1. Scene Safety & Initial Assessment

• Scene Safety Check: Before approaching, confirm the area is safe for entry. Look for drug paraphernalia, needles, or other potential hazards, as well as any aggressive or disoriented bystanders.

• PPE (Personal Protective Equipment): Put on gloves and any other necessary protective equipment.

• Gather Information from Bystanders: Ask witnesses about the patient’s history, what substance may have been taken, the quantity, and how long ago.

2. Primary Assessment (ABCs)

• A - Airway: Check if the airway is open. For unresponsive patients, use head tilt-chin lift (unless spinal injury is suspected) to ensure a clear airway.

• B - Breathing: Assess if the patient is breathing adequately. Look, listen, and feel for breath sounds. If breathing is slow, shallow, or absent, prepare to assist with ventilation or apply rescue breaths.

• C - Circulation: Check for a pulse. If there is no pulse, initiate CPR immediately and prepare for defibrillation if indicated.

3. Assess Level of Consciousness (LOC)

• AVPU Scale: Use the AVPU scale to assess the patient’s responsiveness:

  • A - Alert

  • V - Responds to Verbal stimuli

  • P - Responds to Painful stimuli

  • U - Unresponsive

• Pupils: Check pupil size and responsiveness to light. Constricted (pinpoint) pupils are often associated with opioid overdoses, while dilated pupils may indicate stimulant use.

4. Secondary Assessment (Vitals & Focused Physical Exam)

• Respiratory Rate and Quality: Note if breathing is slow, shallow, labored, or absent. Opioid overdoses often result in respiratory depression.

• Heart Rate and Rhythm: Assess for irregularities, rapid or slow heart rate, or weak pulse, which could indicate drug effects.

• Blood Pressure: Measure blood pressure if possible. Low blood pressure is common in sedative overdoses.

• Skin Condition: Check skin color, temperature, and moisture. Cyanosis (blue lips or fingertips) can indicate oxygen deprivation.

• Look for Signs of Drug Use: Observe for needle marks, drug paraphernalia, or other physical signs (e.g., burns on lips or fingers from smoking substances).

5. Administer Naloxone (If Opioid Overdose Suspected)

• Confirm Opioid Overdose Signs: Check for slow or absent breathing, constricted pupils, and low responsiveness.

• Administer Naloxone: Follow protocol to administer naloxone if available. Note the time and dose given.

• Reassess After Naloxone: Monitor for changes in respiratory rate and LOC. Be prepared to administer additional doses if the patient’s condition doesn’t improve, as naloxone effects may wear off faster than some opioids.

6. Monitor and Support Airway & Breathing

• Position the Patient: If the patient is unresponsive but breathing, place them in the recovery position to prevent aspiration.

• Assist with Ventilation: If breathing is inadequate, provide rescue breaths with a bag-valve mask (BVM) at the appropriate rate until spontaneous breathing resumes.

• Apply Oxygen: If available, administer supplemental oxygen to maintain oxygen saturation levels above 94%.

7. Obtain Patient History (SAMPLE)

• Use the SAMPLE mnemonic to gather relevant patient history if the patient is responsive or from bystanders if not:

  • S - Signs and Symptoms

  • A - Allergies

  • M - Medications (especially recent substance or medication use)

  • P - Past medical history

  • L - Last oral intake (when they last took drugs, alcohol, or food)

  • E - Events leading up to the incident

8. Continued Monitoring and Reassessment

• Vital Signs: Continue monitoring vital signs every 5 minutes if unstable, or every 15 minutes if stable, paying close attention to respiratory status and consciousness.

• Observe for Withdrawal or Agitation: After naloxone administration, some patients may experience withdrawal symptoms, agitation, or become combative. Monitor closely and ensure safety.

• Prepare for Transport: Initiate rapid transport if the patient’s condition does not improve, if there are complications, or if advanced medical care is needed.

