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Conscious but unresponsive?


DwayneEMTP

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I have a great nephew with CP & who is also autistic, that I routinely take care of and I do understand your predicament. He too, can not stand any bracelet, necklace etc... and with the CP communication is more dramatic and hard to understand.

Yes, the description chances are he would be chemically sedated. Although, that is not always bad. We use bemzo's such as Valium, and Ativan. In the ER as well, we will use some form of "restraint" of chemical (sedation) rather than to physically restrain them. I like Fentyl lollipops, that are taken orally and sedate kids.. don't see them used much although. Again, Ativan and Versed which has a great amnesic effect and some still us ketamine.

Since is better to sedate and treat the patient rather to try to hold them down and cause more fear. Like any other medications it does have side effects & risks, but if used properly chances are small. It is very difficult for the physician to suture a moving patient.

Usually, experienced staff can sometimes determine patients with autism, CP, etc.. from head injuries, although there are times it is difficult.

Might I suggest a shoe lace packet.. many joggers wear such that is attached to their shoe laces to hold small items. Placing a medical "star-of-life" decal on the outside might attract attention, and he might not mind it if it in place on the shoe. Place a brief med. hx typed and placed in the container.

Good luck,

R/R 911

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Rid, thanks so much. I do like the idea of chemical restraint over physical, that's for sure. My guess would be it would take several months for him to recover from being physically restrained (If ever).

The shoelace is a great idea!! I will find one tomorrow...He hates shoes but has come to realize they are a necessary evil, maybe If I can find one to match his shoes, and make the Star of Life match as well he will learn to leave it be....

You guys never cease to amaze me. You set a standard all of us should strive to achieve...

Thanks again.

Dwayne

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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

I agree with ya brotha. :wink:

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