Most sections of this guide will have a similar format:

  • General Characteristics: will provide a quick understanding of a given disability or situation.
  • How To Approach: will give suggestions specific to the disability.

TIPS is meant to provide helpful ways to interact with people with disabilities. It is not meant to diagnose any condition.

General Approach: The following is a general approach to interacting with people with disabilities in an emergency. Understand that people with disabilities may need varying degrees of assistance, or none at all. The following are suggestions that you might find useful:

  • Introduce yourself.
    • My name is… I’m here to help you. I am a … (name your job).
    • Show them your badge, but say “I look different than my picture on my badge because (for example) I am wearing protective equipment.”
  • Explain the nature of the emergency.
    • I am here because… Describe the situation using simple and concrete words. Do not go into grave detail.
    • Explain what you are going to do to help them to safety.
    • Explain when they will be able to contact or rejoin loved ones (if you know for sure).
  • As a first responder, you should only ask for that information you need to assist that individual as it relates to their disability.
  • Your best resource for helping anyone with a disability (including children and seniors) is to work with their existing support system, if available. Start with these questions:
    • If a child, ask if their mom or dad is home. If not, how can you reach them?
    • Do you live alone?
      • If yes, who do you call when you need help?
      • How can I reach that person right now?
    • If you live with someone, is that person here now?
  • If an individual is not able to assist in locating a caregiver, check to see if their cell phone has an ICE (In Case of Emergency) contact. (Search ICE in contact list.)
  • Visually check to see if there is a wrist bracelet, necklace, or shoe tags that identify the person as having special health care needs. These identify a medical need, but not necessarily a disability.
  • If a person is exhibiting erratic or aggressive behavior, seek professional assistance immediately and refer to the section on mental illness.
  • When communicating with someone with a disability:
    • Be aware that not everyone can communicate verbally.
    • Use “People First” language. Put the person before the disability. You might be helping a boy with autism, not an autistic boy.
    • Give accurate, honest information.
    • Use pictures and objects to illustrate your words.
    • Use simple language.
    • Avoid using phrases that have more than one meaning, such as “knock it off” or “cut it out.”
    • Be patient. If needed, give extra time for the person to process what you are saying and to respond.
  • Watch for signs of stress and/or confusion (e.g. withdrawing, rubbing hands).
  • Approach the person in a calm manner.
  • Respect the dignity of the person as an equal (e.g. speak directly to the person).
  • Offer your arm or elbow to the person to hold as they walk, if needed.
  • Remember that the person may not understand typical social rules, so may be dressed oddly, invade your space, prefer to be farther away from you than typical, or not make eye contact.
  • Be aware of conditions that might be misinterpreted. For example:
    • Cerebral Palsy is sometimes mistaken for drunkenness.
    • people with autism might act as if the situation is not serious.
    • people with hearing limitations might appear to be ignoring you.
  • Items to bring with the person: Ask the individual what items they will need. It is important to evacuate those necessary items. The goal is for the individual to be as independent as possible in order to reduce additional trauma. Make sure you check/ask for:
    • Essential equipment and supplies (e.g., wheelchair, walker, service animal, hearing aids, glasses).
    • Medication and health instructions.
    • Technology and/or communication devices.
    • Contact information.
  • Trauma: If a person is experiencing trauma, efforts should be made to get this person to a trained health professional. Some people may benefit from a spiritual leader or chaplain. Symptoms or signs of trauma might include:
    • Extreme behavior.
    • Detachment and withdrawal.
    • Lack of concentration.
    • Irritability.
    • Aggression.
    • Flashbacks.
  • Service Animals are used for a number of disabilities.
    • MUST be evacuated with the person.
    • Only two questions can be asked to determine if an animal is a service animal: Is the animal trained to perform a service for you? With what tasks or duties does the animal assist you?
    • Do not touch or give the animal food, water, or treats without the permission of the owner.
    • See Service Animals section for more TIPS.
  • Pets: Pets are vitally important to people. People affected by disasters may actually jeopardize their own well-being to save a pet from harm. For this reason, the government has determined that pets can be evacuated with their owners and provided for through the mass care function.
  • Comfort Animals: Emotional support animals or comfort animals provide comfort and support in forms of affection and companionship for an individual suffering from various mental and emotional conditions. These animals are not required to perform any specific tasks like a service dog. They are not designated as service animals by the Americans with Disabilities Act (ADA). If at all possible, allowances should be made to accommodate the comfort animal and handler as much as possible.