9. Communication with EMS/Receiving Facility

• Report Patient’s Condition and Actions Taken: Relay information to EMS or the receiving facility, including substance taken, doses of naloxone administered, patient response, and current vitals.

• Document Findings and Care Provided: Ensure all assessments, interventions, and observations are thoroughly documented for continuity of care.

10. Post-Incident Actions

• Restock and Clean Equipment: Ensure all used items, especially naloxone kits, are restocked and equipment is cleaned.

• Debrief: Conduct a team debrief if the situation was challenging, discuss what went well, and identify areas for improvement

This process ensures that Emergency First Responders provide structured, life-saving interventions during overdose calls, prioritizing patient safety and rapid response to respiratory depression.

This document provides an outline of the patient assessment process and checklist for Emergency First Responders when responding to calls involving suicide or self-harm. This approach ensures responders can effectively evaluate the patient’s physical and mental status while maintaining a safe and compassionate environment.

1. Scene Safety & Initial Approach

• Ensure Scene Safety: Verify that the scene is safe for entry. Be aware of potential hazards (e.g., weapons, sharp objects) and call for additional resources if there is any safety risk.

• Use Personal Protective Equipment (PPE): Don gloves and any necessary PPE to protect against bodily fluids.

• Maintain a Calm and Non-Threatening Demeanor: Approach the scene slowly and speak in a calm, non-threatening manner to avoid escalating the patient’s emotional state.

• Establish Consent to Help: Gain verbal consent from the patient if possible, reassuring them that you are there to help.

2. Initial Observation

• Assess the Environment: Look for any signs of drugs, alcohol, weapons, or suicide notes. These could provide context for the situation and potential risks.

• Evaluate the Patient’s Physical State: Observe the patient’s body language, breathing, posture, and visible injuries to gauge their immediate physical condition.

• Assess for Immediate Medical Needs: Check for visible signs of self-harm, such as cuts, overdose symptoms, or other injuries requiring urgent attention.

3. Primary Assessment (ABCs)

• Airway: Ensure the airway is clear. For unconscious patients, open the airway using appropriate techniques (e.g., head-tilt, chin-lift).

• Breathing: Check for normal breathing patterns, rate, and depth. If breathing is irregular or absent, provide support as necessary.

• Circulation: Check for a pulse and assess for significant bleeding. Control any life-threatening bleeding immediately.

4. Secondary Assessment - Physical and Mental Health Check

• Vital Signs: Measure the patient’s heart rate, respiratory rate, and blood pressure if equipment is available.

• Level of Consciousness (LOC): Use the AVPU scale (Alert, Verbal, Pain, Unresponsive) to evaluate the patient’s responsiveness.

• Assess for Substance Use: If signs of drug or alcohol use are present, determine the type, amount, and timing of substance use, if possible.

• Identify Self-Harm Injuries: Carefully assess any injuries related to self-harm, such as cuts, burns, or ingestion of harmful substances, and provide appropriate first aid.

5. Suicide Risk Assessment

• Evaluate Suicidal Ideation: Ask questions about any thoughts of self-harm or suicide in a non-judgmental way (e.g., “Are you thinking of harming yourself?”).

• Assess Plan and Intent: If the patient expresses suicidal thoughts, ask if they have a specific plan or intent. The presence of a clear plan increases risk.

• Determine Access to Means: Assess if the patient has access to tools or substances they could use for self-harm, such as weapons, medications, or harmful chemicals.

6. Patient Communication and De-Escalation

• Build Rapport and Trust: Speak slowly, maintain eye contact, and show empathy. Avoid sudden movements, and respect the patient’s personal space.

• Use Active Listening: Allow the patient to express themselves without interruption. Validate their feelings and show empathy by reflecting back what they say.

• Avoid Confrontation: Avoid challenging statements or questions that could increase the patient’s distress. Keep the focus on their safety and well-being.

