Existing protocols for sedation, pain management, and communication techniques for patients with disabilities in...

The challenges that people with disabilities experience within emergency settings are complex. Disruptions in routine, painful procedures, and confusion can be agitating. This makes the need for adequate sedation, pain management, and communication paramount. Anatomical differences, physiological differences, and communication barriers can complicate these goals.

The objective of this paper is to quantify the prevalence of sedation, pain management, and communication protocols for clinicians caring for patients with disabilities among statewide EMS protocols.

Existing statewide protocols were identified and analyzed with descriptive statistics for the presence or absence of disability protocols and behavioral health protocols as defined by the researchers using a standardized approach. Within each protocol, standing orders regarding both medication guidance and behavioral guidance were identified.

30 states were identified to have statewide protocols, and it was found that only 26.7% (8/30) of which had existing protocols for patients with disabilities. Within identified disability protocols, sedation and/or pain management was addressed 75.0% (6/8) of the time, and communication techniques were addressed 75.0% (6/8) of the time. 6.7% (2/30) of states provided the option for emergency care plans for medically complex patients or patients with disabilities.

The authors urge state medical directors to expand protocols for patients with disabilities. More research should be conducted to learn about patient outcomes, patient satisfaction, and clinicians' confidence with appropriate protocols and education versus without such measures. These measures could lead to improved patient outcomes and clinician comfort, addressing a major health disparity.