Introduction

This innovative and individualised knowledge improvement course on selected dysfunctions and degrees of disability is aimed at those responsible for crisis management in organisations. Raising awareness of different types of mobility dysfunctions and degrees of disability, together with promoting the use of methods/techniques and tips useful in the event of an evacuation, aims to help people with mobility disabilities to evacuate quickly and safely during a workplace emergency. People responsible for emergency management in organisations are becoming more aware and recognise the need for development in terms of increasing the safety of people with disabilities. Here, the need to increase their knowledge of the limitations and mobility capabilities of people with varying degrees of disability becomes relevant.

Submodule 5.1 Abilities of people with different degrees of disability

The abilities that disabled people can offer in the workplace

A person with a disability does not mean that they are not able to perform a task or do a specific job. It only means that a task or job comes with challenges and that they might have some limitations fulfilling what is expected. Work is an essential part of life, social interactivity, and survival. People want to be in social environments. They want to feel wanted and needed and they want to be able to be good at something. For people with disabilities, even more so, they want to feel independent.

People with disabilities have abilities and skills to pursue meaningful careers and have the same aspirations. People with a disability are the only ones who can define their limitations.

Today, employers can pick and choose among hundreds of CVs for every vacancy. There might be employers or disabled work-seekers that think employers will want someone who is less “trouble” and it will be less expensive to make the workplace more accessible or disabled-friendly. Sometimes during interview processes, preconceived opinions and possible barriers are already established.

There is so much ability still left within a disabled person like the energy, the sheer drive, self-motivation and the intellect. Their specific disability might have taught them extreme patience and perseverance. Less severe disabled people are also much more independent and good problem solvers. Having someone with such a positive outlook on life and such determination can inspire the entire team and organization.

Living with a disability is not easy. It is also sometimes a barrier when it comes to the educational part within companies. Staff feels uncomfortable and feel awkward not knowing how to deal with disabled staff members.

Companies should rather focus on what the “differently-abled” person brings to the table. They have their own unique set of skills that can do wonders and can lead to colleagues being motivated and inspired.

Disabilities- characteristics

Disability as defined by the World Health Organization constitutes a limitation or complete lack of ability to make certain decisions type of activity, as well as limitation of the ability to participate in various areas of life, resulting from damage or impairment of body function.

People with various types of disabilities are exposed to difficulties in everyday life, which may result in a reduction in the quality of their life and have an impact on the broadly understood social well-being of these individuals. Individuals with motor, sensory or intellectual disabilities usually do not have the opportunity to fully participate in social life on equal footing with able-bodied people, which may be the result of physical, social, educational or cultural barriers that influence the way disabled people are perceived in society, which may contribute to their marginalization. On the one hand, the concept of an individual’s well-being consists of a number of properties that determine the degree of prosperity of his or her life, including the experience of certain mental states such as joy or fulfilment, as well as the possibility to satisfy one’s desires. On the other hand, it depends on the individual. Some people with disabilities, however, are able to have a rich social life and experience joy and fulfilment. It also depends on how determined they are to participate in social life and what opportunities the local community (clubs, organisations etc.) offers them.

Types of disabilities

There are several types of disabilities:

1. Motoric disabilities
2. Sensory disabilities – visual and hearing impairment
3. Intellectual disabilities
4. Psychiatric disabilities
5. Other – e.g. neurological diseases, learning disabilities, chronic illnesses and conditions

Motoric Disabilities

Motoric disabilities refer to impairments that affect a person’s physical functioning, particularly their ability to move and control their muscles. These disabilities can be congenital or acquired and may impact a person’s mobility, coordination, strength, and endurance.

Common examples: Cerebral palsy, muscular dystrophy, spinal cord injuries, multiple sclerosis, and amputations.

Challenges: Individuals with motoric disabilities might experience difficulty with walking, sitting, standing, or manipulating objects. They may rely on assistive devices such as wheelchairs, walkers, or prosthetics to aid their movement.

Support strategies: Accessible environments with ramps, elevators, and automatic doors; use of adaptive equipment; physical therapy and rehabilitation services; and ensuring spaces are designed to accommodate mobility aids.

Motoric Sensory Disabilities – Visual and Hearing Impairments

Sensory disabilities affect one or more of the senses: sight, hearing, touch, taste, and smell. The two most common types of sensory disabilities are visual and hearing impairments.

Visual Impairments

Definition: Visual impairments range from partial vision loss to complete blindness. They can include conditions like cataracts, glaucoma, macular degeneration, and retinitis pigmentosa.

Challenges: Difficulties in reading, recognizing faces, navigating environments, and performing tasks that require visual acuity.

Support strategies: Use of braille, screen readers, magnification devices, guide dogs, tactile markers, and providing high-contrast, large-print materials.

Hearing Impairments

Definition: Hearing impairments range from mild hearing loss to profound deafness. They include conditions such as sensorineural hearing loss, conductive hearing loss, and mixed hearing loss.

Challenges: Difficulties in understanding spoken language, following conversations, hearing alarms or alerts, and enjoying audio media.

Support strategies: Use of hearing aids, cochlear implants, sign language interpreters, captioning services, and visual alert systems.

Intellectual Disabilities

Intellectual disabilities are characterized by significant limitations in both intellectual functioning (such as reasoning, learning, and problem-solving) and in adaptive behaviour, which covers a range of everyday social and practical skills. These disabilities typically originate before the age of 18.

Common examples: Down syndrome, fetal alcohol spectrum disorders (FASD), and Fragile X syndrome.