7. Transport and Handover to Mental Health Professionals

• Prepare for Transport if Necessary: If the patient consents or if involuntary transport is required, prepare them for safe transport to a healthcare facility.

• Document Findings and Actions: Document all observations, assessments, and actions taken, including the patient’s statements, physical findings, and any care provided.

• Communicate with Receiving Facility: Provide a detailed handover to mental health professionals or receiving healthcare providers, including:

  • Physical findings and vital signs

  • Suicidal ideation, plan, intent, and means

  • Any substances used and time of ingestion if applicable

  • Details of any self-harm injuries and care provided

  • Patient’s responsiveness and cooperation level

8. Post-Incident Review and Self-Care

• Debrief with Team Members: Discuss the incident with team members to ensure everyone’s safety and emotional well-being.

• Self-Care for Responders: Recognize the emotional toll that responding to suicide and self-harm calls can take. Use available mental health resources and peer support.

Check List

1. Scene Safety  

• Scene secured and hazards assessed  

• PPE in place  

• Safe approach and calm demeanor maintained  

2. Initial Observation  

• Environmental risks or clues identified  

• Immediate medical needs assessed  

3. Primary Assessment (ABCs)  

• Airway checked and managed if needed  

• Breathing monitored and supported as necessary  

• Circulation checked and bleeding controlled  

4. Secondary Assessment  

• Vital signs recorded  

• Level of Consciousness (AVPU) noted  

• Substance use assessed if suspected  

• Self-harm injuries identified and treated  

5. Suicide Risk Assessment  

• Suicidal ideation or statements noted  

• Plan, intent, and access to means evaluated  

6. Patient Communication and De-Escalation  

• Rapport and trust-building efforts used  

• Active listening and empathy demonstrated  

• Non-confrontational approach maintained  

7. Transport and Handover  

• Patient prepared for transport  

• Documentation completed  

• Handover communicated to receiving facility  

8. Post-Incident Review and Self-Care  

• Team debrief conducted  

• Mental health and peer support accessed  

This outline and checklist offer a comprehensive approach for assessing and managing a patient experiencing a suicide or self-harm crisis, prioritizing both responder safety and patient care.

This document provides an outline of the patient assessment process and checklist for emergency first responders handling calls involving psychiatric or mental health issues. This approach prioritizes safety, empathy, and clear communication to support individuals experiencing a mental health crisis.

1. Scene Safety and Approach

• Personal and Team Safety: Ensure the scene is safe and that you have appropriate backup if needed.

• Environmental Assessment: Look for objects that could be used to harm the patient, responders, or others, such as weapons, sharp objects, or harmful substances.

• Approach Calmly: Move slowly and avoid sudden movements. Keep a safe distance until the individual’s state is better understood.

• Minimize Stimulation: If possible, reduce noise, light, or other stimuli that could escalate agitation or confusion.

2. Establish Rapport and Communicate Clearly

• Introduce Yourself: Clearly state your name, role, and purpose to help build trust.

• Use a Calm and Reassuring Tone: Speak slowly and clearly, maintaining a calm and respectful tone throughout the interaction.

• Ask Open-Ended Questions: Encourage the individual to express their feelings and concerns without pressuring them.

• Be Aware of Non-Verbal Communication: Keep body language open and non-threatening, avoiding crossed arms or sudden movements.

3. Initial Patient Assessment

• Assess for Immediate Danger to Self or Others: Look for signs that the individual may harm themselves or others. This may include verbal threats, aggressive behavior, or possession of harmful objects.

• Check for Medical Concerns: Determine if there are any immediate medical needs, such as injuries, altered consciousness, or symptoms that may indicate a medical emergency (e.g., stroke, low blood sugar).

• Identify Signs of Acute Mental Health Crisis:

• Suicidal Ideation: Look for verbal or behavioral indicators that the individual may have thoughts of self-harm or suicide.

• Hallucinations or Delusions: Notice if the individual seems to be responding to internal stimuli (e.g., hearing voices) or expresses beliefs that seem out of touch with reality.

