Disabilities affect one-fifth of all Americans.
54 million Americans have some form of disability.
27 million have a severe disability.
50% of Americans over the age of 65 have a disability.

Running a patient who has special needs is not a matter of “if” but “when.” Ignoring the problem creates anxiety for the responder, tension for the patient, and frustration for others on scene including family members and care givers. Ultimately, this could result in poor patient care or undesirable citizen service. A responder who is in this situation may have the best intentions but may not be aware that his or her actions are having an adverse impact on the community.

As emergency responders, one of the things that cause us to feel uncomfortable is dealing with the unknown. This is the reason that we train. The “routine” call becomes more familiar when we discuss the problem before the incident. We educate ourselves and practice, and then we review our performance to see how we can do better the next time.

Dealing with children often creates anxiety for responders. We do not respond to emergencies directly involving children every day. We also do not typically respond to individuals with special needs who are having an emergency. When you couple these two things, the potential exists for a responder to experience anxiety while trying to mitigate the situation.

The best way to prepare for this type of emergency is the same way you would prepare for any emergency: to educate yourself and others you respond with, and to train for the potential. It is often beneficial to include other people such as social workers, teachers, doctors and nurses, or therapists in your training sessions. You may also be able to find parent or caregivers who would be willing to talk or participate in your training sessions. Not only do these people work on a daily basis with individuals with special needs, but it will develop a network of resources that you can call upon in the future.

The Scariest Disabilities
Disabilities can come in many different forms. They may be physical, mental, or both. Responders are typically better able to deal with physical disabilities. Physical disabilities may involve a lack of function and an inability to perform common tasks. The defect could also involve organs or systems that you cannot see such as the heart or lungs. Frequently, the patient or caregiver will know about the condition prior to our arrival and will be able to give you advice not only to care of the physical need, but the emotional needs as well.

Developmental disabilities create a different type of anxiety for responders. In not too distant history, people with developmental disabilities were institutionalized and kept far away from society. Today, people with developmental disabilities are fully integrated into public school systems, go to college, get married, drive cars, and hold full-time jobs with benefits. They want to participate in society and be a part of “normal” life. Because of this “main-streaming,” you will have interactions with people with intellectual disabilities.

How to Talk
My son Spencer has Down syndrome. Prior to Spencer, I had no experience with people with disabilities. I felt uncomfortable because I was afraid I would say the wrong thing or because I did not know how to communicate with the person. Even now, I still find myself uncomfortable in certain situations. The difference now is that I know how to overcome my own insecurity and interact with the person close-up.

As responders, we should treat everything we say in public like it is being broadcast over channel one; words such as ‘retarded” and “retard” have become part of normal conversation for many people. The use of these words, especially by the heroes that these people look up to, creates pain and indicates a lack of respect. The words we choose can directly impact our attitudes. If you don’t believe me, go to the website www.r-word.org.

Communication is critically important with both the patient and the family. Putting the person first is one easy way that you can put the person ahead of the disability. This can be done by saying “individual with Down syndrome” instead of “a Downs kid.” This shows emphasis on the person and not the disability.

A Simple Solution
Since communicating with individuals with special needs can be one of the most frustrating for responders and the people involved, building a relationship with the people who have a disability in your district may be a good idea. At the Overland Park Fire Department we found that having a Special Needs Day does many things to help the person with special needs, their families, and the responders.

Our Special Needs Day (or Firefighter Fun Day) gives the kid with special needs and his/ family to experience the activities such as fire truck rides, fire and extrication demonstrations, and an interactive lunch where the emergency responders eat lunch with the kids and their families. Many of the neighboring jurisdictions participate in the day so that the kids can have the maximum benefit for the time they are there.

Over time, we have found that the responders get as much (or more) out of the day as the kids. Clinically, the interaction gives the responder an idea of what types of patients are living in their district. The experience also gives the responder the opportunity to develop relationships so that the first time he or she comes in contact with a person with a developmental disability is not at 2:00 AM in the patient’s bedroom. This gives the responder an idea of how to better communicate and interact with the patient and family, reducing the potential for uncomfortable incident scenes.
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To learn more about taking care of patients with special needs or to find out how you can set up your own Special Needs Day, make plans to attend the FRI workshop, “Taking Care of Patients with Special Needs” on Thursday, August 27 from 1:30-3:00 pm.

You can also contact the Overland Park Fire Department for additional information at www.opkansas.org. To learn more about our Firefighter Fund Day, visit the city website, click on the “Fire” link and visit “Special Needs Fire Fun Day.”

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