Challenges: Difficulties in learning, reasoning, problem-solving, and performing everyday tasks. Individuals may also experience delays in language and social development.

Support strategies: Individualized education programs (IEPs), life skills training, vocational training, supportive employment opportunities, and creating inclusive and accessible learning environments.

Psychiatric Disabilities

Psychiatric disabilities are mental health conditions that significantly interfere with an individual’s ability to carry out major life activities, including thinking, feeling, and social interactions.

Common examples: Schizophrenia, bipolar disorder, major depressive disorder, anxiety disorders, and post-traumatic stress disorder (PTSD).

Challenges: Individuals may experience mood swings, anxiety, depression, hallucinations, delusions, and difficulties with concentration and social interactions.

Support strategies: Access to mental health services, medications, psychotherapy, peer support groups, stress management techniques, reasonable accommodations in the workplace, and creating supportive and stigma-free environments.

Each of these disabilities requires tailored support and accommodations to help individuals achieve their full potential and participate fully in society.

People with disabilities experience extensive problems in many important areas of daily functioning. A person with disabilities faces a variety of difficulties throughout his or her life, which include not only the architectural barriers that are important from the point of view of people with physical disabilities, but also the communication barriers related to mobility difficulties (resulting from special needs that concern issues such as the need to adapt the space to move around using a wheelchair). The lack of ramps may be problematic for people with physical disabilities using a wheelchair, inappropriate measures public transport and public buildings to meet the needs of individuals with mobility disabilities, lack of appropriate elevators, too narrow space or lack of accessible toilets equipped with lifts and parking lots adapted to the needs people with physical disabilities.

There may also be social problems that result from a sometimes negative perception of people with specific disabilities Fortunately, both the perception of disability and the increase in social awareness (also because societies in Europe are ageing, the problem of disability is becoming more visible) are changing quite rapidly.

Barriers in the lives of blind or visually impaired people mainly concern elements of architecture not adapted to their needs. This includes, similarly to people with physical disabilities, the occurrence of unevenness in the ground.

Deaf or other hearing-impaired people encounter barriers such as the lack of induction loops and information boards displaying messages in public buildings or public transport, and the lack of added subtitles.

People with intellectual disabilities might have a problem to enter relationships, they might have a problem to exist in common healthy people life which might affect their marginalisation and exclusion.

The most common problems of people with disabilities regarding their accessibility include architectural difficulties, mobility barriers and sometimes social barriers.

Breaking down architectural, mobility and social barriers

Architectural Difficulties

• Inaccessible Buildings: Many buildings lack ramps, elevators, or accessible entrances, making it challenging for individuals with mobility impairments to enter or navigate these spaces.
• Narrow Doorways and Hallways: Standard doorways and hallways can be too narrow for wheelchair users, creating significant barriers to movement.
• Inadequate Restroom Facilities: Many public restrooms are not equipped with accessible stalls, grab bars, or sinks at appropriate heights, limiting their usability for people with physical disabilities.
• Lack of Signage and Wayfinding: Insufficient or poorly designed signage can make it difficult for individuals with visual impairments to find their way in public spaces.

However, it is fair to say that advanced mobility solutions for people with disabilities are standard in new buildings.

Mobility Barriers

• Inaccessible Public Transportation: Many buses, trains, and other forms of public transportation do not have low-floor access, lifts, or designated spaces for wheelchair users.
• Lack of Curb Cuts: Sidewalks without curb cuts at intersections make it difficult for individuals with mobility impairments to safely cross streets.
• Insufficient Parking: Lack of designated accessible parking spaces close to building entrances can make it difficult for people with disabilities to access facilities.
• Uneven Surfaces: Sidewalks and pathways with uneven surfaces, cracks, or obstacles can pose a tripping hazard or be impossible to navigate with mobility aids.

It can be said (based on the example of Poland) that the process of overcoming barriers to mobility is progressing quite rapidly – for instance according to the law, every new development must include a sufficient number of parking spaces for people with disabilities.

The above-mentioned barriers can cause difficulties in the daily life of people with disabilities. It is important to eliminate social barriers as well. It is good practice, for example, to designate seats for disabled supporters in football stadiums, so that they can watch and enjoy sporting events, too.

In the UK, Premier League was even accused of failing to ensure access for wheelchair-using fans. All Premier League clubs are committed to meeting the Accessible Stadia Guidelines and have undertaken substantial work to improve disabled access for home and visiting fans. This is a priority for the League and significant investment has been made in stadium improvements to ensure they are accessible and welcoming environments for all.”

Submodule 5.2 Assessing the level of functional ability of a person with a mobility disability

The degrees of disability

While physical disability might be the most common type, the category of disabilities is broad. It includes sensory, neurological, cognitive, intellectual and psychiatric disabilities.

These types of disabilities may be permanent, temporary or reversible and affect individuals in different ways. These conditions go beyond just health problems. They encompass activity and social-interaction limitations as well.

While the type and degree of disability is different to each individual, we cannot rule out the fact that all types of disability have a major impact on the life of the person concerned.

However, with the right assistance, interventions and adequate services, these restrictions or difficulties experienced can be minimized. That is where the degree of disability comes in. It helps to precisely define the extent to which disability affects the autonomy of a person so as to avail the necessary tools and services.

The degree of disability is an assessment that determines how disabled an individual is from both medical and social perspective (social factors that may limit their social integration). It is expressed in percentages and adheres to the technical criteria put in place by the government.

