Deaf and hard of hearing patients have the right to effective communication, which often means a qualified sign language interpreter rather than lip reading or family members. Under US law, a service dog may stay with its handler in most care settings, including the ambulance when possible.
Key symptoms
- Communication preference: sign language, lip reading, writing
- Misunderstood questions can hide pain or symptoms
- Anxiety when unable to communicate
- The underlying medical complaint
What you find on exam
- Face the patient, good lighting, get attention with a light touch or wave
- Ask how the patient prefers to communicate
- Do not pet or distract the service dog
- Full assessment of the main complaint
Tests
- Teach-back to check understanding
- Written notes or a picture board in an emergency
- Video remote interpreting when an in-person interpreter is not available
Treatment basics
- Use a qualified medical interpreter; avoid using children or family to interpret
- Explain procedures before touching the patient and get consent
- Keep the service dog with the handler and plan for its care
- Document the communication method and interpreter used
Red flags
- Consent obtained without clear understanding
- Signs of distress the patient cannot express
- Separating the patient from the service dog without need
Practice it in Making Synapses
Making Synapses cases
Related guides
Sources: National EMS Education Standards (2021); NCSBN 2026 NCLEX-RN Test Plan; The Joint Commission, National Patient Safety Goals. Written by Making Synapses. Making Synapses is not affiliated with these organizations.