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Excerpt from the
Handbook on the Late Effects of Poliomyelitis for Physicians and Survivors©

Hospitalization, Emergency

Emergency hospitalization for polio survivors with respiratory insufficiency is often complicated by the lack of experience of paramedics and emergency room staff with people with respiratory muscle paralysis. Respiratory equipment, such as cuirasses, pneumobelts, iron lungs, and many of the older ventilators, may be viewed by them as quaint artifacts of a past era. Portable volume ventilators and bi-level pressure devices, along with the newer nasal and face masks designed for home use, may also be unfamiliar. The tendency is to replace such equipment with the more familiar critical care equipment and techniques such as endotracheal intubation and tracheostomies. While these interventions may be necessary at times, they may be avoided by using and making adjustments to the existing equipment, such as the settings, interfaces, time on machine, etc. When an emergency necessitates a tracheotomy to save one's life, reverting to the usual equipment can be addressed, and most often successfully, once the crisis is over.

Polio survivors with respiratory insufficiency also are encouraged to discuss their unique requirements with their primary care physicians, pulmonologists, or specialists to obtain their agreement to act as an intermediary during emergencies. To help avoid inappropriate interventions during acute respiratory difficulties, familiarize local hospital personnel with the equipment the person uses.

To minimize confrontations and complications when emergencies occur outside of a local area, survivors are encouraged to carry an information sheet with brief instructions and contact phone numbers. Medic Alert coordinates a nationwide 24-hour response center which will transmit vital medical facts to assist with accurate emergency treatment. To sign up for the service, call 800-432-5378. The initial fees cover the application and an ID bracelet. There also is a nominal annual fee for the service.

Pre-planning (see Hospitalization) can reduce stress, complications such as nosocomial pneumonia, and the duration of hospital stays.



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