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Nursing Manual
The "Fatal
Four": Specific risks for people with developmental disabilities
There
are four major health issues that are more common in people with developmental
disabilities and cause
both morbidity and mortality. They are frequently referred to as the "fatal
four": aspiration, dehydration, constipation and epileptic
seizures.
Aspiration,
dehydration, and constipation may be insidious conditions that often go unrecognized
until they cause a
major illness and/or even death. Many of the symptoms of these conditions
are subtle and persons with disabilities may not be able to express their
discomfort or give indications that they are not feeling well.
If a person
has epileptic seizures, it is the suddenness and the unpredictability of this
disorder that places
the person at risk. Hospitalizations and/or death may be caused by injury,
aspiration, drowning, or status epilepticus. Astuteness of the staff and
careful monitoring can greatly minimize the risks and ensure timely interventions.
The following information will help the RN identify persons that have "fatal
four" risks and help guide them in their assessment, plan of care
and protocols.
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