The banner above represented a key day of awareness for a topic that I have taken a passion into researching lately. One of the main reasons that I am interested in the topic of autism is the fact that fire and EMS have struggled trying to figure out the best way to handle emergency responses with individual affected with autism.
Today represents the World Autism Awareness Day, and as a group of providers that represents a large sector of the healthcare system we should embrace the meaning of this day. What is Autism and why does it matter to Fire and EMS responders? Well, answering the first question can be kind of difficult. Without looking at the official definition of autism or autism spectrum disorder, it can be difficult to determine if somebody is affected by this condition. I will look at the definition of autism shortly, but this leads me into the second statement; why does it matter to Fire and EMS responders?
On the fire side, multiple children with autism have lost their lives in fires as they retreat to areas they know well, and/or they attempt to hide from emergency responders because they take them out of their comfort zone. EMS responders are faced with urgent situations conerning children with autism on very regular occasions, and the responding crews are faced with difficult experiences that can potentially border on the combative.
Looking at www.autismspeaks.org, autism and autism spectrum disorders are two general terms to describe "complex disorders of brain development. Now continuing to dig further into the definition of autism will result in your review of a wide variety of behavioral manifestations that will leave you baffled in trying to tailor your emergency response care to their individual needs. Some may have intellectual difficulties, while others experience motor skill deficits and others with GI issues. The list can go on and on, and while some have plenty of deficits, others have significant focus on the arts and will excel in one area with lack of other skills that their peers may have.
As mentioned above, individuals with autism have been noted to hide from emergency responders in time of need such as structural fire attacks. Individuals with autism may have difficulty around strangers which would not lend themselves to impromptu meetings with firefighters, but that situation is exacerbated when those same firefighters are yelling their names through a self-contained breathing apparatus and fire resistive suits. Results from these situations have led to children dying to early in life because they have hid in closets or other places of comfort. How do we as emergency responders help with these individuals. In a fire situation it is a matter of education. I have a good friend of mine that spoke with me about some of the things they used to do with their child. They would actually conduct home fire drills (both planned and unplanned) that would help prepare their child for the unexpected nature of potential fires. They worked out a plan for exit and would also speak about what happens if the primary plan would fail. Because of the potential exact nature of these individuals, you must speak early and often about plans and alternates. So as part of our community education plans, seek to identify families in your community that have family members with autism. Work with those families to develop a comprehensive fire safety plan and a schedule to conduct drills in the house to facilitate individual with autism to seek refuge outside the home instead of inside. Also, work with the families to have them come by the station and let the individual with autism see that the firefighters with all their gear are not there to harm them. Let them see the firefighters put on their gear. Talk about the Gear, and maybe even put it on themselves. This will offer something they can remember.
As EMS responders, the potential is much different. As EMS providers we are going into a situation where an individual with autism has received an injury or are sick. They may be more protective of themselves because of the injury or illness and may not work well with you to help their situation. They may believe that interventions you accomplish as a provider will cause further harm or illness. How can we prepare? Go to the Autism Society and review the education program at the Safe and Sound Campaign. The website has information for first responders, which can help us prepare our response for individuals with autism. On the job training when you get on-scene of an injury or illness to an autistic individual is not the time to try and learn how to interact with these individuals. Having the knowledge about how to interact with individuals with autism will ensure that we "first do not harm".
So as you get on shift tomorrow, or prepare your lectures for the classes next week, think about where you or your students stand when it comes to responding to individuals with Autism. Prepare them before they need the skills. Make sure they understand that involving the parents in the care plan may be instrumental. Simply google/bing/yahoo (insert favorite search bar here) autism and learn all you can about Autism. It will certainly help you, and will provide a better care plan for these individuals.
Take Care and Stay Safe!
The Combomedic
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