In our preparedness planning for emergency situations such as fires, explosions or toxic chemical spills, meeting the needs of the disabled is paramount.

WHAT IS A DISABILITY?
A disability is defined as a condition of impairment, physical or mental. Basic distinctions can be made between the terms "impairment", "disability", and handicap". An impairment is an anatomic or functional abnormality or loss which may or may not result in a disability. A disability is a loss or reduction of functional ability which results from an impairment. A handicap is the disadvantage caused by the disability. Thus, impairment is a medical condition, disability the functional consequence and handicap the social consequence. In other words, the spinal condition of a paraplegic is his impairment. His inability to walk is his disability. His problem in achieving access to buildings, is his handicap. Either visible or hidden impairments may become disabilities under the stress and strain of an emergency.

Disabled persons frequently require special consideration in an emergency because they may be dependent on the help of others, and/or on mechanical aids. This dependence may be total or partial, but it renders the disabled especially vulnerable.

When assisting a disabled person in an emergency situation, treat the individual as you would any adult. Explain what needs to be done. Give the person an opportunity to define his needs and wishes to you. Allow him to make his own decisions as fully as possible. Always keep in mind that frequently impairments are not obvious, and it may be necessary to search for the real problem. If there is any question about procedures to follow, obtain medical assistance as soon as possible. Remember, at all times, when assisting a disabled person in an emergency situation, you are expected to provide for the safety of that person.

ASSISTING A PERSON IN A WHEELCHAIR

Many people are unsure how to act when confronted by a person in a wheelchair. A wheelchair is part of the users body space and should be respected. Always ask whether the wheelchair user needs assistance. Wheelchairs can be tricky to handle, so here are some points to remember:
1. Be aware that the wheelchair user might be able to walk with the assistance of a cane, crutches or braces.
2. Do not try to maneuver a wheelchair alone, unless you are sure you can handle the weight and movement
    safely.
3. Ask how the chair operates. Are the arm rests, leg rests and body supports secure? Is there a seat belt?
    Are the brakes working properly? The brakes are located on both sides of the chair, just above the large
    wheels, and can be operated by a lever. Locate the brakes before you attempt to move the chair.
4. Be sure to lock the brakes when leaving the person even for a moment. Be sure to lock the brake when
     transferring in or out of the chair.
5. Avoid narrow doorways and openings, stairs, bumpy surfaces, wet floors. Be alert for objects in your path.
    Ask the person in the chair if there is a posted floor plan or if he can tell you the quickest escape route; it
    will save time.
6. Always explain what you are doing.
7. Be cautious in attempting to lift a person from a wheelchair. Their weight may catch you off guard. Avoid
    back injury by not attempting activity beyond your capability.

In order to transfer a person who has very little ability to use their lower limbs, place the wheelchair at an angle to the chair or car seat to which you are transferring the person. Stand, facing the person. Lift the person to a standing position, then clasp you arms around the person's waist, if possible. Rotate yourself to align the person for seating, then lower the person carefully to a sitting position. Remove your grip and help the person adjust his body to a comfortable and stable position. When transporting, it may be easier to secure a belt around the person's waist to facilitate lifting.

Always explain what you are going to do. If the victim can help you, ask the person to try to raise himself at the same time that you are lifting him out of the chair.

If you are assisting by pushing a wheelchair over rough terrain, the chair will ride easier, and jolt its occupant less, if it is tilted back on its rear wheels.

                                                          

While descending a curb with a wheelchair, the pusher should be behind the chair, tilting it back on its rear wheels. The pusher can then control the descent by the use of pressure against his own legs. It is important that both wheels touch the lower level simultaneously to avoid jolting the occupant.

If assisting while ascending a curb, again tip the chair back, and place the front, or small wheels, on the upper level. Then using the rear wheels, ride on to the upper level or sidewalk, using your legs to provide pressure.

There will be instances when non-ambulatory persons will have to forsake their wheelchairs during an emergency evacuation. Those co-workers/students who assist them should work out the best method of lifting and carrying the disabled person to prevent the risk of physical damage.

Recently, the National Research Council of Canada supported a research study to evaluate the various techniques for evacuating handicapped persons. Testing was accomplished using a large group of disabled people with a wide range of disabilities and limitations.

