EMS Particular Patient Populations - Cerebral Palsy

EMS Providers should be knowledgeable about cerebral palsy (CP) to effectively assess and provide care for patients with this condition.

Here are some key points they should know:

1. Understanding Cerebral Palsy:

   • Cerebral palsy is a group of permanent movement disorders that appear in early childhood. It is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture.
   • CP can manifest in various ways, including spasticity (stiff muscles), dyskinesia (involuntary movements), ataxia (poor balance and coordination), or a combination of these symptoms.
   • The severity of CP can vary widely, ranging from mild motor impairments to profound physical disabilities.

2. Assessment and Management:

   • Conduct a thorough assessment of the patient's vital signs, airway, breathing, and circulation while being mindful of their motor impairments and positioning needs.
   • Recognize that patients with CP may have difficulty with communication and may require alternative methods of expressing pain or discomfort.
   • Be prepared to provide appropriate pain management and comfort measures tailored to the individual patient's needs.

3. Mobility and Positioning:

   • Patients with CP may have mobility aids such as wheelchairs, walkers, or orthotic devices. Familiarize yourself with these devices and assist the patient in maintaining their mobility and independence.
   • Be mindful of the patient's positioning to prevent contractures, pressure ulcers, and discomfort during transport. Use supportive cushions or padding as needed to maintain proper alignment and comfort.

4. Communication:

   • Patients with CP may have difficulty with speech or may use alternative communication methods such as augmentative and alternative communication (AAC) devices, sign language, or gestures.
   • Take the time to communicate with the patient using methods that they are comfortable with and ensure that their caregivers or family members are involved in the communication process.

5. Seizure Management:

   • Some individuals with CP may have coexisting epilepsy and may be at risk of seizures. Be prepared to manage seizures promptly and effectively, following established seizure protocols and providing appropriate medical interventions as needed.

6. Psychosocial Support:

   • Recognize the psychosocial impact of CP on patients and their families, including potential challenges related to caregiving, social isolation, and stigma.
   • Provide emotional support and reassurance to patients and their caregivers, and connect them with appropriate community resources and support networks as needed.

7. Collaboration with Healthcare Providers:

   • Collaborate with healthcare providers familiar with the patient's medical history and ongoing management of CP, including pediatricians, neurologists, physical therapists, and occupational therapists.
   • Ensure that relevant information about the patient's condition and care needs is communicated effectively during handoffs and transitions of care.

By understanding the unique challenges and needs of patients with cerebral palsy, EMS providers can deliver compassionate, patient-centered care that promotes optimal outcomes and enhances the overall well-being of these individuals.

Further Reading:

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education

Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, Massachusetts: Pearson

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education

Peate, I. & Sawyer, S (2024) Fundamentals of Applied Pathophysiology for Paramedics. Hoboken, New Jersey:  Wiley Blackwell