• Severe Anxiety or Panic: Identify signs of panic, extreme agitation, or inability to calm down, which may require de-escalation techniques.

• Assess Level of Orientation: Check if the individual is aware of their surroundings by asking questions about their name, location, time, and situation.

4. Detailed Mental Health Assessment

• Assess Mood and Affect: Observe the individual’s mood (e.g., sad, anxious, angry) and affect (e.g., flat, labile, congruent with mood).

• Evaluate Thought Processes: Determine if the person’s thought processes are logical and coherent or disorganized and fragmented.

• Insight and Judgment: Try to assess if the individual understands their situation and can make reasonable decisions.

• History of Mental Health Issues: If possible, ask the individual (or those nearby) about any known history of mental health issues or medications they may be taking.

5. Physical Examination (if appropriate)

• Check Vital Signs: If feasible and the patient is cooperative, assess basic vitals like pulse, respiration, and blood pressure.

• Look for Signs of Substance Use: Note any physical symptoms or behaviors that could indicate intoxication or withdrawal.

• Identify Signs of Physical Trauma: Check for any injuries or signs of self-harm, such as cuts or bruises, that may require medical attention.

6. Assess Suicide Risk

• Ask Directly About Suicide: Use empathetic, direct questions such as, “Are you having thoughts of hurting yourself?” or “Are you thinking about ending your life?”  

• Inquire About a Plan or Means: If the individual expresses suicidal thoughts, assess if they have a specific plan or means, which indicates a higher level of risk.

• Evaluate Recent Changes: Ask about recent stressors or changes in behavior, relationships, or support systems that may contribute to suicidal risk.

7. Documentation and Communication

• Document Observations: Record your observations, the individual’s statements, and any assessments conducted. Include the person’s appearance, behavior, mood, and relevant verbal statements.

• Communicate with Medical Personnel: If the individual will be transported for further care, relay all relevant information to medical personnel, including mental health observations and any immediate concerns.

• Notify Law Enforcement or Mental Health Crisis Team (if needed): For situations requiring additional security or specialized intervention, ensure that law enforcement or mental health crisis teams are informed and briefed.

8. De-Escalation and Support Techniques

• Use De-Escalation Techniques: Employ active listening, validate the individual’s feelings, and avoid confrontational language.

• Provide Reassurance and Support: Offer reassurance, affirm their feelings, and explain what is happening at each step.

• Encourage Self-Help Actions: If appropriate, suggest simple actions (like deep breathing) to help the individual calm down.

9. Prepare for Transport (if needed)

• Gain Consent if Possible: Obtain the individual’s consent for transport if they are capable of giving it.

• Ensure Safe Transport: If transport is required, ensure that the individual is safely secured, especially if they pose a risk to themselves or others.

• Involve Family or Friends: If feasible and beneficial, involve family members or friends to provide support during transport.

10. Post-Incident Review

• Debriefing with Team: Conduct a post-incident review to discuss the response, assess the effectiveness of de-escalation techniques, and identify areas for improvement.

• Update Documentation: Finalize all notes and documentation related to the call, ensuring that all observations and actions are accurately recorded.

• Follow-Up Care Recommendations: If appropriate, provide follow-up care instructions or resources to the individual and their support network.

This outline provides a structured approach for emergency responders handling psychiatric or mental health calls, focusing on safety, assessment, communication, and supportive interventions to manage the situation compassionately and effectively.

When responding to calls involving sexual assault, emergency first responders must approach the scene and the patient with sensitivity, care, and adherence to specific protocols to ensure the patient’s physical and emotional safety. The following outline provides a structured approach to patient assessment for these situations.

1. Scene Safety and Situational Awareness

• Personal Safety: Ensure that the scene is safe for entry. Be mindful of the location, potential threats, or hazards.