General Characteristics: Autism spectrum disorder (often just referred to as autism) affects a person’s ability to communicate and interact with others.

It is important to know that 50% of children with autism wander.

Keep them away from potential dangers (busy streets, etc.) since they may not have fear of danger.

Autism affects people in different and varying degrees, but a person with autism might have some of the following characteristics:

  • An intense focus or fixation on:
    • specific interests or ideas.
    • objects.
    • sensory aspects of the environment and may become overstimulated by excessive noise or other distractions.
  • Language: They may:
    • be verbal or non-verbal.
    • have delayed learning of language.
    • have an unusual or monotone voice.
    • have repetitive speech: the person may repeat what you have said, repeat the same phrase over and over, or talk about unrelated topics.
    • have difficulty maintaining a conversation.
  • Behaviors: A person with autism may:
    • show repetitive mannerisms (hand-flapping, twirling objects). Do not try to stop these behaviors unless risk of injury.
    • have difficulty making eye contact or might look at you at an odd angle.
    • appear to not take the situation seriously.
    • display behaviors that you might misinterpret as drug abuse or belligerence. Don’t assume!
    • not understand typical social rules, so may be dressed oddly or invade your space.
  • They may have difficulty with reasoning and planning.
  • Some people with autism don’t show indications of pain; check for injuries.

How to Approach

  • Approach the person in a calm manner.
    • Use direct, concrete phrases with no more than one or two steps.
    • Use alternate means of communication if necessary, look for a picture communication system (physical or electronic), or write brief instructions on a pad if the person can read.
    • Gesture and move slowly.
  • Tell them what you are doing now and next.
  • Allow extra time for response.
  • Avoid touching the person.
  • If possible, turn off sirens, lights, and remove responder’s canine partner, if present. Attempt to find a quiet location for the person, especially if you need to talk with them.
  • Some people on the autism spectrum are very sensitive to noise and vibration. If a person is negatively affected by these stimuli, it would be best to consider not to choose helicopter transport. If possible, speak with family or advocates about how a person might respond to extreme vibrations and noise as experienced in a helicopter before choosing that route.
  • Watch for outbursts or impulsive behavior. If the person is not harming themselves or others, wait until these behaviors subside.

General Characteristics: There is a difference between visual limitations and blindness. Some people who are “legally blind” have some sight, while others are totally blind.

How To Approach

  • Announce your presence.
  • Speak naturally and directly to the
  • Do not shout.
  • Don’t be afraid to use words like “see,” “look,” or “blind.”
  • Ask if you can help guide them. Let the person explain what help is needed.
    • Don’t grab them.
    • Offer your arm, elbow, or shoulder. He or she can feel change of direction and other obstacles through you. He or she may also use a white cane to obtain additional environmental cues while grasping your elbow.
    • As you walk, advise them of any obstacles (doors, stairs, ramps, etc).
    • They may choose to walk slightly behind you to gauge your body’s reactions to obstacles.
  • When guiding someone to a seat, place the person’s hand on the back of the chair.
  • If leading several individuals with visual limitations, ask them to guide the person behind them.
  • Remember that you’ll need to orally communicate any written information.
  • When you have reached safety, orient the person to the location and ask if any further assistance is needed.
  • If the person has a service animal, don’t pet it unless the person says it is okay to do so. Service animals must be evacuated with the person.
  • Items to bring with the person: Ask the individual what items they will need. It is important to evacuate those necessary items. The goal is for the individual to be as independent as possible in order to reduce additional trauma. Make sure you check/ask for:
    • Essential equipment and supplies (e.g., wheelchair, walker, service animal, hearing aids, glasses).
    • Medication and health instructions.
    • Technology and/or communication devices.
    • Contact information.
  • Many individuals who are blind have service animals. Refer to the Service Animals section for additional tips.
  • Some individuals who are blind are also deaf and have additional needs. Refer to the Deaf-blind section for more specific tips.

General Characteristics: Brain injury is often an “invisible disability” with no physical scars or mobility deficits. However, brain injury can affect how the person acts, responds – or doesn’t respond – to questions, walks, talks, reacts to the situation, or controls movements.

Brain injury can affect the person’s cognitive functioning, mobility, perceptions and senses, and emotions. The person may have all, a couple, or only one of these areas of functioning impacted. Keep in mind that every brain injury is unique. If you have seen one brain injury, you have seen one brain injury.

