N O V E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 7
N
ear the beginning of my career, 2 burly men escorted
their large 17-year-old autistic brother into our facility.
"We'll hold him down so you can start the IV," said one
of the brothers. "We've been through this before, and
this is the only way it can work."
Shocked, I protested and suggested premedication, but the family
explained their experiences before were not encouraging. Our facility
had no protocols for patients with autism spectrum disorder (ASD). So,
I reluctantly followed the brothers' suggestion, and after two tries at
catheterization finally got the patient sedated. The procedure was com-
pleted, but at what cost? The process almost certainly further intensi-
fied the patient's aversion to health care. It is a case that I will always
remember and has changed my practice. A child who desperately need-
ed gentle, compassionate care had received the opposite. We needed to
do better.
With my colleagues (Desigen Reddy, FRCPC, and Leora M. Bernstein,
This protocol makes
care easier on and
better for patients,
families and providers.
Amanda J. Whippey, MD
Hamilton, Ontario
A Better Way
To Care for
Autistic Patients
CHANGING THE GAME Rather than assume an autistic child
will be disruptive and sedate them as soon as possible, health-
care providers should do everything they can to engage and
soothe the patient to make them a calm and willing participant
in the surgical process.
McMaster
Children's
Hospital