• Approach with Sensitivity: Recognize that this is a highly sensitive situation. Approach calmly, respectfully, and avoid sudden movements or actions that may cause further distress.

• Privacy and Confidentiality: Ensure the patient’s privacy by minimizing onlookers and keeping details confidential. Limit unnecessary personnel on scene.

2.  Initial Patient Contact and Consent

• Introduce Yourself: Clearly introduce yourself, explain your role, and reassure the patient of your intention to help.

• Seek Consent: Obtain verbal consent for any assessment or intervention, emphasizing that the patient can choose what level of assistance they want.

• Establish Rapport: Use a calm, empathetic tone. Let the patient know that they are in control of the situation and can decline any part of the assessment or treatment if they feel uncomfortable.

3. Assess for Immediate Medical Needs (Primary Survey)

• Airway and Breathing: Check that the patient has a clear airway and is breathing adequately. Be gentle and avoid touching areas that could cause discomfort or be perceived as invasive.

• Circulation: Check for signs of shock or significant bleeding, particularly if the patient has any visible physical injuries.

• Identify Urgent Medical Needs: Prioritize treatment for life-threatening conditions, such as severe bleeding or respiratory issues.

4. Conduct a Secondary Survey (Focused Assessment)

• Check for Visible Injuries: Look for any physical injuries, such as bruising, abrasions, or cuts. Avoid intrusive physical examination unless medically necessary.

• Assess Pain and Discomfort: Ask the patient if they are in pain and if there are any specific areas they would prefer not to be touched.

• Note Signs of Emotional Distress: Observe for non-verbal signs of emotional trauma, such as shaking, withdrawal, or difficulty speaking.

5. Obtain a Limited Patient History (SAMPLE Assessment)

• S - Signs and Symptoms: Gently ask if the patient is experiencing any pain or discomfort.

• A - Allergies: Inquire about any allergies, especially if providing medications.

• M - Medications: Ask if the patient is taking any medications, which could affect treatment options.

• P - Past Medical History: Avoid pressing for unnecessary details. Limit questions to relevant medical history that could impact immediate care.

• L - Last Oral Intake: Note the last time the patient had food or drink, as it may impact medical treatment.

• E - Events Leading Up to the Incident: Avoid detailed questioning about the assault. Only ask what is necessary to understand the immediate medical context, allowing law enforcement or forensic professionals to gather specific details later.

6. Emotional and Psychological Support

• Validate Their Experience: Use supportive phrases like, “I’m here to help you,” and “You’re safe now.”

• Avoid Judgment or Assumptions: Do not make statements or ask questions that could imply blame or judgment.

• Allow Silence if Needed: Recognize that the patient may not want to speak. Allow them to process and express their emotions at their own pace.

7. Encourage, Do Not Pressure, Medical Follow-Up and Evidence Preservation

• Recommend Medical Follow-Up: Advise the patient to consider medical follow-up, even if they do not feel immediate health concerns. This is essential for both health assessment and evidence collection.

• Explain Evidence Preservation: If the patient is open to it, gently advise them not to wash or change clothes before they reach the hospital to preserve evidence. However, if they wish to do so, respect their decision.

8. Documentation and Reporting

• Record Observations Carefully: Document all physical findings and statements made by the patient, being factual and objective.

• Avoid Speculation: Refrain from interpreting or drawing conclusions in documentation. Stick strictly to observable facts.

• Maintain Confidentiality: Ensure all notes and records are kept secure, in accordance with privacy laws and regulations.

9. Handover to Medical/Forensic Professionals

• Provide a Gentle Handover: Briefly summarize the patient's immediate needs and any relevant findings to the medical or forensic team, prioritizing confidentiality and respecting the patient’s dignity.

• Coordinate with Law Enforcement: If law enforcement is involved, limit the information to what is necessary for immediate patient care, allowing the patient control over what they wish to share with authorities.

10. Follow-Up and Support Resources

• Provide Information on Support Services: Offer information on support resources, such as crisis counseling, sexual assault hotlines, or local advocacy groups.