  • An individual with brain injury:
    • may have trouble with impulse control and may do things without thinking of the consequences.
    • may have mood swings, and can go from one extreme to the next very quickly.
    • may not read social cues and may say or do something inappropriate or irrational.
    • can become impatient, irritable, or very emotional.
    • may be sensitive to light and might wear sunglasses inside.
    • may have sensitivity to noise. If possible reduce noise, move to a quiet location to talk.
  • The person may have difficulty with motor skills, including walking steady, walking in a straight line, or grasping objects.
  • The person may be prone to seizures. If possible, turn off lights and sirens when transporting the person.
  • Speech can be affected, and the person may slur or have difficulty pronouncing words.
  • Sometimes physical symptoms can be mistaken for drug or alcohol use, don’t assume that is the cause.

How to Approach

  • Avoid complicated sentences. Use direct phrases. When giving instructions, keep steps to a minimum.
  • Some people with brain injury have trouble with short-term memory, and may need you to repeat something more than once. You might also write down the instructions/process.
  • The person may have trouble verbalizing thoughts. The person may be able to verbalize but have difficulty understanding what you are saying to him or her. Give extra time for a response.
  • The person with brain injury may have trouble concentrating or be easily distracted. If possible, move to a quiet place to talk.
  • The person may have difficulty reporting events in sequence. Ask step-by-step questions using terms like “first,” “next,” and “last.”
  • Items to bring with the person: Ask the individual what items they will need. It is important to evacuate those necessary items. The goal is for the individual to be as independent as possible in order to reduce additional trauma. Make sure you check/ask for:
    • Essential equipment and supplies (e.g., wheelchair, walker, service animal, hearing aids, glasses).
    • Medication and health instructions.
    • Technology and/or communication devices.
    • Contact information.

General Characteristics: Chemical sensitivities can include many items – from fabric softeners to soaps to pesticides.

Ideally, first responders should not wear fragrance. Use fragrance free deodorant, fragrance free laundry detergent and dryer sheets, and fragrance free body wash and lotion.

Emergency supplies should be latex free.

How to Approach

  • Reassure the person that you understand they are chemically sensitive and will work with them in providing care. Be sure to ask what the person is sensitive to, including reactions to medications you may have to administer.
  • Offer mask or respirator – or better yet, suggest they use their own.
  • Whenever possible, take the person’s own medical supplies and equipment with them because they may be sensitive to items issued at a shelter or hospital, including:
    • oxygen mask and tubing.
    • medications.
    • food and water.
    • bedding and clothing.
    • soap and personal toiletries.
  • If the person is taken to an emergency shelter or a hospital, help protect them from air pollution.
  • Avoid placing the person in rooms with recent pesticide sprays, strong scented disinfectants or cleaners, new paint or carpet, or other recent remodeling.
  • Be aware of anything in the environment that might cause distress: smoke from a fire, debris from a wind storm, etc.
  • Be responsive to the individual’s request for limitations on exposure if you need to evacuate. Allow and encourage them to take personal items to which they are not sensitive.

General Characteristics: If you find an unaccompanied minor, call law enforcement officers immediately to take custody. Of course, you cannot leave a child before law enforcement has arrived. The most important element when dealing with a child in an emergency is to immediately try and locate a family member or care giver who might be with the child. This person will know the child’s needs and will be able to help you decide what to evacuate with the child. If possible, try to keep the child and the parent/caregiver together. If there are medical needs, parental approval will be required for medical care.

An unaccompanied minor does not have the right to refuse an evacuation.

How to approach

  • Make sure the child knows who you are, why you are there, and that you are there to help him/her (see details in introduction section of this document). Show them your badge and talk about your uniform.
  • Understand that children respond in different and perhaps unexpected ways.
  • Remember that your feelings will be communicated to the child. Maintain a posture that is less likely to be perceived as threating or intimidating.
  • Get down to the child’s level so that you can talk face to face. This makes it easier to connect with the child.
  • Stay calm. Be patient.
  • Speak slowly and be direct.
  • Provide verbal reassurance and physical comforting. Be gentle with the child.
  • If time permits, look for the child’s comfort items – a teddy bear or blanket right away.
  • If time permits, talk with the child about topics that interest him/her.
  • Ask open-ended questions to encourage communication.
  • Be an active listener. Restate, summarize, or ask questions about what the child said to let them know you were listening and to provide opportunities for clarification.
  • Respond to questions honestly and calmly, in language the child can understand.
  • Understand that the child’s chronological age may not accurately reflect their developmental age or abilities.
  • Tell the child what is happening or what is about to happen.
  • Provide as much routine as possible.
  • If evacuating, take age-appropriate supplies and comfort items.
  • Provide distractions, if available, such as age-appropriate videos, toys, etc.

