abilities are based on outward signs. In other words, just because a person has a white cane doesn't mean they're completely blind. In fact, "blind" people range from a severe vision loss to perfect vision but within a very small field (sometimes called tunnel vision).
• When you're talking to people with disabilities, be sure to do just that: talk to the person. Oftentimes, people end up talking to the disability or any outward sign of it. In other words, they talk to a hearing aid, or they'll talk to a wheelchair and it comes across as condescending. Rather, focus squarely on the person and their responses.
• Be calm, cool and collected. It is OK to admit that you have not been exposed to a certain disability and it is equally OK to ask questions but project an air of confidence and competence.

Online Resources:
- National Organization On Disability: www.nod.org
- University of New Mexico's Center for Development and Disability puts out a great pocket-sized flipchart on disability: http://cdd.unm.edu/products/TipsForFirstResponders.htm