• Encourage Self-Care: Remind the patient to prioritize their well-being and consider reaching out to support services when they are ready.

This patient assessment process for sexual assault cases prioritizes patient safety, emotional well-being, and respects their autonomy. It is essential for emergency first responders to be sensitive, supportive, and objective, avoiding any actions or language that could add to the trauma of the patient.

When responding to calls involving partner-based violence (PBV) or domestic abuse, emergency first responders follow a specialized patient assessment process. This process not only focuses on physical injuries but also on safety, privacy, and sensitivity to the emotional and psychological state of the victim. Here is an outline of the patient assessment process and checklist:

1. Scene Safety and Assessment

• Ensure Personal Safety: Verify that the scene is secure for the responder to enter. Assess any potential threats from the partner or other individuals in the environment. 

• Call for Law Enforcement if Necessary: If the scene is unsafe or there’s any indication of immediate danger, wait for law enforcement to secure the area before entering.

• Observe the Scene: Take note of the surroundings for any indicators of violence (e.g., broken objects, signs of struggle) and be mindful of potential weapons.

• Approach with Caution: Approach the patient calmly, without sudden movements, to avoid escalating tension or fear.

2. Introduce and Build Trust

• Introduce Yourself and Role: Clearly state your name and role as a first responder there to help, to establish trust.

• Create a Safe Environment: Speak calmly and avoid any judgmental language. Be respectful and supportive, ensuring the patient feels safe and understood.

• Ensure Privacy: Ask if the patient would like to speak privately, if possible, away from others or the suspected abuser. If the abuser is nearby, proceed with caution to avoid exacerbating the situation.

3. Initial Medical Assessment (Primary Survey)

• Airway, Breathing, Circulation (ABCs): Conduct a primary survey to assess immediate life-threatening injuries. Check that the patient’s airway is clear, breathing is stable, and circulation is intact.

• Identify and Control Major Bleeding: Look for visible signs of trauma or bleeding and control any life-threatening injuries first.

• Assess Level of Consciousness (LOC): Determine the patient’s level of consciousness to gauge responsiveness and alertness.

4. Detailed Physical Assessment (Secondary Survey)

• Head-to-Toe Examination: Conduct a careful physical examination to identify injuries that may not be immediately visible. Be mindful of potential hidden injuries or areas that the patient may not want to expose.

• Look for Signs of Trauma: Common signs include bruises, cuts, fractures, or burns, particularly in areas that may be hidden (e.g., torso, back, upper arms).

• Document Injuries Thoroughly: Record details of visible injuries, including size, location, and type, as this may be needed later for medical or legal purposes.

• Assess for Signs of Strangulation: Look for signs such as bruising around the neck, voice changes, or difficulty swallowing, as these can be subtle but serious indicators of violence.

• Inquire Gently: If possible, ask the patient about any pain or discomfort, taking care to be respectful and not force disclosure.

5. Mental and Emotional Assessment

• Evaluate Emotional State: Observe signs of fear, anxiety, or confusion. The patient may have difficulty focusing, speaking, or engaging due to trauma.

• Ask Open-Ended Questions: If safe, ask questions to assess their mental state, but avoid direct questions about the abuse if the abuser is present.

• Respect the Patient’s Autonomy: Allow the patient to disclose information at their own pace without pressure. Show empathy and support without assuming the extent of the abuse.

6. Privacy and Confidentiality

• Respect Confidentiality: Reassure the patient that any information they share will be kept confidential unless there’s an immediate threat to their safety or the safety of others.

• Maintain Professional Boundaries: While supportive, avoid getting involved in the specifics of their relationship beyond what’s relevant for immediate care.

• Provide Safe Information: Be cautious about leaving behind information that could place the patient in danger if discovered by the abuser. Provide resources discreetly, if possible.