General characteristics: Hearing aids or cochlear implants do not guarantee that a person can hear and understand speech. They increase volume, not necessarily clarity. Some people can hear almost normally with hearing aids while they provide little help for others.

People who are deaf or hard of hearing are diverse in their approach to communication. They may use any combination of the following: hearing aids, interpreters, cochlear implants, assistive listening devices, sign language, lip reading, or voice.

How to Approach

When communicating with someone who is deaf or hard of hearing:

  • Get their attention by tapping their shoulder, flicking the lights, waving your hands, or stomping on the floor.
  • Establish eye contact with the individual. If an interpreter is present, still maintain eye contact with the individual with whom you are communicating.
  • Ask how best to communicate. A good first step is by offering a pen and paper, picture communication board (if one is nearby), or a phone with a note screen app. Write slowly and let the individual read as you write. Written instructions should work for many people, but not always.
  • Written communication may be especially important if you are unable to understand the person’s speech.
  • Keep communication short and to the point. Use key words.
  • Use facial expressions and hand gestures as visual cues.
  • Check to see if you have been understood and repeat, if necessary.
  • Do not allow others to interrupt you while conveying the emergency information.
  • Be patient–the person may have difficulty understanding the urgency of your message.
  • Good light is essential for communication. Move to a well-lit area, or shine a flashlight on yourself when you communicate. Do not shine a flashlight in the person who is deaf or hard of hearing’s eyes when communicating. This makes lip reading close to impossible.
  • Provide the person with a flashlight to signal their location in the event they are separated from the rescue team.
  • Do not shout or whisper. Doing so distorts your mouth and complicates lip reading.
  • Reduce background noises, if possible, including side conversations.

General characteristics: People who are both deaf and blind have varying degrees of deafness and varying degrees of blindness.

How to Approach

When communicating with someone who is deaf-blind:

  • To get their attention, lightly touch their hand or shoulder. This helps the person get oriented to where you are standing. Once you get their attention, stand still and allow the person to adjust their position. By doing this, they will put you in a place that is comfortable for them for communication.
  • When guiding, offer your arm, elbow, or shoulder. They can feel change of direction and other obstacles through you. They may also use a white cane to obtain additional environmental cues while grasping your elbow.
  • When you start communication, identify yourself.
  • Even if the person is wearing a cochlear implant or hearing aid, do not assume they can hear you.
  • Ask the person who is deaf-blind how to best communicate.
  • If they have indicated they can hear you a little, reduce background noises, including side conversations.
  • You might try these other ways of communication:
    • Use your finger to trace letters on the individual’s palm.
    • They may have a smart phone with an electronic braille device. You might be able to text or type messages back and forth.
    • A heavy marker on paper might work.
  • Keep communication short and to the point. Use key words.
  • Check to see if you have been understood and repeat, if necessary.
  • Do not allow others to interrupt you while conveying the emergency information.
  • Be patient–the person may have difficulty understanding the urgency of your message.
  • Provide the person with a flashlight to signal their location in the event they are separated from the rescue team.

General Characteristics: Intellectual disabilities are not necessarily readily apparent. You might not consider an intellectual disability until you interact with the person.

On the other hand, intellectual disabilities might be symptomatic of other disabilities. For example people with Down Syndrome may have intellectual disabilities as well as physical.

