Tips for Working with Individuals Who Have a Spinal Cord Injury

• People are people, -- when speaking with someone who has a spinal cord injury, make eye contact and talk to them as you would any other person.
• When referring to someone with a spinal cord injury, remember to put the person before the disability: “person with spinal cord injury” or “person with a disability” instead of “disabled person” or “the disabled.”
• It is best not to touch someone’s wheelchair without asking them first. A wheelchair is often considered to be part of someone’s personal space. However, it is appropriate to offer assistance.
• Always respect participants’ privacy. It may be considered rude to ask someone about their injury, unless they initiate the conversation.
• Lifting and transferring individuals with a spinal cord injury is a specialized process. It is preferred that someone has training before attempting a lift or transfer and does so with the consultation of the person who needs it.
• A person with a spinal cord injury will not feel, and may not notice, a cut, burn, or injury that occurs below the level of spinal cord injury.  This puts the person at risk of a condition called autonomic dysreflexia. It is good to be aware of this condition when you are working around or with people who have a spinal cord injury, especially at an adaptive sport event.

Wetsuit Application Protocol

We recommend that our TWSA participants wear a wetsuit to protect them from any potential scratches or bumps that may occur while surfing. We always choose locations that have changing or rest rooms on the beach. Our participants are instructed to wear a swimsuit under their clothing to the event.

Some of our participants are new to surfing and may not have experience donning a wetsuit. The participant may request assistance with changing in and out of one. Sensitivity and privacy are integral when assisting with wet suit application. Volunteers should be the same sex as the athlete and have an appropriate second person (such as a family member, guest of the participant, or another volunteer) present during clothing changes. Be sure to bring extra towels or a blanket for privacy.

Safety Concerns

All LRO TWSA events begin with a safety briefing from the Lifeguards and/or LRO representative. LRO safety briefings teach or review proper floating techniques and how to hold one’s breath under the waves. The ocean is alive, exciting, and some times a bit rough. Being aware of this will help ensure that our athletes are injury-free at events. Athletes may not notice and will not feel a cut or an injury that occurs below the level of their spinal cord injury.

When assisting a participant back to their chair, extra attention should be made to make sure that all pebbles and sand are removed, as these items may lead to a pressure injury. Use of sunscreen is very important for participants, as they are at increased risk for sunburn as well.

Autonomic Dysreflexia (AD)

Autonomic dysreflexia (AD) is a potentially life threatening condition that can be considered a medical emergency. AD is caused by an irritation below the level of spinal cord injury (SCI), such as sunburn, a cut, or problems with bladder/bowel function. It requires quick and corrective action as it can cause serious problems, such as a stroke.

When an injury or irritation occurs below the level of the SCI, the body’s messages—which are sent through the nervous system—are blocked by the injury and not able to travel along the spinal cord. Because the messages cannot get through to the brain, the nervous system begins to overcompensate. This may cause life-threatening conditions for the individual.

For example, a participant who has bruised an ankle begins to have a pounding headache and nausea. He or she may not realize that the headache and nausea are related to the ankle injury, or that they may be experiencing an episode of AD. They can be helped by sitting upright immediately.

Rip Tides

A rip tide, or undertow, is a small but strong channel of water moving out to sea. Rip tides are characterized by darker, deeper and foamier water, sometimes with floating debris. The area where the rip current occurs is usually calm with a rippled surface and smaller waves.

If you get caught in a rip tide:

• Stay calm, and do not swim directly against it.
• If you are a strong swimmer, swim parallel to shore until you are past the current, and then swim toward the shore.
• If you are a weak swimmer, signal to the lifeguard and either float with the current or continue to tread water until help arrives.