Three degrees of disability are listed: mild, moderate and severe. A mild degree of disability is characterized by the presence of impairment that significantly reduces the ability to work compared to a person with similar qualifications, but with complete psychophysical fitness. The limitations possessed by a person with a moderate degree of disability in the performance of social roles can be neutralized, for example, by technical means or orthopaedic accessories.

A severe degree of disability means that a person is incapable of working and requires permanent or long-term care and assistance to fulfil social roles. The first degree of disability is equivalent to an inability to lead an independent life.

The main aim of degrees of disability is to objectively assess how disability influences the autonomy of an individual – by autonomy all aspects of life from health to personal life, education, communication and, most importantly, accessibility are meant. When it comes to measuring the degree of disability, the Barthel index is one of the most applicable methods. The index assesses the level of independence of a person with respect to performing some basic activities of daily living (ADL), the time spent in performing these activities and the need for help.

The concept of disability should not be confused with inability to work. Incapacity for work means partial or complete lack of ability to undertake professional activity. This is caused by a violation of the body’s efficiency. A person unable to work has no prospect of regaining the ability to work after retraining.

The Social Insurance Institution’s medical examiners decide on this topic.

The degree of disability is a very important factor, especially when it comes to workers’ compensation. Since it explains the percentage of disability from the medical perspective while taking the autonomy of the concerned individual into consideration, that number is used to determine payments, services or benefits one will receive to ensure their quality of life is good. The difference between permanent and temporary disability is also important but depends on national regulations. For example, under Australian legislation on the definition of disability, a person is considered disabled when the degree of disability is 20% or more on the impairment tables and they are unable to continue working 30 or more hours per week or retrain for full-time paid work within the next two years. In the case of a first injury and after assessment it is determined that the situation is not permanent and may change, a temporary degree of disability is established. Permanent disability means that level of disability is not expected to change over time.

To summarise, no matter what the type of disability is, conducting degree of disability assessment is vital to ensuring that people with disability get fair compensation, assistance and benefits that will see them enjoy the same quality of life like those without disability.

Functional abilities of people with disabilities

A key question is how to assess the functional abilities of people with disabilities. For this purpose, tests and questionnaires are used, the most common of which is mentioned above the Barthel Index.

The Barthel Index

The Barthel Index is one of the most widely used tools for assessing activities of the level of disability or level of dependability by assessing activities of daily life. Ten basic activities of daily living are assessed, such as personal hygiene, eating, using the toilet, changing position and movement, dressing and sphincter control. The maximum possible score is 100. When a patient receives 86-100 points their condition is assessed as light; with 21-85 points the patient’s condition is assessed as severe, while with 0-20 points as very severe.

The Social Insurance Institution’s medical examiners decide on this topic.

The degree of disability is a very important factor, especially when it comes to workers’ compensation. Since it explains the percentage of disability from the medical perspective while taking the autonomy of the concerned individual into consideration, that number is used to determine payments, services or benefits one will receive to ensure their quality of life is good. The difference between permanent and temporary disability is also important but depends on national regulations. For example, under Australian legislation on the definition of disability, a person is considered disabled when the degree of disability is 20% or more on the impairment tables and they are unable to continue working 30 or more hours per week or retrain for full-time paid work within the next two years. In the case of a first injury and after assessment it is determined that the situation is not permanent and may change, a temporary degree of disability is established. Permanent disability means that level of disability is not expected to change over time.

To summarise, no matter what the type of disability is, conducting degree of disability assessment is vital to ensuring that people with disability get fair compensation, assistance and benefits that will see them enjoy the same quality of life like those without disability.

36-SF

The SF-36 is a method of assessing the current health state of patients at different stages of disease. The scale is comprised of 36 questions divided into eight categories that assess: physical functioning, physical limitations, pain, general health, vitality, social functioning, limitations in fulfilling one’s current role due to emotional disturbances, and mental health. The method of answering each group of questions varies from dichotomous (yes/no) to 3-, 5- and 6-point Likert scales.

After recalculating, according to certain rules, the points from all 8 categories, a score is obtained in the form of a 100-point scale from 0 to 100, where higher scores indicate better quality of life.

The standard form of the SF-36 examines quality of life based on the past 4 weeks.

The SF-36 Health Survey is a multi-purpose, short-form health survey which contains 36 questions. It yields an eight-scale profile of scores as well as summary physical and mental measures. The SF-36 is a generic measure of health status as opposed to one that targets a specific age, disease, or treatment group. Accordingly, the SF-36 has proven useful in comparing general and specific populations, estimating the relative burden of different diseases, differentiating the health benefits produced by a wide range of different treatments, and screening individual patients

Physical activity (PA) is an essential element of maintaining health for adults with intellectual disabilities (ID) that is reflected in their quality of life. However, it was shown that they mostly lead a sedentary lifestyle and have a higher rate of overweight and obesity.

In studies to assess the physical fitness of people with intellectual disabilities, the Zuchora Fitness Index can be used. The index consists of a set of tests (movement tasks) that are easy to perform and do not require specialized equipment.

They make it possible to assess speed, jumping ability, arm strength, flexibility, endurance and abdominal muscle strength, and their level of performance is easy to assess.

1. Speed.

Run quickly in place for 10 sec, raising your knees high and clapping under the raised leg. Count the number of claps.

2. Jumping ability.

Jump far away with both feet from the spot. Measure the result with your own feet. Round the result: less than ½ foot – down, more than ½ foot – up (when the measurement is more than 6.5 feet, for example, count as 7).

