Airport Emergency Communications for People with Disabilities and Others with Access and Functional Needs (2019)

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K-1 A P P E N D I X K Example Full-Scale Exercise Notes This appendix presents the full-scale exercise-related notes that were provided to the evaluation team. The provider has requested to remain unnamed. Notes are provided for illustration purposes and in hopes of facilitating learning across the airport community. Participation by People with Disabilities, Others with Access and Functional Needs, and Those with Limited English Proficiency (DAFN) • Did members of the DAFN community participate in this exercise? – Yes – 1 • Was the person in the DAFN community triaged by first responders? – Yes • If so, describe the interaction between the first responder and the victim [person with DAFN]. – The first responder read the wristband but did not speak to the victim. – The victim had a facial laceration only, but, due to deafness, was not able to hear the overhead announcement that all those that were able to walk should make their way toward the fire trucks. • Did you witness any issues between the first responder and victim? – Yes • If so, what were the issues? – He was unable to communicate verbally but figured out the victim was deaf when the victim started to sign. First and second responders gestured to the victim to stand up and walk. The first responder walked with the victim to the triage location. No other questions were asked about the victim’s name or other injuries. – The first responder established eye contact, gestured while enunciating for lip- reading, and made a verbal hand-off to the triage officer explaining that the victim was deaf and needed to have eyes kept on him. – During the changing of hands, no hand-off or written tagging stating that the victim was deaf was provided so that others could communicate with him.

K-2 Airport Emergency Communications for People with Disabilities and Others with Access and Functional Needs • Was the member of the DAFN community in need of transportation from the crash site due to the injuries? – No; he was ambulatory. – Yes, he needed guidance since he is deaf and was not able to hear the announcement to walk toward the trucks. He was escorted by a first responder. • How was the victim transported from the crash site to a hospital? – Helicopter to Brooks Rehab • Were there any Americans with Disabilities Act (ADA)–related issues when first responders were moving the victim into the transport vehicle? – There was a communication breakdown among exercise controllers here; no first responders transported the patient to a helicopter, but the evaluators did. Therefore, [there was] no hand-off from the first responder to the flight nurse about the victim being deaf or any other information about the victim. – As a result, there was no hand-off from the flight nurse to the ambulance transport for admission to Brooks. Notable Comments “Once the first responder realized that the victim was deaf, it would have been very helpful to have provided any type of pen/paper, cell phone, etc., for him to be able to communicate with other first responders since it is unlikely that one person would be able to stay with him the whole time. This would have assisted in triaging him more quickly and more appropriately so that resources and time could have been spent with those who needed it most. Also, it would have been helpful to identify the victim as someone who was deaf, even if it meant putting a tag on him that said as much so that others who tried to communicate wouldn’t have to go through the process of establishing that he is deaf and finding a new way to communicate with him.” “The deaf victim was also supposed to play the part of someone who had a prior CVA [i.e., stroke] with [the right side of his] body affected. However, communication was avoided. Once people realized that he was deaf, several people just had him sit down and then walked away without attempting to comfort him, ask if he needed anything, or ask if anything else was wrong— to the point that the victim was never able to share with first responders that he had a prior stroke. Due to this, he abandoned this part of the role-play because he sat mostly unattended and unspoken to on the runway. The significance of a prior CVA would have been that, while ambulatory, he may have needed more assistance with walking, and first responders would not want to grab his affected arm and pull on it or help him from the ground with that arm due to the risk of dislocation or tearing of rotator cuff muscles, etc.” – This resulted in the third responder reclassifying him as red rather than yellow and never establishing communication to explain to the victim why he was being moved. They did ask him his name, but, when he could not respond, they stopped trying to establish communication or get any information. – The fourth responder reclassified and relocated him to the yellow triage area— again without communication established or explanation of what was happening to the patient.

Example: Full-Scale Exercise Notes K-3 Participation by Person with Limited English Proficiency (LEP) • Did the members of the LEP community participate in this exercise? – Yes – 1 • Was the person from the LEP community triaged by first responders? – Yes. Initially, it was not clear that she was Spanish-speaking, and she appeared to follow the general flow of traffic and gestures from first responders. • Did you witness any issues between the first responder and the victim? – Yes. When the first responder was collecting demographic information, he asked in English, but she did not understand and spoke back in Spanish. A nearby victim was bilingual and assisted with interpretation. The first responder asked his fellow first responder, “How do you say ‘last name’ in Spanish?” • Was the member of the LEP community in need of transportation from the crash site due to injuries? – No; she was ambulatory.