In response to an emergency, EMS workers are often the first people at the scene. As they attend to the person or people involved in the crisis, they may not be aware that the individual has an autism spectrum disorder. If this is the case, the EMS worker will need to respond in a different way, while providing the quickest and most efficient care possible. Sometimes the ability of these EMS workers to respond in an effective timely manner will save the individual's life. Since individuals with autism spectrum disorders may respond differently to certain stimuli and medical examinations, it is crucial for EMS workers to be able to recognize certain signs that may indicate the individual is on the spectrum and alter their method of treatment accordingly.
Quick Facts for EMS:
- Some individuals with autism do not have a normal range of sensations and may not feel the cold, heat, or pain in a typical manner. In fact they may fail to acknowledge pain in spite of significant pathology being present. They may show an unusual pain response that could include laughter, humming, singing and removing of clothing.
- Individuals with autism often have tactile sensory issues. Band-aids or other adhesive products could increase anxiety and aggression.
- Move slowly, performing exams distal to proximal. Explain what you plan to do in advance and as you do it. Explain where you are going and what they may see and who might be there. This may avert unnecessary anxiety and/or outbursts or aggressions from the patient. Individuals who appear not to understand may have better receptive language, which is not entirely evident.
- Expect the unexpected. Children with autism may ingest something or get into something without their parents realizing it. Look for less obvious causality and inspect carefully for other injuries.
- If possible ask a caregiver what the functional level of the individual with autism is, then treat accordingly. Stickers, stuffed animals and such which are used to calm young children may be helpful even in older patients.
- Attempt to perform exams in a quiet spot if at all possible, depending on the severity of injury and safety of the scene. Demonstrating what the exam will consist of on another person first may help the person with autism have a visual knowledge of what your intentions are.
Rzucidlo, S.F. (2007). Autism 101 for EMS, from SPEAK Web site: www.papremisealert.com
Resources for EMS
Autism Alliance for Local Emergency Responder Training
Autism 101 for EMS
The Autism and Law Enforcement Education Coalition
Autism Risk and Safety Management
Community and Law Enforcement Aware Response
Autism 101 for Fire and Rescue Personnel
Autism Society: Information for Paramedics and Emergency Room Staff