1. Persons with Intellectual Disabilities Advanced

2. On Scene – Conscious Ask patient if assistance is needed and/or wanted
Recognition of a person’s intellectual disability can be fast under normal circumstances – not so fast if injured
Patient may be unable to explain his problem
Look for a nearby coach / guide / assistant / friend
Involve companion in patient’s assessment and treatment
Perform a careful primary assessment
Upgrade call if indicated

3. On Snow - Conscious
Pay attention to any changes in patient’s body functions or mood
Patient may react in unexpected ways
Be prepared to be punched / kicked / bitten
Intellectual disabilities are complex - there may be more than one factor present, for example autism plus a physical abnormality
Patient does not intend to hurt the rescuer – in the absence of verbal skills, physical ones may take over

4. On Scene – Conscious
Physical contact with patient may be difficult unless trust is developed early or obtained through a day companion
Persuasion, kindness and gentle handling may help to put a patient at ease
Make certain that patient’s sensory organs are not blocked; for example vision or hearing
Allow extra time for patient’s mental processing
Do not try to restrain a patient that is resisting care, as further injury may occur to both patient and rescuer

5. Treatment of Injuries Monitor vital signs Loosen constrictive clothing
Patient may be hypersensitive to stimuli such as noise, light, and touch
Position of comfort may override splinting in some cases
Oxygen admin may be difficult due to non-cooperation
PATIENT SHOULD NOT BE LEFT ALONE in the treatment room, or while releasing to EMS or to family
Unpredictable things can and do happen
Patient may not be able to tolerate an NRB mask. Patrollers may need to be creative, perhaps letting the patient hold the cannula or mask

6. On Scene – Unconscious If unresponsive, call for load and go
Apply C-spine control if indicated by the MOI
Request assistance, transport, trauma kit, EMS
Perform primary assessment
When transport arrives, apply oxygen, warm packs, blankets, pad all straps and package gently
Interview patient’s day companion
If patient regains consciousness, he may try to rip off the mask and fight against straps, splints and dressings
Secondary assessment if time, and release to EMS
MOI – mechanism of injury

7. Conclusion Vital signs need to be accurate and frequent
Treat injuries with respect to patient’s comfort zone
Record and transfer all information given by day companion
Patient may have a service animal waiting
Be prepared to go out of your comfort zone and act in patient’s best interest