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Autism sensory meltdown de-escalation a auwana (elopement) ulia pōpilikia

He ʻokoʻa nā helu ulia pōpilikia ma ka ʻāina. Hoʻohana kēia ʻaoʻao i ka 911, ka helu no ʻAmelika a me Kanada. Nui nā ʻāina ʻē aʻe i hoʻohana i ka 112, 999, a i ʻole ka helu ʻē aʻe. E huli i ka helu no kou ʻāina.

ʻElua mau pilikia koʻikoʻi e hoʻopilikia pinepine i nā keiki autistic, ʻōpio, a me nā mākua: ʻo ka naʻi a i ʻole nā ​​manaʻo meltdowns (me autistic shutdowns) a me wandering or elopement, bolting a pahee paha mai kahi home palekana, kula, a i ʻole ka lehulehu. I ka wā o ka hoʻoheheʻe ʻana o ka maʻi autistic, ua hoʻopiha piha ʻia ke kikowaena o ke kanaka e ka naʻau a i ʻole ka cognitive overload, e hoʻoulu ai i kahi pane hakakā neurological involuntary. ʻO ka mālama ʻana i ka hoʻoheheʻe ʻana e like me ka hoʻomāinoino ʻana, ma ka hoʻōho ʻana, ka hoʻoweliweli ʻana i ka hoʻopaʻi, ka hoʻopiʻi ʻana i ke kanaka, a i ʻole ka hoʻohana ʻana i ke kaohi ʻana i ke kino, e piʻi nui ana ka pilikia a lawe i kahi pilikia nui o ka hōʻeha kino a i ʻole ka asphyxiation kūlana.

ʻOi aku ka koʻikoʻi ʻo autistic wandering (elopement), e pili ana i ka hapalua o nā keiki autistic ma kahi o hoʻokahi manawa ma hope o ka makahiki 4. Wahi a ka noiʻi make makaʻāinana mai ka National Autism Association a me nā keʻena ʻimi-a-hoʻopakele honua, ** ʻo ka make ʻana o nā keiki he 71 a hiki i ka 91 pakeneka o nā mea make a pau e pili ana i , no ka mea, ʻo ka poʻe maʻi maʻi maʻi e pili ana i nā mea maʻi. ʻālohilohi a hōʻoluʻolu i ka manaʻo o ka wai me ka ʻike liʻiliʻi i ka hohonu, ke anu, a i ʻole ka pōʻino. Inā nalowale kekahi kanaka autistic a ʻōlelo ʻole paha, ** pono e huli mua ʻia kēlā me kēia kino wai i loko o 800 a 1,600 mika (0.5 a 1 mile) i ke kelepona ʻana iā 911 / 112 / 999 i ka manawa like.

E hana i kēia i kēia manawa

  1. Inā nalo kekahi keiki autistic a makua paha (elope), e kelepona koke iā 911 / 112 / 999 a huli mua i nā pilikia wai a pau: Mai kali i 15 mau minuke e huli mālie i ka hale ma o ʻoe iho. E kāhea koke i kāu helu pilikia kūloko (911 ma US a me Kanada, 112 ma EU, 999 ma UK; e nānā helu pilikia), e ʻōlelo "Nalo ka mea me ka autism, nui ka pilikia o ke poho, ʻaʻole ia e pane i ko lākou inoa," a e hoʻouna i kēlā me kēia kanaka makua i loaʻa e nānā i nā loko ʻauʻau, nā loko paʻa, nā kahawai, nā auwai, nā ʻauwai ʻino, nā loko, a me nā wai wela i loko o 400 a 800 mika (0.25 a 0.5 mau mile) mua.
  2. I ka wā o ka hoʻoheheʻe ʻia ʻana o ka naʻau, hoʻomaʻemaʻe i ke kaiapuni a hoʻōki i ke kamaʻilio ʻana: E hoʻoneʻe i ka poʻe e kū ana i hope, e hoʻomāmā i nā kukui ʻālohilohi ma luna o ke poʻo, e hoʻopau i nā TV leo nui, nā mele, a i ʻole nā ​​​​alila, a e hoʻemi i kāu mau ʻōlelo ponoʻī e 90 pakeneka. Ke loaʻa ke kanaka i loko o ka neurological overload, nā nīnau waha ("No ke aha ʻoe e hana ai i kēia? E ʻoluʻolu a hoʻohana i kāu mau ʻōlelo") kani e like me ka walaʻau paʻa a ninini i ka wahie i ka pilikia.
  3. E pale i ke poʻo a me ke kino o ke kanaka me ka hoʻohana ʻana i nā pale palupalu ma mua o ka hoʻopaʻa ʻana iā lākou i lalo: Inā e kuʻi ke poʻo i ka papahele a i ʻole ka paia, e hoʻoneʻe i kahi ʻūlū sofa mānoanoa, uluna, ʻaʻahu peʻe, a i ʻole ka moena haʻuki ma waena o ko lākou poʻo a me ka ʻili paʻa, a e hoʻoneʻe i nā lako ʻoi aku.
  4. Mai hoʻohana i ke kaohi ʻana (ke alo i lalo) a kau i ke kaumaha ma ke kua, ka umauma, a i ʻole ka ʻāʻī o ke kanaka: ʻO ka paʻi ʻana i ke keiki e hakakā nei a i ʻole ke kanaka makua i lalo i lalo i ka papahele e kaohi ai i ka neʻe ʻana o ka diaphragm a hiki i ka ** kūlana asphyxiation** a hopu koke i ka naʻau i loko o nā minuke.
  5. E hāʻawi haʻahaʻa haʻahaʻa i nā mea hana hoʻoponopono naʻau me ka leo ʻole: E kau i nā poʻo pepeiao hoʻopaʻa leo, nā aniani, kahi pākeʻe kaumaha a i ʻole ka uluna kaumaha, a i ʻole kahi hale lole ʻeleʻele a mālie a hiki i ka lima me ka ʻole e koi aku i ke kanaka e hoʻopā iā lākou, a e noho mālie 1.5 a 2 mika (5 a 6 mau kapuaʻi) ka mamao ma kou kino a ma lalo o ko lākou mau maka.
  6. Inā hōʻea nā mea lapaʻau a i ʻole nā ​​makai i ka wā o ka hoʻoheheʻe ʻana, e hālāwai me lākou ma waho ma mua o ko lākou komo ʻana i ke keʻena: E haʻi mālie i nā luna ma ka puka mua: * "He autistic kaʻu keiki/ʻohana a me ka hoʻoheheʻe ʻana o ka naʻau.
flowchart TD
    A["ʻIke ʻia ʻo Autism Emergency"] --> B{"Nalo paha ke kanaka (Elopement) a i ʻole he meltdown?"}
    B -- "Nalo / Hoʻopaʻa ʻia (Elopement)" --> C["E kelepona iā 911 / 112 / 999 koke: Moku'āina 'Nalo ke Kanaka Autistic: Huli Mua i ka Wai'"]
    C --> D["Hoʻouna i nā mākua i ka manawa like e nānā i kēlā me kēia loko, loko, kahawai, canal & alanui i loko o 800m (0.5 mi)"]
    D --> E["E nānā i nā wahi huna i hoʻopaʻa ʻia (nā pahu kaʻa, nā hale, nā mea hana) & hoʻāla i ka GPS / Radio Tracker"]
    B -- "Acute Sensory Meltdown a Paʻa paha" --> F["Hoʻomaʻemaʻe i ka poʻe e kū ana, Wehe i nā mea weliweli, a hoʻopaʻa i nā ʻili paʻa me nā uluna"]
    F --> G["ʻOki i ka ʻōlelo i ʻōlelo ʻia i Zero a i ʻole 2-Word Reassurances & Lower Lights / Noise"]
    G --> H{"Loaʻa koke i ka pōʻino a i ʻole ka pōʻino?"}
    H -- "ʻAʻole" --> I["Hāʻawi i 2 mau mika (6 kapuaʻi) o ka lewa pilikino, noho ma lalo o ka ʻili o ka maka, a hāʻawi i nā mea hana sensory me ka leo ʻole."]
    H -- "ʻAe" --> J["E hoʻohana i nā pale ʻoluʻolu e pale ai i ka hopena; Mai hoʻohana i ka pale alo i lalo (prone)."]

