This story was first published on the 26th April 2017 for Pomegranate, a podcast of the Royal Australasian College of Physicians. Subscribe to the series on iTunes Store or Android.

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Patients with autism spectrum disorder (ASD) can present unique challenges for the emergency physician. As these patients often have trouble making sense of their own emotional and physical states, they can become very distressed when experiencing pain. Many are also limited in their language abilities, and therefore can’t communicate verbally what is wrong.

In this episode of Pomegranate, carer Annette talks about raising her teenage grandson Aaron, who needs continual care. Consultant paediatrician Meenakshi Rattan FRACP (Campbelltown Hospital, NSW), and psychiatrist Kenneth Nunn FRANZCP FRACP (Children’s Hospital Westmead, NSW) share the techniques they use to calm distressed patients living with autism and make medical assessments. They also describe the appropriate sedation that might be used for the most agitated and aggressive cases, and how gaps in the transition of patients to adult care might be filled.


This episode was produced by Mic Cavazzini. Music from Blue Dot Sessions (“A Path Unwinding”), Loch Lomond (“From Here to Iceland,” “Violins and Tea”), Chris Zabriskie (“Out of the Skies, Under the Earth”); photo courtesy iStock. Pomegranate’s executive producer is Anne Fredrickson.