The deaf injury victim who is not unconscious may alert you to deafness in a number of ways. The deaf person may: • point to his ear and shake his head; • try to reach for a note pad & pencil or make writing motions in the air; • move his lips without making any sound; • make unintelligible sounds • gesture to the part of his body that is injured. You may need to ask the patient questions to identify his illness or injury. If his speech is not intelligible or he does not seem to benefit from his hearing aid, point to the following questions printed in large letters on a card: Are you deaf? Can you speak? Read lips? Read or write? Fingerspell? Understand signs? Do you want/ need an interpreter? If the patient is lying down, it will be difficult for him to read your lips. Try to speak from the same level, and remember the communication tips listed above. Show friendly concern on your face. The hearing impaired patient gets clues of your compassion from facial expression and body language, which substitutes for tone of voice. A light, reassuring touch may help. Do not indulge in side chat. Although reassuring to hearing people, side conversation may cause deaf people to feel they are missing important information and they become confused. Maintain contact with the hearing impaired emergency patient in whatever way you can: gestures, facial expressions, signs, touch, and simple clear speech. Do not withdraw from him. THE HEARING IMPAIRED PATIENT IN HOSPITAL Since effective care for the in-patient depends on effective communication, all hospital personnel who have page 4

direct contact with the hearing impaired patient must be made aware of his condition. When the deaf or hard of hearing patient is admitted, "Hearing Impaired" should be noted on the patient's file. A sticker (showing the International Symbol for Access-Hearing Impairment) on the chart will identify the patient. It is helpful if the hospital staff is given an indication of how to communicate with the patient. Notes on the chart such as "Deaf-uses Sign Language. Write message." "Hard of hearing-lipreads." will help. THE HEARING IMPAIRED OUT-PATIENT When a deaf or hard of hearing patient comes to a clinic, doctor's or dentist's office, be prepared to allow extra time for mutual understanding. Remember, he will not hear his name called when it is his turn. Keep a pad and pen on hand, and write important phrases, even if he seems to understand speechreading. Follow the tips for communicating listed earlier. THE PERSON WHO LIPREADS For communicating with hard of hearing patients, remember the communication tips listed earlier. Important instructions or diagnoses should be written as well as spoken, so that they will be clearly understood. Many sounds look the same on the lips, so speak slowly and clearly. If the patient uses a hearing aid, be sure it is in place and working properly. It is a simple matter to try a new battery if the aid is not functioning, or check the earmold for wax. Allow the hearing aid user to keep his aid until time for the anaesthetic; he is cut off from communication once the aid is removed. THE PERSON WHO USES SIGN LANGUAGE For the deaf patient whose first language is sign language, an interpreter should be made available for important communications. Some deaf people may have good speech but be unable to lipread. page 5