Māhele 1: Hoʻomaopopo i nā Meltdowns vs Tantrums vs Autistic Shutdowns

ʻO ka hewa pōʻino loa i hiki i ka makua, ke kumu, ka mea e kū ana, a i ʻole ka mākaʻi ke hana, ʻo ia ka ʻike hewa ʻana i kahi autistic meltdown ma ke ʻano he ʻano hoʻomāinoino a i ʻole ka hōʻole ʻana. Ma muli o ka ʻokoʻa loa o ke kumu neurological, ʻo nā ʻano hana makua maʻamau i hoʻohana ʻia no ka huhū (e like me ka hoʻopaʻi paʻa ʻana, nā koi pili maka, nā hopena, a i ʻole ka nānā ʻole ʻana i nā pilikia pilikia o ke keiki) e ʻoi aku ka ʻino.

Hoʻohālikelike hoʻohālikelike: Behavioral Tantrum vs Autistic Meltdown vs Autistic Shutdown

Hiʻona ʻO ka hoʻomāinoino ʻana i ke ʻano o ka pahuhopu Autistic Sensory / Emotional Meltdown Paʻa Autistic ("Hoʻokuʻu / Dorsal Vagal Collapse")
Ka Mokuʻāina Neurological Underlying Prefrontal cortex mau ma ka pūnaewele: Makemake ke keiki i kahi hopena kiko'ī (he mea pā'ani, ka lole, ka manawa pale, e pale ana i ka hana) a ho'ohana i ka leo nui i mea e pono ai. Automomic nervous system hijack (Amygdala fight-or-flight): ʻOi aku ka nui o ka naʻau, ka pilikanaka, a i ʻole ka naʻau noʻonoʻo. Parasympathetic immobilization ("Freeze / Shutdown"): ʻO ka hoʻonui nui ʻana ke kumu e huki ai ka ʻōnaehana nūnū i ka ʻūhā pilikia a pani i nā pane o waho.
Ka ʻike o ka poʻe hoʻolohe a me ka palekana Kiʻekiʻe: Nānā e ʻike inā e nānā ana nā mākua; ʻaʻole i hōʻeha nui iā lākou iho; kū koke inā hāʻawi ʻia ke koi. Zero: ʻAʻole mālama i ka mea nāna e nānā; ua nalowale ka mana hoʻokō a ʻaʻole hiki ke hoʻōki inā hāʻawi ʻia ka mea a lākou i noi mua ai; kiʻekiʻe ka pilikia o ka hōʻeha iā ia iho. Hoʻokomo ʻia: ʻIke ʻia paha ke kanaka kaʻawale, ʻoniʻoni ʻole, ʻōwili ʻia ma lalo o ka papaʻaina, nānā pono ʻole, a ʻaʻole hiki ke ʻōlelo (situational mutism).
Nā hōʻailona hōʻailona ("The Rumbling Stage") ʻO ka hoʻopaʻapaʻa, ke kūkākūkā ʻana, ka ʻōhumu ʻana, ka hehi ʻana i nā wāwae i ka nānā ʻana i ka hopena o ka mea mālama. ʻO ka hele wāwae ʻana, uhi ʻia nā pepeiao/maka, hoʻonui ʻia ka ** hoʻoulu ʻana** (ʻo ka haʻalulu, ka paʻi lima, ka leo ʻana), ka echolalia, ka ʻili ʻili, ka hou ʻana, a i ʻole ka hoʻāʻo ʻana e haʻalele i ka lumi. ʻO nā neʻe lohi, hāwanawana robotic a i ʻole hoʻokahi huaʻōlelo, hāʻule ke kūlana, hoʻi i nā kihi, luhi loa, hiki ʻole ke pane i nā nīnau maʻalahi.
Ka hopena o nā uku, nā hoʻoweliweli, a i ʻole "E hoʻohana i kāu mau ʻōlelo" Hiki ke hoʻopōkole a hoʻopau paha i ka huhū ke maopopo nā palena. Pino a hoʻolōʻihi i ka pilikia: ʻAʻole hiki i ka lolo ke hoʻoponopono i ka ʻōlelo a i ʻole ke kaupaona ʻana i nā hopena e hiki mai ana i ka wā o ka ʻino autonomic. Ke kumu o ka hoʻihoʻi ʻana i ka hohonu: ʻO ke koi ʻana i ka nānā ʻana i ka maka a i ʻole ke koi ʻana i ke kanaka e ʻōlelo i ka wā e pani ʻia ai ka ʻeha a me ka weliweli.
Pale ʻana i ka ulia pōpilikia ʻO ka mālie a me ka hoʻonohonoho palena paʻa ʻole me ka uku ʻole i ka puka ʻana. Low-Arousal De-Escalation: Ka hoʻemi ʻana o ka naʻau, ka hāmau, ka pale kino/wahi, a hiki i ka 1 a i ka 2 hola o ka hoʻomaha hoʻomaha. Kūlaʻa mālie: Hāʻawi i kahi wahi pōwehiwehi a hāmau, kahi pākeʻe mahana a i ʻole mea kaumaha, ʻaʻohe koi waha, a me nā kamaʻilio ʻē aʻe (kikokikona/kāleka) wale nō ke mākaukau.