How to Approach

  • Introduce yourself using simple language.
    • My name is… I’m here to help you. I am a … (name your job).
    • Show them your badge, but say “I look different than my picture on my badge because (for example) I am wearing protective equipment.”
  • Explain the nature of the emergency.
    • I am here because… Describe the situation using simple and concrete words.
    • Explain what you are going to do to help them to safety.
    • Explain when they will be able to con-tact or rejoin loved ones (if you know for sure).
  • Show that you are calm and competent.
  • Give extra time for the person to process what you are saying and to respond.
  • Respect the dignity of the person as an equal and as an adult (example: speak directly to the person).
  • Allow quiet time to rest, if possible, to lower stress and fatigue.
  • Use short sentences.
  • Give accurate, honest information. Look for essential equipment and supplies (e.g., wheelchair, walker, communication devices, etc.).
  • Items to bring with the person: Ask the individual what items they will need. It is important to evacuate those necessary items. The goal is for the individual to be as independent as possible in order to reduce additional trauma. Make sure you check/ask for:
    • Essential equipment and supplies (e.g., wheelchair, walker, service animal, hearing aids, glasses).
    • Medication and health instructions.
    • Technology and/or communication devices.
    • Contact information.
  • Watch for signs of stress and/or confusion (e.g., withdrawing, rubbing hands together).
  • Repeat reassurances (e.g., “You may feel afraid. That’s okay. You’re safe now.”).
  • Give encouragement (e.g., “Thanks for moving fast. You are doing great. Other people can look at you and know what to do.”).
  • Provide frequent updates on what’s happening and what will happen next. Refer to what you told them will happen, for example: “Just like I said before, we’re getting into my car now. We’ll go to…..now.”
  • Reduce distractions – for example, lower volume of radio. Use flashing lights on vehicle only when necessary.
  • Explain any written material (including signs) in everyday language.
  • Repeat public address system announcements in simple language.
  • Share the information you’ve learned about the person with other workers who will be assisting the person.

General Characteristics: You may not be able to easily determine if a person has a mental illness. If you suspect someone has a mental health issue, be aware that these situations can be unpredictable and can quickly become volatile. Watch for sudden changes in behavior.

Of course not everybody with mental illness will act out, but in some cases the situation can be difficult and dangerous.

If the situation does appear to be getting out of control, do not hesitate! Seek assistance! Make an immediate resource request through your chain of command. Request a professional with specific skills and knowledge of mental or behavioral health. Depending on the size and scope of the emergency, resources may be available that can range from specially trained emergency medical technicians to Crisis Intervention Teams to on-call mental health professionals to community mental health services providers to voluntary organizations disaster mental health services workers.

How to Approach

  • Ask if the person has a mental health issue, although they may not be able to accurately articulate their condition.
  • Coping mechanisms for a person with a mental illness might have the appearance of belligerence or toughness. Be careful not to escalate the situation.
  • Be aware that:
    • mental health conditions are sometimes misinterpreted as drunkenness.
    • mental health conditions may be caused by a physical condition.
  • In an emergency, the person may become confused or disoriented. Speak slowly in a calm tone. Keep your communication simple, clear, and brief.
  • If the person becomes agitated, help them find a quiet corner away from the confusion.
  • If they are confused, don’t give multiple commands. Ask or state one thing at a time.
  • Be empathetic. Show that you have heard them and care about what they have told you. Be reassuring.
  • If the person is delusional, don’t argue with them or try to talk them out of it. Let them know you are there to help.
  • Ask if there is any medication they should take with them.
  • Try to avoid interrupting a person who might be disoriented or rambling. Let them know that you have to move quickly.
  • Don’t talk down to them, yell, or shout.
  • Have a forward leaning body position. This shows interest and concern.

General Characteristics: Mobility limitations refer to the inability of a person to use one or more of his/her extremities, or a lack of strength to walk, grasp, or lift objects. Mobility limitations may be caused by a number of factors, such as conditions present at birth, disease, an accident that may be the result from neuro-muscular and orthopedic conditions. The use of a wheelchair, crutches, a walker, or even a support animal such as a large dog or miniature horse, may be utilized to aid in mobility.

Evacuate their personal wheelchair, walker, canes, etc. If you have concerns about equipment, contact the EOC for guidance on evacuating equipment.

  • Don’t make assumptions about the person’s abilities. Always ask the person how you can help before beginning any assistance. Even though it may be important to evacuate quickly, respect their independence to the extent possible.
  • Ask the person the best way to carry them. Ask first before carrying a person.
  • Ask if they have limitations or issues that may affect their safety.
  • Some people may need assistance getting out of bed or out of a chair, but can then proceed without assistance. Ask!
  • Here are some other questions you may find helpful:
    • “Are you able to stand or walk without the help of a mobility device like a cane, walker or wheelchair?”
    • “You might have to [stand] [walk] for quite a while on your own. Will this be okay?  Please be sure and tell someone if you think you need assistance.”
  • When carrying the person, avoid putting pressure on his or her arms, legs, or chest. This may result in spasms, pain, and may even interfere with their ability to breathe.