3. Arm strength.

Grasp the bar or branch so that you can hang freely. Do not touch the ground with your feet. Attempt successive exercises of increasing difficulty.

4. Flexibility.

Stand at attention without bending your legs at the knees. Perform a slow forward bend of the torso in a continuous motion. Legs straight. The only thing that counts is the correct execution of the task.

5. Endurance.

Try how long you can run. You can perform the test in two ways: on the spot at a pace of about 120 steps per minute or at a distance. In the first case, the duration of the run is decisive, in the second – the distance covered.

6. Abdominal muscle strength.

Lie on your back. Raise your legs just above the ground and perform cross scissors. The result is determined by the duration of the trial.

Principles for Assessing the Degree of Dependency in national legislation

The general principles for assessing the degree of disability are, of course, also regulated by national legislation, for example in the Czech Republic (Act No 108/2006 Coll. on social services, as amended):

1. When assessing the degree of dependency, the ability to manage ADLs (activities of daily living) is evaluated:

1. mobility,
2. orientation,
3. communication,
4. eating,
5. dressing and footwear,
6. personal hygiene,
7. toileting,
8. health care,
9. personal activities,
10. household management.

A. Mobility
a) The ability to manage this basic ADL (activity of daily living) is considered as the state when a person is capable of managing:

1. getting up and sitting down,
2. standing,
3. assuming and changing positions,
4. moving with step-by-step walking, possibly with intermittent stops, within the apartment and on usual terrain for a distance of at least 200 meters, including uneven surfaces,
5. opening and closing doors,
6. walking up and down a flight of stairs,
7. getting on and off transportation, including those with barriers, and using them.

When evaluating the ADL mobility, the functional impact of the impairment of the musculoskeletal system (limbs, pelvis, and spine) is assessed, that is, the impairment of bones, muscles, and nerves, and its impact on the ability to move independently as defined above.

Inability to manage the activity of opening and closing doors is most commonly due to concurrent impairment of both upper and lower limb function, or due to traumatic injuries of both upper limbs. The ability to manage ADLs in cases of traumatic injuries is assessed with facilitators (especially prostheses).

The management of the ADL mobility is not assessed in relation to sensory impairments (not even for activities of opening and closing doors, walking on stairs, and getting on and off transportation for the blind) and mental or psychological impairments, which are included and assessed in the ADL orientation.

b) Barrier transportation is considered to be those transportation means where entry/exit involves using stairs.

c) Walking on uneven surfaces is particularly considered walking on sidewalks with cobblestones or repaired roads. The ability to walk is assessed in a usual environment, i.e., walking on sidewalks and other urban roads, and does not include walking on, for example, tourist mountain trails, as this is not a usual everyday activity.

d) The inability to be mobile is not considered when a person can manage everyday movement around the apartment by holding on to furniture, or outside the apartment and residence with the use of supportive aids, i.e., canes, forearm crutches, crutches, and potentially walkers.

e) The inability to be mobile is considered when a person is reliant on a wheelchair, unless the wheelchair is used temporarily due to a current worsening of health. The inability to be mobile can also be considered for walking in a small range with a severely impaired walking pattern (symbiotic movements of both lower limbs with significant support on two forearm crutches), as this does not constitute walking in an “acceptable standard.”

f) Severe impairments or complete loss of function of both lower limbs due to congenital or acquired defects, regardless of etiology, can lead to an inability to be mobile. Plegia means that neither motor nor sensory function is present, or incomplete sensory function is preserved, with muscle strength graded 0 to 1. At least severe paresis (muscle strength grade 2) should typically be demonstrated in two limbs; the person is usually dependent on the use of a wheelchair due to their health impairment.

g) Internal diseases can lead to the inability to be mobile in severe (terminal) stages of diseases where the individual loses the ability to live independently, such as global heart or respiratory failure, or in elderly individuals with severe sarcopenia.

The need for assistance or supervision by another person for mobility cannot be considered as the accompaniment for an outdoor walk to increase safety due to the common risk of a fall in seniors or to increase the safety of a child in public transport and traffic.

Submodule 5.3. Introduction to the application of useful methods and techniques when evacuating people with disabilities in the workplace

Problems accompanying people with disabilities are varied and largely depend on type of disability and associated limitations in general body fitness, as well as the type of damage to specific organs.

Rules for the active and safe evacuation of these people in the event of an emergency situation at work and the need to evacuate.

Considering the difficulties that people with disabilities face on a daily basis, below are some important rules for the active and safe evacuation of these people in the event of an emergency situation at work and the need to evacuate.

The preparation of evacuation procedures should take into account:

→ the type of building (number of floors, parameters of escape routes, types of notification systems used),

→ the number of people with disabilities likely to be evacuated,

→ the type and severity of their disability (and therefore the possible number of evacuation equipment and number of assistants).

When developing evacuation procedures, it is also important to bear in mind that not every person with a disability is able to move around the building independently, including especially in the event of an emergency. After the person’s needs have been diagnosed, it may be necessary to appoint an assistant / helper / functionary responsible for assisting in the evacuation of that person.

The number of assistants should be selected with the individual person in mind in each case, and it is advisable for each assistant to have an alternate. This is to avoid a situation where, during an emergency, the assistant is absent, and the person is left without assistance.

Those in charge of the evacuation must remember that, when rescuing others, that, above all, safety first: it may be that informing the services of the location of a person with a disability may be more effective than trying to assist in their evacuation.