Māhele 2: ʻAi-i-kaʻanuʻu Low-Arousal De-Escalation i ka wā o ka meltdown nui

Paionia e ke kauka noʻonoʻo noʻonoʻo lapaʻau ʻo Professor Bo Hejlskov Elvén a kākoʻo ʻia e ka National Autistic Society (UK) a me nā loea pilikia autism ma ka honua holoʻokoʻa, ʻo ka Low-Arousal Approach e kālele ana i ka hoʻoponopono ʻana i kāu ʻōlelo kino ponoʻī a me ke ʻano o ka naʻau a puni i hiki i ke kino o ke kanaka autistic ke puka i waho o ka hakakā a lele palekana.

KaʻAnuʻu Hana 1: E hopu i ka "Rumbling Stage" ma mua o ke kiko kiko

ʻAʻole hiki ke hoʻoheheʻe ʻia ma waho; ʻO ia ka hopena o ka trigger stacking (ka "stress bucket" e hoʻopiha ana i nā hola mai nā lole ʻokiʻoki, nā hums fluorescent, nā hoʻololi hoʻonohonoho, nā alaloa piha, ka pōloli, a i ʻole ka uhi ʻana). Ke ʻike mua ʻoe i nā hōʻailona halulu, e uhi ana i nā pepeiao, nīnau hou, kaʻi ʻana, ka haʻalulu wikiwiki, a i ʻole ka huhū hikiwawe, ** hoʻokuʻu koke i nā koi koʻikoʻi ʻole ** a hoʻoneʻe i ke kanaka i kahi puka mālie a i ʻole ka naʻau ma mua o ka piha ʻana o ka bākeke.

KaʻAnuʻu Hana 2: E hoʻokō i ka "Low-Arousal Protocol" inā ua hoʻomaka ka meltdown

Ke hoʻomaka ka hoʻoheheʻe ʻana, ʻo kāu ** pahuhopu wale nō ka palekana kino a me ka hoʻoponopono ʻana i ka naʻau**, ʻo ke aʻo ʻana a i ʻole ke aʻo ʻana he 100 pakeneka mai ka papaʻaina:

