Emergencies are chaotic events. They cause a great deal of stress not only for those directly involved but also for their family and friends. The conditions present during an emergency often bring out emotional distress and panic, which, in turn, often lead to poor decision making and irrational actions. This is a difficult experience for anyone. However, now imagine that you have a disability that restricts your mobility, your ability to speak, or your ability to process information clearly, magnifying the impact of an emergency. Even a simple emergency becomes a much more terrifying and potentially life-threatening event.
The health and welfare of a person with a disability rely heavily on the fire prevention training, preplanning, and response of the emergency responders in their area. These individuals are more likely to need help and rely more on emergency responders when they need help. As responders, we need to be aware of this and ensure that we are prepared to help, and we need to do it before an emergency happens. Responders should know which people may need more help than others, where they live, what the disability is, and how the disability impacts the individual with the disability.
Persons with a disability (and their families) live much of their everyday lives at a constantly high stress level. Emergency responders need to ensure that they are proactively doing what they can to make their lives safer, reducing their stress level and increasing their quality of life.
Think of what it would be like if your life was always stressful and then an emergency situation, such as a fire, arises. At this point, the stress can become debilitating. As hard as you try, you can’t speak or even move; the harder you try to do something, the less successful you are. That is what it can be like for individuals with a disability. If you don’t know this as an emergency responder, you may make the situation worse for the person you are trying to help, for yourself, and for other responders.
Moreover, if the stress from the emergency event wasn’t enough, add in even more stressors like a big red truck, sirens, flashing lights, large tools, masks, positive-pressure ventilation fans, and blaring portable radios. At this point, a meltdown is not only possible, but likely, making self-rescue nearly impossible for an individual with a disability.
All firefighters should receive training in and become familiar with the disabilities of residents in their response area. They should get to know them and their families because these residents are not only more likely to be involved in an emergency, but they are also more likely to need our help during that emergency. This is at the core of why we exist as emergency responders.
Autism Spectrum Disorder (ASD)
Disabilities generally can’t be determined by physical appearance. There may be some occasions when a disability may be evident through appearance, but don’t plan on it. Most times, responders must be familiar with various disabilities and trained to look and listen for cues before they can recognize them.
This category includes a wide spectrum of neurological conditions the individual may experience. Diagnoses in this category are increasing. The disabilities relate to language/communication, social skills, and behavior. An individual with a spectrum disorder may make repetitive motor movements such as spinning, spitting, rocking, or flapping, which are likely to increase in severity as the individual’s level of stress increases.
An individual with ASD may have a strong focus on specific favorite items, such as a super hero, a celebrity, a type of vehicle, items with common shapes, items with common colors, or even specific foods like black licorice. The individual may make little or no eye contact and usually averts his gaze. The individual may be nonverbal and completely unable to talk or may be able to talk but has difficulty communicating.
In stressful or emergency situations, the individual may act in an inappropriate manner by humming, laughing, or singing. In addition, he could appear completely preoccupied or unaware that a fire is burning around him even though the smoke detector is alarming right above his head and smoke is in the air.
The firefighter must know that an individual with a spectrum disorder most often cannot be recognized by his appearance and that, in an emergency, this individual likely will hide in a favorite spot, run away from emergency responders, refuse or appear to refuse to cooperate, and insist on finishing a menial task before exiting a burning building. He may not like being touched even if it is done to get him to safety. The sooner emergency responders recognize this, the better prepared they will be to successfully and safely handle the situation. Preplan before an incident occurs.
Hopefully, you are beginning to get a picture of how important it is that emergency responders and safety professionals do our best to proactively help those with disabilities and their families. We must know who these people in our communities are. We must train our responders to recognize disabilities and to react appropriately using techniques that calm the individual. This means speaking slowly and calmly, using short, clear sentences like “wait here” or “get in.”
We must reach out to this population and their families and provide fire safety training in an individualized manner because traditional group fire station tours and fire prevention presentations are often not effective for those with a disability. Proper response techniques will help calm the situation.
The important thing to remember is to reduce any stressors without compromising your or others’ safety. Additional stressors you may or may not be able to reduce include sirens and emergency lights at the scene.
Emergency Medical Services (EMS)
In EMS situations, it is important to note that those with ASD may have an easily triggered gag reflex and may not tolerate an oxygen mask. It is appropriate for the responder to model the desired behavior while remaining with the individual in case he panics and tries to flee from care or run back into a home on fire. Also, individuals with a disability may not feel cold, heat, or pain in a typical manner, so they may not know they are injured or how severely. They also may be prone to seizures, especially if flashing emergency lights are nearby.
The fire department needs to be a fire prevention resource for everyone in the community, including individuals with disabilities and their families. A good way to begin is to partner with local resources such as the school district and parent groups. Get to know them, use them as a resource, develop a program, build a reference library of resources to hand out, get to personally know the individuals in your community who have a disability, and get to know what the specific disability is. Doing this will help you to get to know, teach, and respond to the individual.
Although there are many types of disabilities, they often involve similar care actions. With a little effort on our part, we can help those in our community with disabilities lead safer lives. Methods we can use to teach fire safety include video modeling, social stories, and one-on-one contact.
While teaching appropriate actions, there will also need to be a focus on the specifics of each step. For example, when teaching about escaping a fire, cover step by step a detailed description, practice the things that alert you to a fire, follow through on the actions needed to escape a fire: routes, the doors and locks, the speed of actions, and so on.
If you have the staffing, schedule home visits; this is a good way to get to know the individual and his disability. It also provides responders with an opportunity to develop a relationship with the individual, which will be helpful in an emergency situation, and to become familiar with the individual’s residence from a preplanning perspective-for example, identifying special locks that may be in place or favorite hiding spots.
CRAIG NELSON is a battalion chief for the Fargo (ND) Fire Department. Over the years, he has worked part-time at Minnesota State Community and Technical College as a fire instructor and seasonally for the Minnesota Department of Natural Resources as a wildland firefighter in Northwest Minnesota. Prior to working in the fire service, he was an airline pilot. He has a bachelor’s degree in business administration and a master’s degree in executive fire service leadership.
Craig Nelson will present “Special Needs Fire Prevention and Response Awareness” on Thursday, April 21, from 10:30 a.m.-12:15 p.m., at FDIC International 2016 in Indianapolis.
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