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Treating Autistic Persons in the Emergency Room

Hear From Expert Doctors on How to Treat Autistic Persons in the Emergency Room.

Doctors give advice on the special treatment of autistic persons in the emergency room in an article.

Everyday the challenges of the emergency room doctor seem to multiply. With the greatly increased incidences of diagnosed autism and related syndrome conditions in children it only seems to follow that these kids will be showing up more and more in the operating room.

Treating autistic persons in the emergency roomThus presenting many special challenges for the emergency room doctors and nurses. The manifestation of autism symptoms vary to a great degree. Iisolating the way autism affects each individual will become a major factor in determining how too approach treating the emergency.

In a post on the Pittsburg Post-Bazeette by Phola Smith we get a great perspective on the situation. Smith writes about an article penned by several prominent Emergency Room Doctors who are experienced with autism. Dr. Arvind Venkat of Allegheny General Hospital was the prominent author ant the report had critical information for emergency treatment of people with autistic disorders.

Doctors need to understand autism, which is a range of complex neurodevelopment disorders, in order to help their patients, the article says. Overreacting to light, sound and touch is a common behavior found in people with autism. Some may not answer to their names and avoid eye contact with others. Responding to questions from a medical professional also may be difficult because people with autism often cannot interpret social cues such as tone of voice or facial expressions. Many children and adults with autism also make repetitive movements that may seem distracting during a medical exam or treatment, such as rocking and twirling, or that may threaten to harm themselves, such as biting or head-banging.

Most important, said lead author Arvind Venkat of Allegheny General, is “to listen to the caregiver and listen to the patient to the extent possible. They’re very unique in how they interact. To take a knee-jerk approach and say this is how [doctors] react to a patient … this is not the way to go. You really need to take time to talk to the caregiver to speak with [him about] how can we treat the patient in a way that’s productive and not cause the conflict and stresses that we talked about.”

That means finding out from the parent or caregiver techniques for touching the patient and what words to use, as well as what textures or smells that should be avoided.

It also means taking a detailed case history from both caregiver and patient, one that includes baseline behavior, communication ability, degree of sociability, dietary habits, pharmacological history, vaccination and menstrual history and sleep patterns, the article says.

Next important, said Dr. Venkat — who has experience dealing with pediatric and adolescent patients from his medical training days and his emergency work — is telling all the staff who will come in contact with the patient everything learned from the talk with the caregiver.

“The third part is you need to be willing to accept there are certain techniques that are very important … an unorthodox way to approach the patient,” he said. “You need to keep an open mind to approach the patient for his history and approach the patient in order to assess him.”…

“I think the biggest thing is when you communicate with the caregiver, also communicate with the patient,” Dr. Venkat said. “Multistep questions don’t work with the patient. You need to be very methodical with the patient. Ask, ‘Does your head hurt?’ not, ‘Does your head and back hurt?’

“When you’re doing invasive treatment, make your patient understand the tactile and smell-related [aspects]. … Allow the patient to feel the cast material [before applying a cast for a broken bone, for example].”…

The doctor also should demonstrate each step of the exam on the caregiver or the stuffed animal…

The taste of medications should be considered; Pediatric formulas might be used for adult patients.

Doctors should watch for repeated movements such as swaying, tics or repeated phrases. “These behaviors can be comforting if the patient is in an agitated state,” the article says. “If the behavior becomes rapid and intense in its repetition, it can also be an indicator that the person is about to become overwhelmed and explosive.” If that happens, the patient should not be forced to stay still.

If possible, the exam should be done in a quiet room where the lights can be dimmed and equipment can be moved out.
The caregivers’ beliefs also must be kept in mind, Dr. Venkat said. They often give their charges alternate therapies such as dietary supplements and other treatments such as chiropractic, acupuncture and neurofeedback and that must be respected.

Read mor about the article concerning treating autistic persons in an emergency room at  http://www.post-gazette.com/stories/news/health/treating-autism-patients-in-emergencies-presents-challenges-640834/#ixzz1yOCb8ajt

Emergency rooms can be one of the most hectic environments there can be. Doctors and nurses who perform the day to day activities with seeming ease are pillars of patience and empathy.  We never hesitate to give them credit they rarely receive.

Please leave a nice word of thanks for all those unsung heroes.  Share these great tips with those who may find themselves providing medical care for autistic persons.