  1. Hana i 2-Meter (6-Foot) Palekana Palekana a Wehe i ka Poʻe Hoʻolohe:
  2. E hoʻoneʻe i nā mea hiki ke hoʻolei ʻia a hoʻolele ʻia paha (nā ipu aniani, nā noho, nā mea pāʻani paʻakikī) i waho o ka hiki.
  3. Inā ʻoe i loko o ka hale kūʻai, ka mokulele, a i ʻole ke alahele a ke nānā nei a hāʻawi mai paha nā malihini i nā ʻōlelo aʻo makua ʻole i makemake ʻia, mai hoʻoikaika i ke kanaka autistic e neʻe i ka wā i hoʻoheheʻe ʻia ai ka piko ke ʻole ke kino o ke kino (e like me ke ala keʻa alanui). Akā, e huli i kou kua i ka lehulehu no ka pale ʻana i ka pilikino o kou ʻohana, a i ʻole e hāʻawi i kahi mea nānā i kahi ** Kāleka ʻIke Autism** i paʻi mua ʻia ("He autistic koʻu lālā o ka ʻohana a loaʻa ka meltdown sensory overload. ʻO ke ala maikaʻi loa e hiki ai iā ʻoe ke kōkua iā mākou ʻo ka hāʻawi ʻana iā mākou i kahi mālie a hoʻomau i ka hele ʻana. Mahalo.").
  4. E hoʻokō i ka "Rule of Silence" (Nīnau Zero, Zero Commands):
  5. I ka wā hoʻoheheʻe ʻana, hoʻopahemo ʻia nā wahi ʻōlelo a Broca a me Wernicke i ka lolo. Nīnau ʻana "He aha ka hewa?", "Makemake ʻoe i ka wai?", a i ʻole "E nānā mai iaʻu a hanu hohonu" e hoʻoikaika i ka lolo o ke kanaka e hoʻololi i ka syntax auditory paʻakikī, e hoʻoulu koke i ka huhū a i ʻole ka hopohopo.
  6. E noho hamau loa, a i ʻole e hoʻohana ** ma kahi o 2 a i ʻole 3 mau huaʻōlelo mālie a mālie** i ʻōlelo ʻia me ka leo pumehana a haʻahaʻa i kēlā me kēia minuke: "Pale ʻoe." "Aia wau." "E lawe i kou manawa."
  7. Hoʻokomo i ke kino hoʻoweliweli ʻole:
  8. Mai kū pololei ma luna o ke kanaka i hoʻoheheʻe ʻia me kou mau lima i keʻa, nā lima ma kou pūhaka, a i ʻole nā poʻohiwi e kū i mua; i ka lolo i ka hakakā a i ʻole ka lele ʻana, ʻo ke kūlana kiʻekiʻe kiʻekiʻe e like me ka hoʻouka kino kino.
  9. E kū a noho paha ma kahi kihi 45-degere (ma ka ʻaoʻao) ma mua o ke alo a he alo, e hoʻohaʻahaʻa iā ʻoe iho ma lalo o ka ʻili o ka maka (e noho ma ka papahele a i ʻole kahi noho haʻahaʻa he 2 mika ka mamao), e hāmama a ʻike ʻia kou mau lima ma kou ʻūhā, a ** hōʻalo i ka nānā pono ʻana o ka maka i ka lōʻihi **.
  10. Paʻa i ka hana ʻino iā ia iho (SIB) me ka hoʻohana ʻana i ka pale pale palupalu:
  11. Inā paʻi ke poʻo o ke keiki autistic a makua paha i ka papahele, ka paia, a i ʻole nā mea lako, mai hopu i ko lākou mau lima lima a i ʻole ke poʻo i lalo me kou mau lima ʻole. ʻO ka hopu ʻana i nā lālā o ke kanaka i ka wā pilikia o ka naʻau e hoʻoulu ai i kahi hakakā paʻakikī e hemo, e hōʻeha iā ʻolua.
  12. Akā, pale i ka ʻili, ʻaʻole ke kanaka: e hoʻoheheʻe i kahi moe moe mānoanoa, ka moena yoga, ka uluna hoʻomanaʻo-foam, a i ʻole ka ʻaʻahu hoʻoilo i pelu ʻia ma waena o ko lākou poʻo/lima a me ka paia a i ʻole ka papahele. Inā nahu lākou i ko lākou mau lima lima a i ʻole ko lākou mau lima ponoʻī, e hāʻawi mālie i kahi paipu silikoni maʻemaʻe i ʻōwili ʻia, a i ʻole ke kihi uluna palupalu.

PILI KE OLA: Mai hoʻohana i ke kaohi (ke alo i lalo), ka hīnaʻi-paʻa, a i ʻole nā pākeke kaumaha ma ke ʻano he pahele.

Ua make nā ʻumi o nā keiki autistic, ʻōpio, a me nā poʻe makua mai ka ** positional and compressional asphyxiation** ma hope o ka mālama pono ʻana o nā mea mālama kula, nā limahana kula, a i ʻole nā ​​mea hoʻopuka pilikia i hoʻopaʻa ʻia i lalo i ka papahele (prone restraint), kukuli ma ko lakou kua a poohiwi, pelu iho la i ko lakou lama i mua o ko lakou mau kuli (seated hyperflexion), a i ʻole i ʻōwili paʻa iā lākou i loko o kahi pākeke kaumaha a i ʻole moena haʻuki ("burrito wrapping") i hiki ʻole iā lākou ke hoʻonui i ko lākou umauma. I ka hyperventilating a me ka hakakā ʻana o ke kanaka me ka hopohopo, nui ka koi o ka oxygen; ʻo ke kaomi mālie ʻana i ka iwi ʻaoʻao a i ʻole ka ʻōpū e hoʻōki i ka neʻe ʻana o ka diaphragm. Mai hoʻopaʻa i ke alo i lalo, ʻaʻole e kau i ke kaumaha o ke kino ma ka ʻōpū a i ʻole ka ʻāʻī, a mai ʻōwili a paʻi paha i ke kanaka i loko o kahi pākeʻe kaumaha. Pono e hoʻohana ʻia nā pākeʻe kaumaha i ka wā e hiki ai i ke kanaka ke hoʻokuʻu wale aku i ka pākeʻe mai iā ia iho i kēlā me kēia kekona.

KaʻAnuʻu Hana 3: Kākoʻo i ka "Recovery / Hangover Phase"

Ke pau ka uwa, ka uwe, a me ka hahau, aole i pau ka hehee. Ua ʻike ke kanaka i ka piʻi nui ʻana o ka adrenaline a me ka cortisol, e waiho ana iā lākou i loko o kahi "autistic hangover" (kahi hoʻomaha) kahi e hiki ai i kahi koi liʻiliʻi ke hoʻāla hou i ka lua i loko o kekona:

  • Hāʻawi i kahi kīʻaha wai me kahi mauʻu, kahi lumi polū mālie, a me kā lākou mea hōʻoluʻolu punahele a i ʻole wikiō hoihoi kūikawā.
  • Mai noi iā lākou e kala mai, hoʻomaʻemaʻe koke i kahi ʻino, a kamaʻilio e pili ana i "ka mea i hana" no ka liʻiliʻi he mau hola (a i ka lā aʻe). Nui ka poʻe autistic e ʻike i ka amnesia hapa i ka wā o ka meltdown kiʻekiʻe a hilahila nui ma hope; e hālāwai me lākou me ka pumehana a me ka hōʻoiaʻiʻo.

