Step 3. Author Jean Zimmerman demonstrates the correct way to physically lower a student onto the bus floor, which may be necessary in an evacuation.
Implications for evacuation
The following other implications must be taken into account when doing an emergency evacuation for a student with cerebral palsy:
• If able to walk, the student will have difficulty with balance.
• Loud noises and hurried activities may cause increased spasticity in the student’s extremities.
• The student may have difficulty controlling arm movements.
• In an evacuation, the student will be slow to move and/or speak.
• The student will need assistance to walk down the bus aisle and up and down steps.
• You may have to help the student physically down onto the bus floor. You may also have to help the student maintain this seated position until the person on the ground outside of the bus is able to offer full protection. The person on the ground must have a wide base of support and steady balance and be ready to accept the student, whose balance may be impaired.
• Do not tell students with spasticity to relax. In an attempt to follow directions, they will only become more spastic and have even more difficulty with their movements. Instead, try a distraction, which may take their attention off their muscles. Give alternative directions — e.g., “Let’s go see Miss Jean at the back of the bus.”
• Be aware that in an emergency evacuation, the student may have a seizure even if he or she has not had one in a while. Bus staff must time the seizure and notify dispatch as soon as possible once the evacuation is complete.
• These students will have difficulty controlling arm movements.
• If evacuating a student using an emergency evacuation device, try curling up the edges of the device around the student’s arms so as the student is dragged down the aisle, rigid arm extensions will not slow evacuation.
• Hurrying may cause muscles to become spastic, causing rigid extremities.
• The student may have a tracheostomy (a surgical opening in the windpipe to allow the student to breathe). Avoid blocking the tracheostomy in any way. Protect the student’s head from falling forward, which could potentially block the tracheostomy.
• Many students will have very poor head control and may wear a soft cervical collar during transportation. When evacuating, leave the neck collar on, as it will give extra support and protection for the student’s head and neck areas.
Prior to any actual evacuation, it is critical that a transportation team discuss the student and his or her medical condition in full details.
The team needs to discuss all of the possibilities listed and decide on the options for evacuating the student depending on which exits are not blocked.
Jean M. Zimmerman is supervisor of occupational and physical therapy for the School District of Palm Beach County (Fla.). She is the author of Evacuating Students With Disabilities, a comprehensive manual and training course written in conjunction with the Pupil Transportation Safety Institute. The program can be purchased at www.ptsi.org or by calling (800) 836-2210.