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Conscious but unresponsive?


DwayneEMTP

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Everybody has anectdotal evidence that a particular treatment will "cure" autism. I've yet to see any of them backed up scientifically. Hey now, if it works for your kid great, but my wife and I have bought into too many ad-hoc plans of treatment that amounted to nothing more than snake oil.

As you said, every autistic patient is different. Makes it tough to say that any one treatment will work better than any other now doesn't it?

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Thanks to all.

The said "program" doesn't even claim to cure autism on it's own page. Doesn't mean it's not good though...Thanks for the link.....

To all....didn't mean to start an autism discussion in the scenario forum...sorry.

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Dwayne:

I would personally like to thank you, this is a very thought provoking situation, any apology is far from indicated as your scenario/ fears as a parent are very realistic and quite valid concerns and good teaching points.

I have had some experience in the Triage Officer role with this type of presentation and especially if no medic alert or indication of history was evedent I would suspect that your son would be treated as a head injury, with a possible complication of abdo involvement.

Quiet children gain my attention far more quickly than a crying or noisy child....as they are moving air. Having a tiny bit of experience with ASL, attempts would be made with this form of communication, but under the circumstances and the picture you paint it would be doubtful that ASL would produce a positive response.

I believe ( but you never know till your wearing that hat and standing in the rain) that I would Triage this patient as Yellow in the system that I work, ironically would most likely be bumped up within that category.

If chemical sedation was indicated, I would be very conservative, as this is frowned upon by the Neuro Men that I work with, the indiscriminate use of Benzodiazapines can mask and complicate the picture.

The use of Halodol on a child would be not prudent....and may produce idiosyncratic response's.....children should not be treated as small adults.

Never the less, this is an excellent teaching point....."Expect the Unexpected" and as the forum commentators suggest there is far many more individuals in the EMS community that are Very Aware of the needs of your child.

Breath Easy Dwayne

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Thanks again everyone. I have to admit I'm pretty surprised by the responses. I had assumed going in that he would be treated as combative, if not mistakenly hostile. I am amazed by how many of you are at least somewhat familiar with special needs children hands on, but also it seems like most have given some thought to this "just in case".

We attempted to get him to wear a medic alert braclett when he was younger but he wouldn't tolerate it, but it is certainly time to try again.

If the ems community cares enough to consider him and those like him, I will make sure they have as much info as possible to treat him with.

As always, thanks for reading between the lines and answering the questions I don't know how to ask properly.

Dwayne

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  • 1 month later...

Im fairly late to reply to this, but not once did you mention an ID band, bracelet, or (not sure) a necklace. The EMS personnel should be aware of his autism right off the bat to better prepare your son for his treatment, rather than restraining him and freaking him out more (most likely scenerio though). From what i understand of autism, persons with it are very protective of their surroundings and dont like (maybe cant adapt) to changes in the routine. I would suggest getting a band or ID of some kind to put on your son, that would help a lot. (Name, Parents, #'s, condition, age). Good luck.

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Didn't read through all of the posts, but here's my $.02

If I was assessing your son in the scenario you described, particularly given the mechanism of injury, and I had no way to gather his medical history, especially in a mass casualty situation, I would probably go with the presumptive diagnosis of a head injury, and such measures as oxygen therapy, IV therapy, and spinal immobilization would be in order. IF necessary, soft restraints would be used to prevent him from harming himself or others. When properly placed by well trained providers, soft restraints are good safety devices that cause little to no harm to the patient, besides emotional distress, of course

You asked about drugs, and to the best of my knowledge, so called "chemical restraints", or the use of sedatives to provide restraint such as benzodiazepines are not used by any advanced prehospital care providers. If someone knows otherwise, feel free to speak up, but I know even in the hospital chemical restraints are really a last resort.

That being said, going back to your scenario, if someone mistook your son's agitated and combative behavior for a seizure (quite possible, especially if we are ruling out a head injury), then the appropriate pediatric dose of a sedative might be given.

Now I'm giving of course the worse case scenario, your son is alone, no one knows his medical history, and you have a medic thinking on the mass casualty battlefield fly.

I can't imagine how much worry you must go through with a special needs child, and I hope that if your son is ever faced with an emergency, the fact that he has a developmental disorder is picked up on by the providers, and they act with the appropriate amount of care and understanding.

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Asys, thanks for your response. It is pretty scary...But I feel better having some of the facts, at least I have some idea how to handle the fallout if he should ever be in this situation.

The responses from providers like you, and others has really lessened the burden. I truly expected many replies of "We would have to restrain him, that sucks but life is...." But have been pleasantly surprised by the fact that his issues seem to weigh on the hearts of you all as well. That is pretty inspiring to say the least.

As suggested by some earlier, we are trying to get him to wear a bracelet, but he is very resistant. Even attaching a tag with his pertinent info to his cloths makes him a little crazy...and he removes it. We will figure something out soon...I'm sure...

Thank you for responding, being honest...and being the kind of provider I hope will care for my boy, and others like him.

Dwayne

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