Mahele 3: Auwana Autism a me ka Elope (Water-First Search Emergency)

Ma nā huaʻōlelo lapaʻau, hiki mai ka elopement (ʻauwana a i ʻole bolting) ke haʻalele ke kanaka autistic i kahi wahi mālama ʻia a palekana me ka ʻike ʻole o ka mea mālama. ʻAʻole like me ka dementia auwana ʻana i ka poʻe ʻelemakule, ka mea i alakaʻi ʻia e ka pohō hoʻomanaʻo a me ka hoʻokaʻawale ʻana, ** ʻo ka hele ʻana o ka autistic he mea maʻamau i alakaʻi ʻia i ka pahuhopu a i ʻole naʻauao **: holo i kahi mea hoihoi (he loko ʻālohilohi, kahi kaʻaahi e hele ana, kahi paka punahele) a i ʻole ka holo ʻana mai ka walaʻau nui, ka pilikia, a me nā koi.

flowchart TD
    A["ʻIke ʻia ʻo ke keiki autistic a i ʻole ke kanaka makua i nalowale"] --> B["MINUTE 0: E kelepona iā 911 / 112 / 999 koke (Zero Kali Kali)"]
    B --> C["E haʻi iā Dispatcher: 'Nalo ke kanaka me ka Autism: ʻAʻole ʻōlelo / Manaʻo Manaʻo: E ʻimi Mua i ka wai āpau'"]
    C --> D["MINUTE 1 A 10: ʻO ka wai 360-Degere koke a me ka holoi ʻana i ka pōʻino"]
    D --> E["Manaʻo mua 1: Nā loko o kua hale a me nā hoa noho (ʻoiai i uhi ʻia), nā loko, nā kahawai, nā ʻauʻau paʻa, nā ʻauwai ʻino."]
    D --> F["Manaʻo 2: Nā Alanui Kiekie, Nā Ala Kaʻaahi / Alanui Alanui, a me nā kahua kūkulu"]
    D --> G["Manaʻo 3: Nā Wahi Paʻa Paʻa (Nā Kaʻa Pumehana/Puke, Mekini Holoi, Hale Hōʻikeʻike, Mea Paʻa Paʻa Paʻa)"]
    E --> H["E hoʻohana i ka makaʻala kamaʻāina: E noi i kēlā me kēia hoalauna i loko o 800m (0.5 mi) e nānā koke i kā lākou loko a me ka pā."]
    F --> H
    G --> H
    H --> I{"Loaʻa ke kanaka i loko o ka wai a pane ʻole paha?"}
    I -- "ʻAe" --> J["Hoʻopakele me ka palekana & hoʻomaka koke i nā hanu hoʻopakele + nā hoʻopaʻa umauma (CPR)"]
    I -- "ʻAʻole" --> K["Hāʻawi i nā mākaʻi me nā kiʻi hou loa, nā lole pololei, nā mea hoʻonani naʻau, a me ka ʻōlelo hoʻomaha"]

No ke aha he pilikia olakino "Water-First" 911 ka auwana auwana

Hōʻike nā ʻikepili i aʻo ʻia e ka American Academy of Pediatrics (AAP) a me ka National Autism Association (NAA) i ʻehā mau mea koʻikoʻi e pono i kēlā me kēia makua a me ka mea pane mua e ʻike:

  1. 49 pākēneka o nā keiki autistic e hoʻāʻo e haʻalele ma ka liʻiliʻi hoʻokahi ma hope o 4 mau makahiki, a ʻoi aku ka hapakolu o ka poʻe e auwana ʻaʻole hiki ke kamaʻilio i ko lākou inoa, helu wahi, a i ʻole helu kelepona ma ka waha.
  2. ** ʻO ka luʻu ʻana ke kumu o 71 a 91 pakeneka o nā hopena make a pau**: ʻAʻole i like ka huki ʻia ʻana o nā keiki autistic a me nā mākua e lele ana i ka wai, nā loko ʻauʻau ma hope, nā loko paʻa wai ʻino, nā kahawai wai, nā kahawai, a me nā kahakai, komo pinepine i ka wai me ka ʻaʻahu piha ʻole.
  3. ** ʻAʻole e pane ka nui o ka poʻe maʻi i ka wā e hoʻōho ai ka poʻe ʻimi i ko lākou inoa**: no ka mea, inā holo ka poʻe ʻimi i loko o ka ululāʻau me ka hoʻōho nui, puhi ʻana i nā kiʻi, holo ʻīlio hae, a i ʻole nā ​​kukui uila e ʻālohilohi ana, ʻo ke kanaka autistic i makaʻu a hopohopo paha e ** huna pinepine i loko o nā wahi paʻa, ʻeleʻele ** (nā ʻāwīwī, nā kumu kaʻa, ʻaʻole e kolo.
  4. Ka ʻeha ʻeha a me ka ʻike anu: He nui ka poʻe autistic i loaʻa nā paepae ʻeha kiʻekiʻe a i ʻole interoception i hoʻololi ʻia (ka hiki ke ʻike i nā hōʻailona o loko e like me ke anu anuanu, wela nui, a me ka wai maloʻo), ʻo ia hoʻi e noho lākou i loko o ka wai anuanu a piʻi paha i loko o kahi kaʻa i hoʻopaʻa ʻia me ka uē ʻole.