Frequent staff training (general and specific) is also of key importance, including practical training rather than just theoretical training. Individuals/teams responsible for evacuating persons with disabilities (or other persons in need of support) find the assigned persons and proceed according to current needs, assist in exiting the facility in the most effective way available at the time (if needed, using evacuation trolleys/mattresses). The number of coordinators depends on the organisation of work in the company. Depending on the size and type of organisation, one coordinator may be designated for a department, floor or stairwell. After leaving the facility, the person coordinating the work of the evacuation team reports to the evacuation commander on the presence of all persons who have been evacuated by the team.

Example of escape route signs:

The proper evacuation of all people with disabilities should proceed as follows:

• People with limited mobility should be among the first evacuees for various reasons, while those who can move with their own strength should be closing the stream of movement,
• Evacuation equipment such as evacuation chairs, stairlifts or other specialised evacuation equipment should be used first. If for some reason this is not possible, then people with reduced mobility and vision should be evacuated by being carried on hands, chairs, wheelchairs, blankets or other equipment designed to evacuate people.

Personnel responsible for evacuation and those appointed to replace them should be properly trained and know how to act during an evacuation, depending on the type of disability of the of the persons being evacuated. It should be remembered that in all cases the most important is communication, as it is the basis for effective action.

The transfer of rescued persons who are injured, with mobility impairments

The transfer of rescued persons who are injured, with mobility impairments and, if necessary, with visual impairments (at high risk) can be carried out using one of the following methods:

– “limb” grasp – one of the rescuers grabs the evacuee under the armpits, standing on the side of his head, and the other under the knees, standing with his back to the rescued. The evacuee is carried forward with his legs,

– transfer “on a stool” – rescuers with a suitable hand grip form a seat from the hands, on which the rescued person sits, holding the rescuers by the neck. Rescuers slightly facing each other, diagonally to the direction of evacuation, carry the rescued person,

– transfer with a “swinging grip.” – rescuers grasp each other’s hands “externally”, putting them under the seat of the rescued, with “internal” hands after mutual grip at the level of the elbow secure the rescued from behind, creating support at the level of the upper part of his back.

– The carrying out of persons using the “stool” may take place when the evacuee is able to help himself / herself with his / her hands.

-The “swing” grip is used in the case of rescuing people who have suffered injuries to one or both hands and cannot hold on to the neck of the rescuers,

– transfer with the “fireman’s grip” – consists in the fact that the rescued person, after an appropriate initial grasp performed by the rescuer, is in a lateral position – hanging on his shoulders. The rescuer has one hand passed between the rescuee’s legs, holding the rescuee’s hand at wrist level, while the rescuee’s other hand hangs freely behind. The rescuer also has the other hand free and can use it, for example, to hold on to the handrail of stairs, the sides of a ladder, etc…,

– When carrying with a “crowd grip” – The rescued person puts his / her arms from behind over the rescuer’s shoulders so that they hang over the rescuer’s chest. The body should rest on the rescuer’s back so that the legs hang 15 – 20 cm above the ground. In certain cases, the rescuer holds the dangling arms of the transferee.

Submodule 5.4 Examples of the application of methods/techniques useful when assisting people with disabilities during an emergency situation in the workplace

Special evacuation rules for persons with disabilities by type of disability.

Principles of evacuation of persons with mobility disabilities (e.g., in wheelchairs, moving on crutches, with a cane) in a blocked elevator situation:  

• ensuring priority in the evacuation of people with disabilities or special needs;
• transferring a person with a disability or special needs using a “limb” grip
• carrying a person with disabilities or special needs “on a stool”
• transferring with the “crowd method”

Use of chairs and carrying devices

Ordinary chairs are not designed for carrying people. Lifting one with a person on it is very awkward and risky. There are not any good handholds. On stairs the chair legs will tend to strike the steps. Various versions of a sedan-chair type of evacuation chair are marketed to overcome some of the difficulties. The sedan chair, generally used with the carried person facing to the rear, imposes a heavier load on the front carrier when used on stairs. A “Carry Chair” – simply a folding seat and back with braces serving as side carrying handles – can be used as a carrying device or as a transfer device. It is especially easy to use if the person normally sits in it while using the wheelchair. You and one other person then simply lift by the side handles and walk away from the wheelchair. A sling-type carrying device called the “Scoop Transporter” even has shoulder straps that allow to use hands for other activities (like opening doors). It is primarily marketed for use outdoors.

Stair descent devices:

Evacuating People in Wheelchairs

People in wheelchairs generally prefer to stay in them during their evacuation as the wheelchair is crucial for their normal mobility. Removable or moving parts such as armrests, footrests, or wheels should not be grabbed. Even the grips on the rear push handles may slide off.

Familiarization with the various parts of at least the standard wheelchair is necessary, and practicing rolling or carrying it downstairs before an emergency occurs is recommended. Practice should start with an unoccupied wheelchair.

When moving a wheelchair on stairs, it should be tipped back to help keep the occupant from falling out and to make it easier to carry. For rolling, with the larger rear wheels on the step edges, the handles will be too low for the back carrier. Assistance from one or two people at the front of the wheelchair is required.

At the front, hold the wheelchair frame behind the footrests just above the smaller front wheels. If there is no second person helping at the front, it may be necessary to face the chair and back down the stairs gingerly. However, with two people at the front, there is a risk of bumping into the sides of the stairway.

