Autism in the Emergency Room

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Autism families learn fast and early how to effectively anticipate and manage a crisis. When that crisis involves a trip to the emergency room, it can escalate quickly due to the sights, sounds, smells, and accelerated pace of the environment, which can quickly overwhelm an individual with autism.

Recognizing that someone has autism is only one part of a successful emergency room experience. Here are some other tips for the ED staff to help ensure a safe and manageable experience for everyone.

Emergency Room Tip #1: Decrease Wait Time if Possible

Recognize that simply entering a noisy, crowded waiting room may trigger acute anxiety and sensory overwhelm for a person with autism. This can result in escalated and challenging behaviors. If at all possible, accompany the patient and primary caregiver to a quiet room for initial assessment and registration. If the triage nurse determines the patient will need to wait to see a physician, provide a quiet place to do so.

Dim overhead lighting if necessary and possible and monitor the patient continuously for signs of overstimulation.

Emergency Room Tip #2: Caregivers Are a Wealth of Information

Most autism parents or caregivers are well versed in their child’s medical information and are extremely helpful in gaining cooperation. Use this information! Make sure to ask early about the patient’s primary form of communication; if they are non-verbal, make sure they have a method of communication familiar to them, such as a paper and pencil, pictures, gestures, or a communication device.

Find out from the caregiver what has worked in the past when at medical visits, what their particular sensory issues are, and what their heat, cold and pain tolerances are.

Emergency Room Tip #3: Explain and Demonstrate First

Order and expectation is everything to someone with autism. Try to explain procedures before performing them to help alleviate anxiety. Use simple words and drawings if necessary.

Demonstrating what you are about to do on yourself, a colleague or the caregiver is also helpful. These modifications call for extra effort and understanding, but go a long way toward a positive experience for everyone involved.

Finally, recognize that people with autism may be on many different medications due to comorbid conditions. They can be prone to allergic reactions or dangerous drug interactions. Only administer medications when absolutely necessary.

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