Crutches, Canes, or Other Mobility Devices

  • A person using a mobility device may be able to negotiate stairs independently. One hand is used to grasp the handrail while the other is used for the crutch or cane. Do not interfere with the person’s movement unless asked to do so, or the nature of the emergency is such that absolute speed is the primary concern. If this is the case, tell the person what you’ll need to do and why.
  • Ask if you can help by offering to carry the extra crutch.
  • If the stairs are crowded, act as a buffer and run interference for the person.

Evacuating Wheelchair Users

  • Sit or kneel to speak to the person at eye level.
  • Wheelchair users are trained in techniques to transfer from one chair to another. Depending on their upper body strength, they may be able to do much of the work themselves.
  • Ask before you assume they need help, and ask what help is needed.

Carrying Techniques Down Steps for Non-Motorized Wheelchairs

The in-chair carry is the most desirable technique to use, if possible.

One-person assist

  • Grasp the pushing grips, if available.
  • Stand one step above and behind the wheelchair.
  • Tilt the wheelchair backward until a balance (fulcrum) is achieved.
  • Keep your center of gravity low.
  • Descend the stairs frontward.
  • Let the back wheels gradually lower to the next step.

Two-person assist

The first person follows the one-person assist as above. The second person does the following:

  • The second person should stand in front and face the wheelchair.
  • Stand one, two, or three steps down depending on height of the other rescuer.
  • Grasp the frame of the wheelchair.
  • Push into the wheelchair.
  • Descend the stairs backward.

Motorized Wheelchairs

  • Motorized wheelchairs can weigh up to 200 pounds unoccupied, and combined weight of occupant and wheelchair can exceed 300 pounds. They can also be longer than manual wheelchairs. Lifting a motorized wheelchair and user up or down stairs requires two to four people.
  • People who use motorized wheelchairs probably know their equipment much better than anyone. Before lifting, ask about heavy chair parts that can be temporarily detached, how you should position yourselves, where you should grab hold and what, if any, angle to tip the chair backward.
  • Turn the wheelchair’s power off before lifting.
  • Most people who use motorized wheelchairs have limited arm and hand motion. Ask if they have any specific requirements for being transported down the stairs.
  • The easiest way to move a motorized chair if the individual is not in it, is to sit in it yourself and drive it – ask permission of the owner first if possible.

Service Animals are used for a number of disabilities.

  • MUST be evacuated with the person.
  • See Service Animal section for more TIPS.

General Characteristics: Usually, pregnancy is not an emergency. In fact, if the pregnant woman is otherwise healthy, it’s likely that she can be included in any plans for evacuation.

If someone is in active labor, call for emergency assistance immediately. Make her comfortable while you wait for help. If emergency assistance is not available, they can assist you over the phone.

High Risk: A pregnant woman experiencing any of the problems listed below, now or within the last three hours, is considered high risk, especially if the woman has had a cesarean section (“C Section”) in the past.

  • Steady bleeding “like a period” from the vagina.
  • Convulsion or a really bad (unusual) headache that will not go away with Tylenol.
  • Constant strong belly or back pain with hardness in her pregnant belly.
  • Strong pains and hardening belly that comes and goes every couple of minutes and a “due date” three weeks away or more.

If the pregnant woman has had any of these problems, she should be taken to a hospital (if hospital access is available) or other health care facility for an assessment. If taking her to a facility is not possible, she should be helped to find a comfortable position and not be left alone.

Labor: If a woman is in active labor:

  • Be as calming as possible. Expectant mothers may be especially anxious in emergency situations. Reassure them you will do everything you can for them.
  • Try not to separate the expectant or newly delivered woman and her family, even if transporting.
  • If you must transport a pregnant woman, regardless of whether she is in labor or not, transport her lying on her side, not flat on her back.
  • Ask her if she has a copy of her pregnancy/prenatal records. If she does, make sure they are brought with her.

Newborns

  • Dry and rub the baby gently to keep baby warm and to stimulate breathing.
  • Give the baby to the mother.
  • Cutting the cord is not an emergency. Leave this for a medical professional.
  • Usually, the placenta (afterbirth) will follow the baby on its own in about thirty minutes or less. After it comes, it can be put in a plastic bag, wrapped with the baby, or left behind, depending on the circumstances.
  • Give new mothers plenty of fluids to drink (water or juice is best).
  • If you need to transport a mother and her newly born baby:
    • Keep the mother and newborn together: baby in mother’s arms or on her belly.
    • If available, take diapers, baby clothes, formula, and bottles (if mother is bottle feeding the baby).