Transferring from a wheelchair to an evacuation device

Often, the person being transferred can assist the rescuer. If there is little or no lower limb strength, it will be necessary to lift the entire weight. The wheelchair should be parked with its brakes applied, close to and at an angle to the other device. The person assisting should face the person being transferred, placing their feet between the legs of the person being transferred. Hands should be placed under the arms of the person being transferred, and then they should be lifted to a standing position. Feet should be pivoted to align with the device onto which the person will be seated. If the person being transferred must hold on, they should grasp the waist or shoulders of the helper, not the neck. Using a transfer belt around the waist of the person being transferred will ease the process and reduce the likelihood of flexing or bending the back.

Evacuation of people with visible signs of anxiety and panic or people on the autism spectrum:

Persons with mental disorders may, in an emergency situation, can hide in various dark or inaccessible rooms; guiding such a person (taking him or her by the hand) by a third party towards the emergency exit in a calm and decisive manner, shown by gestures and voice (which will ensure that the person with a disability feels safe); when guiding such a person, verbally describe the surroundings and announce the approaching obstacles, e.g., “down” or “up” stairs.

Rules of evacuation of visually impaired or people

• guiding the person by a third party towards the waiting point (if there is one) or directly to the emergency exit (the third party puts the hand of the visually impaired person on his shoulder.
• In a tight passage, the visually impaired person should be signalled verbally and extend his / her elbow back. Then the visually impaired person will follow the leader behind their back. When guiding a visually impaired person, verbally describe the surroundings and announce upcoming obstacles, e.g. “down” or “up” stairs; other ways are ways appropriate for evacuation of people with mobility disabilities.
• When evacuating, warn the blind person before you make physical contact. Start by making verbal contact. Mention your name and be sure to say what is happening.
• Blind people use their hands for balance, so do not grab the person’s hand, jerk it, grab the cane, push or move it. If you want to guide such a person, offer her your arm. Then they will stand behind you and grasp you with her hand slightly above the elbow. They will slide four fingers between your arm and torso and put her thumb around your arm from the outside. In this way, the blind person will be able to see perfectly what movements you are making.
• Remember that when moving with a blind person, the assistant always and everywhere goes first, and the blind person half a step behind the rescuer.
• Remember to observe not only the ground in front of you and the blind person, but also the space covering the body of the blind person. The idea is to make sure that you do not snag on any items hanging, standing, protruding outside the building’s outline, etc.
• If you find yourself in a tight space (such as a narrow doorway), signal the blind person verbally and by extending your elbow back. Then the blind person will hide behind your back and you will be able to cross the road behind the rescuer’s back. When walking, be sure to describe your surroundings and point out obstacles, such as “up” or “down” stairs.

Principles of evacuation of hearing-impaired people

The organisation of evacuation of hearing-impaired persons consists of guiding such a person (touching his / her arm and shaking hands) by a third person in the direction of the emergency exit (which will ensure that the person with a disability feels safe).

In a workplace with employees who are hearing impaired, traditional auditory alarms (like fire sirens) may not be effective in alerting these individuals about an emergency such as a fire. To ensure their safety, the following methods and techniques can be applied:

Visual Alerts:

• Strobe Lights and Flashing Alarms – These visual signals should be placed in all common areas, including hallways, restrooms, and workstations, ensuring they are visible from any location.
• LED Message Boards: LED message boards that can display emergency messages. These boards should be strategically placed where they can be easily seen by employees. During an emergency, they can display clear instructions such as “Evacuate Now” or “Fire in Building.”

Tactile Alerts:

Vibrating Devices: personal vibrating devices. These can be wristbands, pagers, or devices integrated into their workstations. When an alarm is triggered, the device vibrates to alert the individual.

Bed Shaker Alarms: For workplaces with overnight shifts or accommodations, bed shaker alarms can be used to wake hearing impaired individuals during an emergency.

Evacuation rules for persons with disabilities at the University.

Adherence to evacuation rules for people with disabilities is critical to the smooth running of the process. Companies, universities and colleges are aware of this and therefore prepare appropriate procedures, which should also be trained from time to time. An example of the above is the ‘Guide for Assisting Individuals with Disabilities in an Emergency’ and “Guide for Individuals with Disabilities in an Emergency” published by Stanford University.

Guide for Assisting Individuals with Disabilities in an Emergency

During an emergency, everyone should act appropriately and deliberately. If you see a person with a disability having trouble evacuating, ask if they need help before taking action. Ask how best to assist them and whether any specific precautions or items need to be taken. Consider these guidelines when assisting individuals with disabilities:

Individuals Who Are Blind or Have Low Vision

• Communicate Nature of Emergency: Explain the emergency and provide clear instructions for exiting.
• Offer Assistance: Offer your arm to guide them.
• Verbally Communicate: Describe where you are going and any obstacles along the way.
• Orient at Safe Location: Once safe, orient them to their surroundings and ask if further help is needed.
• Service Animal: Ensure the service animal stays with the individual, understanding it may be anxious.

Individuals Who Are Deaf or Hard of Hearing

• Alert Individual: Use lights, arm waves, or touch to get their attention.
• Communication: Face them, speak clearly, use gestures, or write instructions if time permits.
• Assist as Needed: Escort them out if communication is not clear.