There are generally four methods whereby one person can carry a non-ambulatory employee/student. None of the techniques is suitable for all

persons. With increasing weight of the disabled person, there is an increasing difficulty, unless the person retains a moderate amount of arm strength.

The PACK-STRAP technique, often preferred by health care professionals, restricts the breathing of the person being evacuated and may induce leg spasms where there is a history of proneness to this condition.

The PIGGY-BACK technique causes less restriction of breathing. Lifting a person for the piggy-back technique can be made easier if done at the top of a flight of stairs where the person offering assistance can use the handrail for support in lifting.

The CRADLE LIFT may be favoured by both the person assisting and the disabled person, but is very risky if they are approximately the same size and weight; the person assisting is forced to assume a posture during the lift which can result in injury to the back.

The FIREFIGHTER'S LIFT requires considerable skill on the part of the person providing the assistance to get the position where breathing is not restricted.

The Research Council study concludes that if it is necessary to move a person out of a wheelchair and down a flight of stairs, then the PIGGY-BACK position is preferable. If, however, the handicapped person has no arm strength, or weighs less than half of the person assisting him, then the CRADLE LIFT is preferable.

Never take a wheelchair up or down steps with less than two persons. When going up, place the back of the chair (large wheels) directly against the first step, with the front of the chair facing away from the stairs. Stand behind and pull the chair upward. The second helper should stand in front of the chair and assist by supporting the front of the chair. Be sure to hold on to solid part of the chair, such as rods, rather than footrests, arm rests or wheels.

When taking the chair down steps, tip the chair backward and use only the rear wheels. The pusher can control by flexing his legs. The second helper stands in front and steadies the chair by holding its solid parts. The front of the chair should be held by the bars, not the footrests or wheels. For safety purposes, the person in front should never left the chair. Try and avoid bouncing or jolting the chair.

Always be concerned for the safety and comfort of the chair's occupant. Never tilt the chair to the front; always back.

A visually impaired person may be totally or legally blind. Legally blind implies that a person may be able to differentiate between light and dark or see very large objects, but is not able to see anything clearly enough to safely depend on his vision.

The following suggestions will help you assist a blind person in an emergency situation:
  1. Speak out when approaching a visually impaired person. Let the individual know exactly where you are.
  2. Explain who you are, why you are there, and what needs to be done.
  3. Ask the person's name and use it when speaking to the person.
  4. Offer your help, but let the person choose what help is needed.
  5. Ask the person what degree of vision he has, to help you determine how best to help or how much the
      person can help themselves.
  6. To help compensate for lack of visual stimuli, use voice inflections.
  7. Let the blind person take your arm for walking. Always explain what you want to do ahead of time. The
      blind person may wish to walk slightly behind you in order to gauge your reactions to obstacles and curbs.
  8. If you are leading several blind persons at the same time, ask them to hold each other's hand.
  9. Speak naturally, directly to the blind person, not through a third party. Do not shout.
10. Don't be over solicitous. Most blind people are quite capable and lead full lives.

A hearing impaired person may be totally or partially deaf, and may not wear hearing aids to improve his hearing, but they may not be adequate under the stress of an emergency situation. Realize that a hearing aid amplifies background noise, and may, therefore, create an uncomfortable noise level during the bustle of an emergency. A totally deaf person may not be able to speak clearly.

The following suggestions will help you assist a deaf person in an emergency situation:
1. Face a deaf person directly and speak slowly and naturally, even if an interpreter is present. The deaf person
    may be trying to read your lips. Do not cover your face with you hands or other objects which you may be
    holding, and do not turn your face away. The person may be trying to see your facial expressions.
2. Wave, or tap the person gently on the should to attract the person's attention.
3. Flick the light to get attention in a crowded room, especially to attract the attention of a deaf person.
4. Have a pad and pencil available so that both you and the deaf person understand the same message; this is
    especially necessary if you cannot understand the person's speech. Write slowly, and let the deaf person
    read as you write.
5. Do not be impatient even in an emergency situation where time is critical. The deaf person may have
    difficulty understanding the urgency of your message.
6. Do not allow others to interrupt you, or the deaf person, during you conversation. Distractions may result in
    confusion.
7. Remember the terms "hard of hearing", "deaf" or "hearing impaired" are the acceptable terminology to use
    when referring to hearing impaired persons.