General Characteristics: For many seniors, their biggest fear is leaving their home. Some have a fear of the government, a fear of being moved to a nursing home, and a fear of losing belongings.

Additionally, they may fear losing their pets, which for many seniors is their primary source of comfort and company.

If you need assistance, call the Elder Abuse and Neglect Hotline at 800.392.0210. This hotline is also appropriate for adults with disabilities.

How to Approach

  • Always ask the person how you can best assist them.
  • Some seniors may respond more slowly to a crisis and may not fully understand the extent of the emergency. Repeat questions and answers, if necessary. Be patient!
  • Reassure the person that they will receive medical assistance without fear of being placed in a nursing home.
  • Explain that this relocation hopefully is temporary.
  • Before moving a senior, assess their ability to see and hear. Adapt rescue techniques for sensory limitations.
  • Persons with a hearing loss may appear disoriented and confused when in reality they simply can’t hear you. Determine if the person has a hearing aid. If they do, is it available and working? If it isn’t, try and find a new battery to make it work. Adjust your speaking volume as needed. (See also the Tips for Deaf/Hard of Hearing.)
  • If the person has a vision loss, identify yourself and explain why you are there. Let the person hold your arm and then guide them to safety. (See also the Tips for Blind/Low Vision.)
  • Items to bring with the person: Ask the individual what items they will need. It is important to evacuate those necessary items. The goal is for the individual to be as independent as possible in order to reduce additional trauma. Make sure you check/ask for:
    • Essential equipment and supplies (e.g., wheelchair, walker, service animal, hearing aids, glasses).
    • Medication and health instructions.
    • Technology and/or communication devices.
    • Contact information.
  • If the person has dementia, turn off emergency lights and sirens if possible. Identify yourself and explain why you are there. Speak slowly, using short words in a calm voice. Ask “yes” or “no” questions and repeat them, if necessary. Maintain eye contact.
  • Your best resource for helping seniors is to work with their existing support system, if available. Start with these questions:
    • Do you live alone?
      • If yes, who do you call when you need help?
      • How can I reach that person right now?
    • If you live with someone, is that person here now?
  • If an individual is not able to assist in locating a care-giver, check to see if their cell phone has an ICE (In Case of Emergency) contact. (Search ICE in contact list.)

General Characteristics: Traditionally the term “service animal” referred to seeing-eye dogs.  However, today there are many other types of service animals. Service animals are used for a number of disabilities.

Service animals MUST be evacuated with the individual.

Only two questions can be asked to determine if an animal is a service animal:

  1. Is the animal trained to perform a service to you?
  2. With what tasks or duties does the animal assist you?

A person is not required to give you proof of a disability that requires a service animal. You should accept the claim and treat the animal as a service animal. If you have doubts, wait until you arrive at your destination and address the issue with the supervisor in charge. However, if the animal is out of control or presents a threat to the individual or others, remove it from the site.

How to Approach

  • Remember—a service animal is not a pet.
  • Do not touch or give the animal food, water, or treats without the permission of the owner.
  • Plan to evacuate the animal with the owner. Do not separate them. Also, service animals should be decontaminated with the owner.
  • Usually when a dog is wearing its harness, it is on duty. A service animal must be in a harness or on a leash. In the event you are asked to take the dog while assisting the individual, hold the leash and not the harness.
  • According to the ADA, if the harness or leash interferes with the dog’s work/tasks or if the person’s disability prevents it, the dog does not have to be harnessed. If they are not in harness or leash, the handler must have control by voice or hand signals.
  • Pets: Pets are vitally important to people. People affected by disasters may actually jeopardize their own well-being to save a pet from harm. For this reason, the government has determined that pets can be evacuated with their owners and provided for through the mass care function.
  • Comfort Animals: Emotional support animals or comfort animals provide comfort and support in forms of affection and companionship for an individual suffering from various mental and emotional conditions. These animals are not required to perform any specific tasks like a service dog. They are not designated as service animals by the ADA. If at all possible, allowances should be made to accommodate the comfort animal and handler as much as possible.

Dear Responder:

Whether you are responding to an emergency caused by natural forces such as fire, flood, tornado, or pandemic, or one caused by a terrorist attack, you will likely encounter persons with disabilities or some type of access or functional need. While some needs will be obvious, others, including some cognitive disabilities or mental illness, may be difficult, if not impossible, to detect.

These Tips are not meant to be comprehensive, but contain specific information that can be read quickly either before or while you are responding to an incident.