ʻO nā minuke 15 mua: Ka Papa Hoʻopaʻa Huli Elopement Pono

Inā huli ʻoe ma ka home, kahi paka, kahi kahua hoʻomoana, a i ʻole kahi hale kūʻai a ua hala kāu keiki autistic a ʻohana makua paha, e hana i kēia mau hana i ka manawa like:

  • 1. Kāhea iā 911 / 112 / 999 ma Minute Zero: Mai hoʻohilahila ʻoe e kelepona i nā lawelawe ulia pōpilikia inā he 2 mau minuke wale nō kāu keiki i ʻike ʻole ʻia. ʻO ke kānāwai Pekelala ma ʻAmelika Hui Pū ʻIa (Suzanne's Law, 34 U.S.C. § 41307, a me ka National Child Search Assistance Act) ʻaʻole loa e hoʻokō i nā keʻena hoʻokō kānāwai mai ka hoʻokō ʻana i kekahi manawa kali** ma mua o ka lawe ʻana i kahi keiki nalo a hōʻike kanaka endangered a hoʻokomo iā lākou i loko o ka FBI National Crime Information Center (NCIC).
  • 2. Hāʻawi i ka Dispatcher 911 i ka "4 Critical Autism Facts":
  • "Ua nalo kaʻu keiki [makahiki] makahiki/ʻohana [Name] a he autism kona."
  • "ʻAʻole lākou [ʻōlelo ʻole / ʻōlelo liʻiliʻi] a ** ʻAʻole e pane ke kāhea ʻoe i ko lākou inoa* a holo a peʻe paha mai nā leo kani leo nui a i ʻole nā ​​lole."*
  • "Ua huki ikaika ʻia lākou i [wai / kaʻaahi / kaʻa / ʻīlio / elevators]. ** E ʻoluʻolu e aʻo i nā luna kiaʻi pane e huli mua i kēlā me kēia loko, loko, a me ke kino wai i loko o 800 mika (0.5 mau mile).**"
  • *"Ke ʻaʻahu nei lākou i [nā waihoʻoluʻu pololei/kāmaʻa] a ke lawe nei i ka mea hoʻolele lekiō / AirTag hiki ke hoʻohana ʻia.
  • 3. Huli i KĒIA kino wai i loko o 800 mika (0.5 mile) ma ke kino:
  • E nānā mua i kāu pūnāwai ponoʻī, ʻauʻau wela, ʻauʻau ʻauʻau, a me ka loko iʻa nani, ʻoiai inā e kau ʻia ana ka uhi o ka lā a i ʻole ka uhi palekana (hiki i ke keiki ke paheʻe ma lalo o kahi uhi lana a ʻike ʻole ʻia mai ka ʻili). Huki hope loa i ka uhi i ʻike ʻoe i kēlā me kēia kihi o lalo o ka loko.
  • Holo i ka pā hale o kou mau hoalauna: Mai kīkēkē wale i ka puka mua a haʻalele inā ʻaʻohe pane; lele a wehe paha i ka puka no ka nana ana i ka wai auau o kela hoalauna, ka trampoline, a me ka hale, a e hooho i na hoalauna mawaho: "Ua nalo ka'u keiki autistic, e oluolu e nana i kou loko o ka hale a me ka hale i keia manawa."
  • E nānā i nā loko paʻa, nā kahawai, nā ʻauwai, a me nā ʻauwai ʻino: E hele i nā kapa e ʻimi ana i nā kapuaʻi i loko o ka lepo, nā kāmaʻa lana, a i ʻole nā ​​lole.
  • 4. Huli i "nā wahi huna huna" i loko a puni ka hale:
  • Piʻi pinepine nā keiki autistic e ʻimi ana i ka manaʻo hoʻokomo hohonu a i ʻole ka pōʻeleʻele mālie i nā wahi liʻiliʻi i hoʻopaʻa ʻia kahi e lele ai ka ʻimi maʻamau ma luna o lākou: i loko o nā kaʻa paʻa a me nā pahu kaʻa (e nānā i kāu mau kaʻa i paʻa a wehe koke i nā kaʻa kamaʻāina e pale i ka wela wela), i loko ** nā mīkini holoi hoʻouka mua a me nā pahu holoi lole a i ʻole nā hale lole, ma hope, ma lalo o ka pahu holoi lole a i ʻole ka pahu holoi. nā puʻu, i loko o nā hale kua, a i ʻole ma lalo o ka lānai.
  • **5. I loko o kahi hale kūʻai kūʻai kūʻai, hale kūʻai, kahua mokulele, a i ʻole ka paka kumuhana, koi koke i kahi laka "Code Adam" perimeter **:
  • Mai auwana wale i na aisles. E hopu i ka limahana a i ʻole kiaʻi kiaʻi kokoke loa a e ʻōlelo: "E kāhea iā Adamu (keiki nalo me ka autism) a laka/koʻokoʻo i kēlā me kēia puka puka a me ke kahua kaʻa i waho i kēia manawa." * E nānā koke i ka palekana i nā ** escalators, elevators, punawai, hoʻouka pahu, a me nā lumi hoʻomaha*.

Pehea e kāhea aku ai ka poʻe ʻimi i kahi kanaka autistic nalo i hūnā mai ka walaʻau

E hoʻomanaʻo i nā mākaʻi a me ka poʻe ʻimi manawaleʻa ʻo ** ʻo ka hoʻōho ʻana i ka inoa o ke keiki me ka ikaika e hiki ai i kahi keiki autistic ke huna hohonu**. ʻOiai e nānā wikiwiki ana kekahi hui i nā pōʻino wai, pono e kāhea ka poʻe ʻimi e nānā ana i ka ululāʻau, iwilei, a i ʻole hale me ka ** mālie, upbeat, leo mele** e hoʻolaha ana i kahi makana punahele a hoihoi kūikawā paha ma mua o ke kani ʻana i ka huhū (e laʻa: "[Name], loaʻa iaʻu kāu iPad a me nā kīʻaha Farani mahana ma ʻaneʻi, ʻaʻohe kanaka huhū, palekana ʻoe, palekana ʻoe"), a pāʻani i ke mele leo punahele no ka Bluetooth. 15 kekona no ka hoʻolohe ʻana i ka neʻe ʻana a i ʻole ke kani ʻana.