7. Safety Planning and Resource Provision

• Assess Immediate Safety Needs: If the patient expresses concerns about their immediate safety, coordinate with law enforcement or social services to arrange safe housing or shelter if appropriate.

• Provide Information on Resources: Offer discreet information on resources such as domestic violence hotlines, shelters, and counseling services. If possible, give this information verbally rather than in written form if privacy is a concern.

• Encourage Medical Follow-Up: Advise the patient to seek additional medical attention if there are signs of significant trauma or any risks of complications from injuries.

8. Documentation

• Record Details Carefully: Document the patient’s injuries, statements, emotional state, and the details of the interaction thoroughly and objectively.

• Avoid Speculation: Stick to observable facts and direct statements from the patient, avoiding personal assumptions or speculative notes.

• Maintain Confidentiality in Records: Ensure that any documentation is handled in accordance with confidentiality standards and securely stored.

9. Communication with Other Responders

• Inform Medical Staff of Domestic Violence Indicators: If the patient is transported to a healthcare facility, communicate potential indicators of domestic abuse to the receiving team discreetly.

• Coordinate with Law Enforcement: If law enforcement is involved, provide details relevant to the patient’s immediate safety and the nature of injuries while respecting privacy.

• Follow Protocols for Mandatory Reporting: In cases where mandatory reporting is required by law, follow all protocols for reporting domestic abuse while prioritizing patient safety.

This patient assessment process allows emergency first responders to provide comprehensive care while maintaining sensitivity to the complexities of partner-based violence and domestic abuse. The checklist aims to ensure both physical and emotional support while respecting the patient’s privacy and autonomy.

When emergency first responders attend calls involving persons with disabilities, the patient assessment process requires additional considerations to ensure safety, respect, and effective care. Here's an outline and checklist for conducting a patient assessment in these situations:

1. Scene Assessment and Preparation

• Safety Check: Assess the scene for hazards, ensuring it’s safe for both responders and the individual.

• Gather Initial Information: Attempt to gather information on the individual’s disability type, preferred communication method, and any specific needs from caregivers, family members, or dispatch, if possible.

• Respect Privacy and Independence: Approach with respect for the individual's autonomy and privacy, being mindful not to assume their needs based solely on appearance or mobility aids.

2. Introduce Yourself and Obtain Consent

• Identify Yourself Clearly: Introduce yourself, stating your name and role clearly, and ensure the individual knows you are there to help.

• Ask for Consent: Request permission before beginning the assessment, explaining each step in simple, clear language.

• Be Patient and Listen: Allow extra time for communication and encourage the person to express any specific needs or preferences.

3. Communication Adjustments

• Determine Communication Needs: Ask if they prefer written, verbal, or non-verbal communication and if they need assistive devices or a caregiver’s assistance.

• Use Visuals or Simple Language: If the individual has a cognitive or sensory disability, use simple language, visual aids, or gestures to explain what you are doing.

• Allow for Augmentative Communication: If the individual uses an alternative communication device or sign language, work within their communication style.

4. Primary Assessment (ABCs)

• A - Airway: Check that the airway is clear. If the individual has a disability affecting head or neck positioning, ask about their preferred positioning or seek assistance from someone who knows their routine.

• B - Breathing: Observe breathing rate and quality, and adapt if the individual has respiratory aids (e.g., a ventilator). Seek caregiver input if specialized knowledge of respiratory devices is needed.

• C - Circulation: Check for pulse and signs of bleeding. Be mindful of any adaptive equipment that might affect circulation (e.g., prosthetics, braces).

5. Secondary Assessment

• Assess Disability-Specific Needs: Depending on the disability, certain considerations should be included:

• Mobility Disabilities: Inquire about specific movement preferences, and avoid moving the individual unless necessary. Be mindful of prosthetics, wheelchairs, or other mobility aids.

• Sensory Disabilities (Hearing/Vision): Face the person directly, speak clearly, and consider visual aids or written communication. Respect service animals as working animals and avoid distraction.

