Remembering a visit to the E.R.

Researchers have come out with a protocol for emergency room personnel who find themselves caring for a person with autism. I’m glad to see this.

In January 2009, I took Sam to the emergency room in the middle of the night.

He got a bladder infection. He came home from the first day of competition at Chisholm Challenge and was passing blood, which alarmed him. I told him we’d skip the second day of competition and see a doctor in first thing in the morning. But, he woke me up at 2 a.m., shaking uncontrollably and a little panicked.

Even though he’d just turned 21, the pediatrician was still his primary care doctor. So I phoned the nurse on call. Because he was exhibiting signs of shock, she told me to take him in. By the time we got there, he had stopped shuddering, but his urine sample was brown.

We’d gone to Baylor-Grapevine, which was a fairly new hospital at the time. He was already familiar with it because an occupational therapist working out of the rehab center there helped teach him to drive. (Big shout out to Cathy.)

I remained concerned. Would it be filled with people? Would the sounds of arriving ambulances distress him? I was worried most about the staff. Would they be brusk and stand-offish? Would he be hustled around? I didn’t have time to prep them the way I had prepped the many other doctors, dentists and health care givers in his life.

With the first interaction, I saw the lightbulb go off in the ER nurse’s head. She immediately adapted. And everyone who followed after her knew to take their time, be calm and explain each step.

We were lucky, too, that it was a quiet night. The visit wasn’t much different from one at a doctor’s office, except for reams more paperwork and the occasional paramedic tromping down the hallway.

Here’s what the research recommends and what I noticed the folks at Baylor-Grapevine already knew to do:

·       Usher patients to a quiet, more dimly-lit room with less equipment

·       Avoid multistep questions and stick to questions that require only a “yes” or “no” answer

·       Communicate with the care giver or family member, if one accompanies the patient, to get an effective medical history

·       Keep voice calm and minimize words and touch

·       Let patients see and touch the instruments and materials that will be placed on their bodies

·       Use a warm blanket to calm a patient down and administer mild doses of medication rather than physical restraints to quiet a patient


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