Individuals With Mobility Limitations – Non-Wheelchair Users

• Ask if Assistance is Needed: Check if they can use the stairs independently or with minimal help.
• Ensure Clear Path: Clear any debris obstructing the exit route.
• No Imminent Danger: They might choose to stay or move to an Area of Refuge until help arrives.
• Imminent Danger: Use a sturdy chair or assist in carrying them to safety if necessary.
• Mobility Aids and Devices: Make sure their mobility aids are brought to them as soon as possible.
• Notify Emergency Personnel: Inform emergency personnel about anyone left in the building and their location.

Individuals With Mobility Limitations – Wheelchair Users

• Discuss Manner and Preferences: Ask how they would like to be assisted.
• Evacuation Chair(s): Know the location and operation of evacuation chairs if available.
• Ground Floor Evacuation: They may evacuate independently with minimal help if on the ground floor.
• Ensure Clear Path: Clear any debris obstructing the exit route.
• No Imminent Danger: They may choose to stay or move to an Area of Refuge until help arrives.
• Imminent Danger: If they prefer not to leave their wheelchair, direct them to the nearest Area of Refuge or stairwell and notify emergency personnel.
• Carrying Wheelchair Users: Most wheelchairs are too heavy to carry, so discuss the best carrying method if needed.
• Mobility Aids and Devices: Ensure their mobility aids are brought to them as soon as possible.
• Notify Emergency Personnel: Inform emergency personnel about anyone left in the building and their location.

Individuals with Psychological Disabilities

• Observe Behaviour and Assist: Recognize that alarms, smoke, or crowds may be overwhelming. Offer help calmly without touching them without permission.
• Provide Reassurance: Ask how you can help and offer to stay with them once evacuated if needed.

Guide for Individuals with Disabilities in an Emergency

The awareness of disabled people themselves on what to do in the event of an evacuation is also extremely important. Therefore, Stanford University has also prepared rules for them to prepare for and deal with emergencies.

Individuals with disabilities who require assistance during an emergency should take time to develop a personal evacuation plan and consider the following when creating this plan:

• Create a plan to shelter-in-place and a plan to evacuate, depending on the type of emergency and your location (academic setting or residence).
• Ensure that contact information and any alternate means of communication (e.g., email, phone/text) are up to date.
• Program Stanford’s emergency hotline into your cell phone.
• Arrange a buddy system with a friend or colleague who can alert you of an emergency, knows your schedule, can check on you, and assist as needed.
• Be aware of the availability of emergency evacuation chairs in your building and know how to instruct others in their use.
• Consider wearing medical alert tags to inform others of any pertinent health conditions during an emergency.
• Assemble a kit of emergency supplies necessary to sustain yourself for at least three days (e.g., water, non-perishable food, first aid kit, medication).
• Label adaptive equipment with current contact information.
• Include your service animal or pet in your emergency planning.
• Show others how to operate your wheelchair or other assistive devices.
• Be able to clearly articulate your needs to emergency personnel and volunteers.
• Identify locations near campus for life-sustaining medical treatment (e.g., dialysis, home health care).
• Identify primary and secondary evacuation routes for campus facilities, including classrooms, labs, work areas, recreational facilities, libraries, and residences (noting Areas of Refuge/stairwells).
• Familiarize yourself with the Emergency Assembly Points (EAP) of buildings you frequent and note the accessible paths of travel, including alternate pathways.
• Communicate your plan with campus emergency coordinators, including your preference for assistance during an evacuation.
• Advocate for yourself and practice your personal evacuation plan frequently and revise it as necessary.
• In the event of an emergency, take appropriate and deliberate action. Dial for emergency assistance and contact Stanford’s emergency hotline for the latest information. If assistance is available, ask for help if needed.

Earthquake

• Create a safe space for yourself.
• Avoid trying to immediately exit the building to prevent injuries from falling debris.
• Move to a safe location, such as an interior wall or doorway, and stay away from windows, unsecured furniture, or heavy items that could fall or tip over.
• Lock your wheelchair.
• Cover your head and protect yourself as best as possible.
• Do not attempt to transfer from your wheelchair or bed until the shaking stops.
• Once the shaking has stopped, check yourself for injury, look for hazards, and decide if it is safe to evacuate or remain in place until emergency personnel arrive.

Fire

• If on the first floor, evacuate the building on your own or with assistance as needed.
• If on upper floors, proceed to the Area of Refuge or stairwell.
• Inform your supervisor, building manager, or colleague that you will remain in that safe location and wait for assistance or emergency personnel to arrive.
• Never open doors that are too hot.
• Request assistance to be carried down in your wheelchair or transfer to an evacuation chair if available.
• Report to the building’s designated Emergency Assembly Point (EAP) and await further instructions.

In summary, an efficient evacuation in a large and complex area such as university depends to a large extent on proper planning and knowledge of procedures, both by those assisting people with disabilities and by the people with disabilities themselves.

Summary of Key Points

1. Disabled individuals possess valuable skills and aspirations, capable of significantly contributing to the workplace. Employers should focus on the unique contributions of disabled employees, fostering inclusive and supportive environments that enhance productivity and morale.
2. People with disabilities face a range of barriers, including architectural obstacles, mobility challenges, and social stigmas, which can lead to their marginalization.
3. Effective support strategies encompass creating accessible environments, utilizing adaptive equipment, and providing comprehensive mental health services to ensure full societal participation.
4. Disabilities encompass a wide range of categories including physical, sensory, neurological, cognitive, intellectual, and psychiatric conditions, all of which can affect individuals in various ways and have significant impacts on daily life and social interactions. The degree of disability is assessed to determine how much a disability affects an individual’s autonomy.
5. Tools such as the Barthel Index and SF-36 are commonly used to evaluate functional abilities and overall quality of life, focusing on activities of daily living and health status. Assessments like the Zuchora Fitness Index measure physical fitness in individuals with intellectual disabilities
6. Effective evacuation procedures must account for building specifics, the number of individuals with disabilities, and the nature and severity of their impairments. It is crucial to provide specialized assistance and equipment and to assign dedicated assistants with suitable training to ensure safe evacuation.
7. Evacuation plans should include the designation of assistants and alternates, who are responsible for guiding individuals with disabilities to safety. Coordinators, based on the organization’s size and structure, should report to the evacuation commander after ensuring all individuals are evacuated. Regular and practical staff training is essential-staff responsible for evacuating people with disabilities must be well-trained in specific procedures and communication strategies.