• Cognitive/Intellectual Disabilities: Use clear, simple instructions, allow additional time for responses, and maintain a calm demeanor.

• Speech Disabilities: Be patient and do not assume an understanding level based on speech. Confirm understanding and repeat or rephrase questions if necessary.

6. Pain and Symptom Assessment

• Ask About Pain Using Accessible Language: Ask questions about pain location, severity, and type using terms the individual can easily understand.

• Observe for Non-Verbal Cues: For individuals who may have difficulty communicating pain, watch for facial expressions, body movements, or vocalizations that indicate discomfort.

• Respect Descriptions from Caregivers: If a caregiver or family member is present, consider their insights into symptoms the individual may be experiencing.

7. Functional Assessment and Assistance Needs

• Ask About Mobility and Transfer Preferences: For individuals who need assistance with movement, ask about preferred methods for transfer or if they have specific techniques to prevent injury.

• Respect Adaptive Devices: Ask if they rely on adaptive devices, such as ventilators, oxygen, or communication devices, and ensure these are handled carefully.

• Assistive Animals and Devices: If they have a service animal or device, keep these accessible to the individual.

8. Medical History and Medications

• Ask About Medical History Relevant to Disability: Inquire about the disability and any associated conditions that may affect your care plan.

• Medication Assessment: Ask about any medications, especially if they affect respiration, mobility, or cognition. Be cautious when moving or repositioning to avoid disrupting medication delivery systems.

9. Documentation

• Note Disability and Specific Needs: Document the individual’s disability, adaptive equipment, preferred communication methods, and any relevant care preferences.

• Record Interventions and Observations: Clearly document all assessment findings, interventions, and communication methods used to facilitate follow-up care.

• Ensure HIPAA Compliance: Maintain confidentiality and document only relevant information about the individual’s disability to respect privacy.

10. Reassure and Monitor

• Provide Reassurance: Offer calm and supportive reassurance throughout the assessment, allowing the individual to feel more at ease.

• Continuous Monitoring: Regularly monitor vital signs, pain, and comfort level, especially if they have a disability that affects sensory awareness or communication.

 Checklist Summary for Emergency First Responders

1. Scene Safety: Confirm a safe environment for responders and patients.

2. Introduce and Gain Consent: Obtain consent, explain steps, and communicate with respect.

3. Adapt Communication: Modify communication methods based on the individual’s needs.

4.  Primary Assessment (ABCs): Conduct airway, breathing, and circulation checks with adaptive techniques.

5. Secondary Assessment: Tailor the assessment to specific disability needs.

6.  Pain and Symptoms: Use accessible language and observe non-verbal cues.

7.  Assistive Devices and Mobility Needs: Respect and maintain accessibility of any adaptive devices.

8.  Medical History and Medications: Gather relevant information about the disability and medications.

9. Documentation: Record findings, methods, and disability-specific needs.

10. Reassurance and Monitoring: Reassure continuously and monitor comfort and safety.

This assessment outline emphasizes an individualized, respectful approach that adapts to the specific needs of persons with disabilities, ensuring they receive safe and effective care during emergency responses.

Managing Civil Disturbances on a University Campus

• Preparation: Develop emergency plans, conduct risk assessments, train staff on de-escalation, and prepare resources.  

• Monitoring: Track disturbances through real-time updates and assess threat levels to activate response teams.  

• Communication: Provide clear updates to the campus, and engage with protest leaders to encourage peaceful actions.  

• Safety Management: Secure critical areas, designate safe zones, and deploy trained responders to manage crowds without escalating tensions. 

• Emergency Response: Provide first aid, facilitate evacuations, and involve law enforcement if necessary.  

• Post-Incident Recovery: Assess damage, debrief stakeholders, offer support services, and update emergency protocols based on lessons learned.  

This approach ensures safety, minimizes disruptions, and fosters continuous improvement for future incidents.