Māhele 4: Kāohi, ʻenehana hiki ke komo, a me ka hoʻopaʻa inoa mua-pane

Ma muli o ka hele ʻana a me nā pilikia ʻike lehulehu i kekona, ʻo ke kūkulu ʻana i kahi ʻupena palekana kino a me ke kaiāulu ma mua e hōʻemi nui i ka pilikia.

Layered home and wearable checklist checklist

  1. E hoʻouka i nā laka puka paʻa kiʻekiʻe a me nā puʻupuʻu kani kani nui:
  2. E hoʻouka i nā pahu kuʻekuʻe lua, nā kī paheʻe, a i ʻole nā ​​laka paʻa ma ka luna loa o nā puka o waho (1.8 mika / 6 kapuaʻi mai ka papahele, ma mua o ka hiki ʻana o ke keiki), ** inā ʻike nā mākua a me nā kaikuaʻana o ka home pehea e wehe koke ai i ke ahi hale**.
  3. E hoʻopaʻa i nā pahu kani maʻemaʻe ** i nā puka makani a me nā puka kani kani ** (hoʻonoho ʻia i kahi chime 90 a i 120 dB) ma kēlā me kēia puka waho a me ka puka makani papahele i lohe ʻoe i kahi makaʻala koke i ka manawa e hāmama ka puka i ke ao a i ʻole ka pō.
  4. Inā loaʻa iā ʻoe kahi ʻauʻau ma hope, e hoʻopuni iā ​​​​ʻoe iho me ka 4-ʻaoʻao, 1.2-mika (4-kapuaʻi) ka palena liʻiliʻi e pani ponoʻī iā ia iho, hoʻopaʻa paʻa ponoʻī iā ia iho a me kahi puʻupuʻu wai nalu.
  5. E hoʻohana i ka ʻenehana Hoʻopaʻa Wearable kūpono (Radio Frequency vs GPS vs Bluetooth):
  6. ** Nā mea hoʻouna i ka lekiō (RF) (Project Lifesaver / Care Trak)**: Hoʻohana ʻia e nā tausani o nā keʻena makai kalana a me nā keʻena mākaʻi ma waena o US, Kanada, a me ka honua holoʻokoʻa, ua kau ʻo Project Lifesaver i ka lima a i ʻole ke kāʻei kuʻekuʻe wāwae ma luna o ka mea nāna e hoʻopuka i kahi hōʻailona lekiō. ʻAʻole like me ka GPS kelepona, hana nā hōʻailona RF i loko o nā hale, nā ululāʻau paʻapū, a me nā tunnel me ka ʻole o nā hale kiaʻi kelepona, e ʻae ana i nā keʻena i hoʻomaʻamaʻa ʻia e ʻimi i kahi keiki nalo i ka awelika o 30 minuke.
  7. ** ʻO GPS kelepona hoʻolaʻa ʻia + LTE Trackers (AngelSense, Jiobit, Gabb, a i ʻole LTE Smartwatches)**: Hāʻawi i ka nānā ʻana i ka GPS mode runner-mode i ka manawa maoli ma ke kelepona o ka makua, ke kula/home hiki ke hoʻonohonoho ʻia geofence boundary alerts, a me kahi ala hoʻokahi "Sensory-Friendly Speaker" e hiki ai i ka makua ke ʻōlelo i nā huaʻōlelo hoʻomaha i ke keiki ma kahi mamao a i ʻole ke pāʻani i kahi kani kani leo nui i hiki i ka poʻe ʻimi kokoke ke kuhikuhi iā lākou.
  8. Nā mea hahai Bluetooth (Apple AirTag, Tile, Samsung SmartTag): He mea hoʻohana ma ke ʻano he kākoʻo maʻamau * lua * i humuhumu ʻia i loko o ke alelo kāmaʻa, kāʻei kāʻei, a i ʻole ke kapa ʻike, ** akā, mai hilinaʻi wale i kahi AirTag ma kahi kokoke i ka wai a i ʻole nā wahi kuaʻāina**, no ka mea, ʻaʻohe GPS i kūkulu ʻia i loko o nā mea hoʻokele Bluetooth a hoʻololi wale i ko lākou wahi i ka wā e hele ai kahi malihini iPhone a Android paha i loko o 10 a 30 mau mika (33 a 100 kapuaʻi) o ke keiki.
  9. E hoʻopaʻa inoa mua me kāu 911 Center a me ka Oihana Makai:
  10. Hāʻawi ka nui o nā kaona i kahi 911 Disability / Special Needs Premise Alert Registry (e like me Smart911 ma US, ʻo ka Herbert Protocol / Pegasus Card / Safe & Found ma UK, a i ʻole nā ​​mea kākau inoa ʻo Vulnerable Person ma Kanada a me Australia). Hoʻouka ʻoe i ke kiʻi hou o kāu ʻohana, ka wehewehe kino, ke kūlana ʻōlelo ʻole, nā mea hoʻoulu manaʻo, nā hiʻohiʻona wai/kaʻaahi punahele, a me ka hoʻolālā de-escalation no laila e pahū koke ia ma ka pale kamepiula o ka mākaʻi hoʻouna i ka lua o ke kāhea ʻana o kekahi iā 911 mai kāu helu wahi.
  11. E kākau inoa i nā haʻawina ʻauʻau a me ka wai ola ʻana:
  12. Paipai ikaika ka American Academy of Pediatrics i nā haʻawina ola wai a me nā haʻawina ʻauʻau no nā keiki autistic i ka hikiwawe loa (aʻo ʻia e nā kumu aʻoaʻo adaptive aquatics e hoʻohana ana i nā papa hana ʻike a me ka holomua ʻana o ka naʻau) no laila inā hāʻule ke keiki i loko o ka wai, ʻoʻa lākou ma ko lākou kua e lana a hanu.

