PATIENTS WITH SPECIAL NEEDS

This protocol includes:

• Patient with tracheostomies
• Patient on ventilators
• Patients with indwelling catheters (Central Line)
• Patients with gastrostomy tubes
• Bariatric patients

GENERAL CONSIDERATIONS

• Treat the ABC’s first. Treat the patient, not the equipment. If the emergency is due to an equipment malfunction, manage the patient using your own equipment.
• Parents and caretakers are usually trained in emergency management and can be of assistance to EMS personnel. Listen carefully to the caregiver and follow his/her guidance.
• When moving a special needs patient, a slow, careful transfer with two or more people is preferable. (The bariatric population will require as many people as possible to safely move the patient.) Do not try to straighten or unnecessarily manipulate contracted extremities as it may cause injury or pain to the patient.
• Caregivers may also carry a brief medical information card or form. The patient may be enrolled in a medical alert program where medical personnel can get quick access to the patient’s medical history.
• Knowing which patients in your response area have special needs and keeping a log book is encouraged.
• Children with chronic illnesses often have different physical development from well children. Therefore, their baseline vitals may differ from normal standards. The size and developmental level may be different from age-based norms and length-based tapes used to calculate drug dosages. Ask the caregiver if the child typically has abnormal vital signs (i.e., tachycardia, low pulse oximeter reading, etc.)