Lombardi Eric, Lepore Fred, Greer Collin
Emergency Medicine, Franciscan Crown Point Health, Crown Point, USA.
Emergency Medicine, Franciscan Health Dyer, Dyer, USA.
Cureus. 2024 Nov 28;16(11):e74702. doi: 10.7759/cureus.74702. eCollection 2024 Nov.
Autism spectrum disorder (ASD) is a prevalent neurodevelopmental disorder characterized by social, communication, and behavioral challenges. Emergency medical services (EMS) environments, with their loud noises, bright lights, and unfamiliar personnel, often exacerbate these challenges, making care for individuals with ASD particularly complex. To address these challenges, the Franciscan Crown Point EMS system introduced the "Ben's Blue Bags" (BBBs) program. These bags, available on every transport vehicle, contain sensory aids, headphones, a dry erase board for communication with nonverbal patients, and a pictogram of the human body for identifying injuries. The BBB program serves 18 different municipalities across four counties in Northwest Indiana, covering over 200 paramedics, 500 emergency medical technicians (EMTs), and 60 transport vehicles in both rural and urban settings. Over an eight-month period in 2023, 77 EMS providers participated in a survey assessing the effectiveness of BBBs. The results indicate that 94.2% of respondents found BBBs enhanced their ability to deliver high-quality care to individuals with ASD. Sensory aids were deemed the most valuable component, helping calm patients and reduce anxiety during EMS interventions. On a scale from 1 to 10, the mean rating was 9.08, with a standard deviation of 1.757, signifying that BBBs were "overwhelmingly helpful." All but three respondents reported that BBBs were helpful in keeping individuals with ASD calm during interactions, and 58 out of 65 paramedics found BBBs useful for calming and/or distracting patients to enable intravenous (IV) placement. Additionally, 61 respondents reported at least one instance where an unnecessary emergency room visit was avoided due to help from BBBs. This study concludes that sensory aids and communication tools can significantly improve prehospital care for patients with ASD. We recommend the broader implementation of such tools and further research to explore their impact within EMS and emergency medicine.
自闭症谱系障碍（ASD）是一种普遍的神经发育障碍，其特征是社交、沟通和行为方面存在挑战。紧急医疗服务（EMS）环境中噪音大、灯光亮且人员陌生，常常会加剧这些挑战，使得对自闭症谱系障碍患者的护理格外复杂。为应对这些挑战，方济各会皇冠角紧急医疗服务系统推出了“本的蓝色急救包”（BBB）项目。这些急救包配备在每辆运输车上，里面装有感官辅助工具、耳机、用于与非言语患者沟通的白板以及用于识别损伤的人体象形图。BBB项目服务于印第安纳州西北部四个县的18个不同市镇，涵盖200多名护理人员、500名急救医疗技术员（EMT）以及城乡环境中的60辆运输车辆。在2023年的八个月时间里，77名紧急医疗服务提供者参与了一项评估BBB有效性的调查。结果表明，94.2%的受访者发现BBB增强了他们为自闭症谱系障碍患者提供高质量护理的能力。感官辅助工具被认为是最有价值的组成部分，有助于在紧急医疗服务干预期间让患者平静下来并减轻焦虑。在1到10的评分标准中，平均评分为9.08，标准差为1.757，这表明BBB“极其有用”。除了三名受访者外，其他所有人都报告说BBB有助于在互动过程中让自闭症谱系障碍患者保持平静，65名护理人员中有58人发现BBB有助于让患者平静下来和/或分散其注意力以便进行静脉输液（IV）。此外，61名受访者报告至少有一次因BBB的帮助而避免了不必要的急诊室就诊。这项研究得出结论，感官辅助工具和沟通工具可以显著改善对自闭症谱系障碍患者的院前护理。我们建议更广泛地使用此类工具，并进一步开展研究以探索它们在紧急医疗服务和急诊医学中的影响。