Useful links

Case Study

Self- Assessment

Conclusion

Given the complexity of the problem, a multi-pronged approach is needed to help both workers and people with disabilities learn to evacuate effectively. Including different senses and ways of learning would provide a more complete experience and help capitalize on each person’s strengths. Evacuation drills remain an important educational factor for employees and people with disabilities. It would be interesting to develop alternative methods of practical training. For example, creating games that use technology as a medium could realistically simulate a fire situation and provide people with disabilities the opportunity to learn with less risk. Additionally, these types of practices can be developed for employees as well. Indeed, conducting exercises is time-consuming and difficult to organize with high frequency of occurrence. Although this has not yet been tested, a place to explore could be serious drills that simulate the game, providing training for new employees and serving as a reminder for older employees, potentially reducing the need for frequent real-world drills.

Bibliography

Thériault, W., Blanchet, G., Vincent, C., Feillou, I., Ruel, J., & Morales, E. (2024). Current learning strategies in fire evacuation for seniors and people with disabilities in private seniors’ residences and long-term care homes: a scoping review. Frontiers in rehabilitation sciences, 5, 1305180. https://doi.org/10.3389/fresc.2024.1305180

Mahoney FI, Barthel DW. Functional evaluation: The Barthel Index. Md State Med J 1965, 14: 61

Ware JE. Jr. Scales for measuring general health perceptions. Health Serv Res 1976, 11: 396-415.

Baranowski, Mariusz. 2015. “The ethics of selfishness and the spirit of globalization. On the antisocial foundations of social policy.” In P. Zuk and P. Zuk (eds.). On the culture of fear and the security industry (pp. 115-124). Warsaw: Oficyna Naukowa.

Baranowski, Mariusz. 2016. “Sociological Dimension of the Welfare State.” In M. Baranowski, P. Cichocki and M. Maraszkiewicz (eds.). Public space and the welfare state (pp. 59-72). Poznan: Scientific Publishing House of the Faculty of Social Sciences. UAM.

Baranowski, Mariusz. 2019. “The Struggle for Social Welfare: Towards an Emerging Welfare Sociology.” Society Register 3(2): 7-19.

Chrzanowska, Iwona. 2013. “Disability and the Threat of Marginalization and Exclusion. Reflections in the context of underclass theory.” Educational Studies 25: 63-74.

Gleń, Piotr, Jarocka-Mikrut, & Aleksandra. 2015. “The role of architecture in the daily functioning of people with disabilities with special attention to people the blind and visually impaired.” Building and Architecture 14(2): 40.

Konarska, Joanna, 2019. disability in an interdisciplinary perspective. Kraków: Oficyna Wydawnicza AFM.

Maciarz, Aleksandra. 2003. “Educational integration in light of the expectations and experiences of children with disabilities.” Special School 4/2003: 196-201.

Polakowski, Michal, & Dorota Szelewa. 2013. “Disability: a brief overview. international.” In Warsaw Debates on Social Policy. 3. Warsaw: Friedrich-Ebert-Stiftung.

Ware E. Jr, Gandek B.  1998 Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project Journal of Clinical Epidemiology Volume 51 Issue 11; 903- 912

Assignment

Develop a comprehensive evacuation instruction tailored for disabled employees, encompassing wheelchair users, visually impaired, hearing-impaired   employees, ensuring their safety during emergencies within the workplace.

Instructions:

Identify Types of Disabilities:

• List the specific disabilities among employees that require evacuation assistance, including wheelchair users, visually impaired and hearing-impaired employees.

Detailed Evacuation Procedures:

• For physically disabled people who use wheelchairs:

• Specify how to assist employees in wheelchairs to reach designated emergency exits and safe evacuation areas.
• Describe the use of evacuation transport devices or methods to safely evacuate wheelchair users.

• For visually impaired employees:

• Explain the provision of auditory and tactile indicators along evacuation routes.
• Outline how trained staff should assist blind employees verbally during evacuation.

• For hearing impaired employees:

• Describe the use of visual indicators and clear signage to communicate emergency information to deaf employees.
• Specify communication methods or trained personnel capable of using sign language during evacuation procedures.

Additional Recommendations:

• Recommend regular drills and training sessions involving disabled employees to ensure familiarity with evacuation procedures.
• Highlight the importance of maintaining open communication channels with disabled employees to accommodate their specific needs during emergencies.

Submission Guidelines:

• Format the evacuation instruction professionally, ensuring clarity and accessibility for all stakeholders.
• Include diagrams or visual aids where applicable to enhance understanding

Conclusion:

This task aims to equip you with the skills to create inclusive evacuation procedures, ensuring the safety and well-being of all employees, including those with disabilities, in the event of an emergency.

Presentation

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