If you would like more information about how to best assist persons with disabilities and access and functional needs in disaster situations, or have suggestions for future editions of this web resource, please see the contact information below.

Missouri Developmental Disabilities Council

1706 E. Elm St.
Jefferson City, MO 65101

To give feedback about the Tips for First Responders website, ask questions, or offer suggested resources to be included in this guide, please contact us at:

moddc@moddcouncil.org

We appreciate permission to reproduce “Tips for First Responders” from Dr. Anthony Cahill, Center for Development and Disability, Albuquerque, New Mexico.

Other contributors were: New Mexico Department of Health, Office of Health Emergency Management; American Association on Health and Disability; New Mexico Governor’s Commission on Disability; and, Research and Training Center on Independent Living, Missouri Department of Mental Health, Missouri State Emergency Management Agency, Kansas City Police Department and Independence Emergency Preparedness Division. In addition, these tips were reviewed by first responders representing law enforcement, fire departments and Emergency Medical Services (EMS) personnel.

Special appreciation to the University of Missouri Kansas City – Institute of Human Development (UMKC-IHD), for creating this internet version of this tool for first responders.

United Way 2-1-1

  • United Way 2-1-1 is a 24/7 connection to agencies and resources for every community in Missouri and includes the metro area around Kansas City that extends into Kansas and the metro area around St. Louis that extends into Illinois.
  • United Way 2-1-1 has a comprehensive database of local community resources that will connect people to needed services, including services for basic needs, such as food, clothing, and shelter, or more complex issues such as health care, mental health, education, and employment.
  • In an emergency situation, United Way 2-1-1 can help locate resources for disaster relief and counseling, including services that benefit people with access and functional needs.
  • United Way 2-1-1 is a partner of emergency management and can help first responders that need community resources to assist with disabilities and/or access and functional needs of disaster or emergency affected individuals and households. To call dial 2-1-1 or 800-427-4626

Missouri Hotlines & Crisis Intervention

  • MO Adult Abuse and Neglect and Exploitation Hotline
    • Responds to reports of abuse and neglect for adults with disabilities 18 years and older adults 65 years and older without disabilities, living in the community or in long-term care facilities. Call (800) 392-0210 or make an online report.
  • MO Child Abuse and Neglect Hotline
    • Responds to reports of abuse and neglect of children and youth under the age of 18. Call (800) 392-3738 or make an online report.
  • MO Medicaid Fraud Control Unit
    • Responds to reports of financial abuse, neglect, or exploitation of persons who reside in nursing homes or board and care facilities. Call (800) 286-3932
  • MO Department of Mental Health Crisis Assistance
    • This site provides information about the DMH service regions including DD regional offices, Behavioral Health Crisis hotlines, and information on suicide prevention.
  • MO Coalition Against Domestic and Sexual Violence
    • MCADSV provides a directory of victim services by location including domestic violence shelters, support groups, counseling, hospital/medical advocacy, assistance in court and with law enforcement, immigration advocacy, as well as additional resources and support.
  • National Sexual Assault Hotline
    • RAINN provides 24/7 support, information, and referrals to local resources for individuals who have experienced sexual assault or abuse. You can call the 24/7 hotline 1-800-656-4673 or begin a live chat www.rainn.org
  • National Domestic Violence Hotline
    • Provides 24/7 support, information, and referrals to local resources for individuals who have experienced domestic violence or abuse from a partner. You can call the 24/7 hotline 1-800-799-7233 or begin a live chat www.thehotline.org
  • National Suicide Prevention Lifeline
    • The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. Video relay Service – Dial 800-273-8255; TTY – Dial 800-799-4889; Voice/Caption Phone – Dial 800-273-8255
  • Deaf LEAD
    • Provides 24/7 crisis support through videophone and text for Deaf people. To speak with someone via video phone call 321-800-3323 or text HAND to 839863

Disability Resources and Training

Services and Supports

Communication

  • Signing Savvy
    • Signing Savvy is a sign language dictionary containing several thousand videos of American Sign Language (ASL) signs, finger-spelled words, and other common signs used within the United States and Canada.
  • Google Translate
    • Google’s free translation service instantly translates words, phrases, and web pages between English and over 100 other languages.
  • A Communication Aid for Emergency Personnel
    • This flipbook provides useful tips and tools for emergency personnel supporting people with unique access or functional needs. It includes general interaction guidelines and communication aids such as picture symbols and common sign language phrases.