Crash Cart Emergency Medicine

SDoH: Caring for the Deaf and Hearing Impaired


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Hearing impairment is a significant social determinant of health that often impacts emergency department care. In this episode, Dr. Kim Bambach (Assistant Professor of EM) interviews Dr. Sophie Bolaños (PGY-2) about practical approaches to improve care for deaf and hearing-impaired patients in the ED. From understanding barriers to effective communication to leveraging local resources, this discussion provides actionable insights for creating a more inclusive and supportive care environment.

Guests: Sophie Bolaños, MD
Host: Kim Bambach, MD
Editors: Kim Bambach, MD and Chris San Miguel, MD

Key Learning Points:

  1. Understanding Hearing Impairment:
    • Over 1.5 billion people worldwide are deaf or hard of hearing, including 33 million children.
    • By 2050, one in ten people globally will have disabling hearing loss.
    • Hearing impairment intersects with other social determinants like unemployment, homelessness, and mental health challenges.
    • Barriers to Care in the ED:
      • Communication challenges due to the need for ASL interpreters or clear communication methods.
      • Bias and frustration among clinicians unfamiliar with deaf culture or communication techniques.
      • Practical challenges such as non-functional nurse call buttons for hearing-impaired patients.
      • Actionable Solutions:
        • Utilize an ASL translator even if the patient can read English or lip-read.
        • Stock audio amplifiers or use stethoscopes to enhance communication with hard-of-hearing patients.
        • Use clear masks to facilitate lip-reading.
        • Learn basic ASL signs, like the sign for “doctor,” and your last name to establish rapport while waiting for interpreters.
        • Maintain visual accessibility by keeping curtains open when privacy isn’t an issue.
        • Community Resources:
          • Deaf Services Center (Columbus, OH): Offers ASL classes, advocacy, and peer support.
          • Ohio Relay: Provides a free service to facilitate phone calls for deaf and hearing-impaired individuals, supporting communication in English and Spanish.
          • Bottom Line:
            Caring for deaf and hearing-impaired patients requires empathy, awareness, and resourcefulness. Clinicians should strive to minimize barriers and biases while leveraging available tools and resources to provide equitable care.

            Resources to Learn More:

            • Deaf Services Center
            • Ohio Relay
            • ASL sign for doctor and how to fingerspell your last name
            • World Health Organization Report: Deafness and Hearing Loss
            • ...more
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