Hiki ke hoʻohana ʻia ka ID lāʻau lapaʻau no nā ʻōpio a me nā pākeke ʻōlelo ʻole

No nā ʻōpio autistic a me nā poʻe mākua e holo kūʻokoʻa ana a i ʻole e ʻike paha i ka meltdown a i ʻole ke kūlana mutism (pani ʻia) i ka lehulehu, kahi kūpeʻe makaʻala olakino i kahakaha ʻia, ka inoa kāmaʻa, a i ʻole ka heluhelu kāleka lanyard: AUTISTIC / MAY BE NON-SPEAKING UNDER STRESS: NOT INTOXICATED: DO NOT RESTRAIN: CALL ICE: [NUMBER] pale i nā kuhi hewa ʻole me ka palekana hale kūʻai, nā limahana transit, a me ka hoʻokō kānāwai.

Nīnau pinepine

Pehea e hiki ai iaʻu ke ʻike inā e hele ana kaʻu keiki autistic a i ʻole kaʻu hoa pili i kahi "Autistic Shutdown" ma kahi o ka meltdown, a he aha kaʻu e hana ai?

ʻOiai ʻo ka hoʻoheheʻe ʻana he piʻi "hakakā-a-lele" waho (ka uē ʻana, ka uē ʻana, ka holo ʻana, a i ʻole ka hoʻopaʻa ʻana i waho), ʻo ka pani ʻana i ka autistic he pane "freeze" kūloko kahi e pani ai ka ʻōnaehana hopohopo i ka kamaʻilio a me ka mana kaʻa e mālama i ka ikehu. Hiki i ke kanaka i pani ʻia ke hāmau loa (situational mutism), haka pono ʻole, wili i ka papahele a i ʻole ma lalo o kahi pākeʻe, neʻe me he mea lā i lalo o ka wai, a i ʻole e hiamoe hohonu. Mai hooluliluli iā lākou, e koi i ka nānā maka, a i ʻole e koi iā lākou e ʻōlelo leo nui. Akā, e alakaʻi mālie iā lākou i kahi lumi pōwehiwehi a mālie, hāʻawi i kahi pākeʻe pumehana a kaumaha paha, e hōʻoia mālie ʻaʻole pono lākou e kamaʻilio, a e ʻae iā lākou e kamaʻilio ma ke kunou ʻana, kuhikuhi ʻana, a i ʻole ke paʻi ʻana i kahi leka uila ma kā lākou kelepona ke hoʻi hou ko lākou puʻupuʻu.

He aha kaʻu e hana ai inā ʻoi aku ka nui o kaʻu ʻōpio autistic a makua paha ma mua oʻu a lilo i mea ʻino a luku paha i ka waiwai i ka wā o ka hoʻoheheʻe ʻana?

ʻO ka mea mua, e pale i kou palekana kino a me ka palekana o nā kaikaina me ka hoʻāʻo ʻole e hakakā a lanakila paha i kahi ʻōpio nui a makua paha. E ho'ōki koke i nā hoʻopaʻapaʻa waha, wehe i kahi ala maopopo i ʻole e manaʻo ke kanaka ke kihi ʻia ma ka puka a i ʻole ke alahele (ʻo ke kihi e hoʻoulu ai i ka huhū pale kūlohelohe), a hoʻoneʻe iā ʻoe iho a me nā ʻohana ʻē aʻe i loko o kahi lumi kaʻawale me kahi puka paʻa (e like me ke keʻena moe me ka laka o loko) ʻoiai e nānā ana i ko lākou palekana inā hiki. Hiki ke hoʻololi mau ʻia ka waiwai (drywall, electronics, dishes); hiki ole ke kino kanaka. Inā pono ʻoe e kelepona iā 911 no ka loaʻa ʻana o kekahi i kahi pōʻino koʻikoʻi koʻikoʻi, e noi pololei i kahi luna hoʻomaʻamaʻa Crisis Intervention Team (CIT) a hui i nā luna ma waho e haʻi aku iā lākou i ke ala autism haʻahaʻa haʻahaʻa ma mua o ko lākou komo ʻana i ka home.

No ke aha i huki ikaika ai nā keiki autistic i ka wai ke auwana lākou?

He nui ka poʻe autistic e ʻimi nei i ka wai no ka mea e hāʻawi ana ia i nā hoʻoponopono multi-sensory ikaika a hiki ke wānana: ʻo ka ʻike maka ʻana o ka lā ma nā nalu, ke kani kani o ka wai e neʻe ana, a me ke kaomi hohonu hydrostatic i ka ʻili (e hoʻomaha i kahi ʻōnaehana proprioceptive overloaded). I ka manawa like, ʻokoʻa ka manaʻo pilikia a me ka hana hoʻokō, ʻo ia ka mea hiki i ke keiki autistic ke hele pololei i loko o kahi loko wai hohonu hohonu a i ʻole ka loko o ka hoalauna e hoʻopā i kahi lau e lana ana a noʻonoʻo ʻole me ka ʻike ʻole he wai ma luna o ko lākou poʻo. ʻO kēia ke kumu o ka nānā ʻana i kēlā me kēia kino wai i loko o 800 mika (0.5 mau mile) i nā minuke 5 mua loa ka helu hoʻokahi i nā pilikia auwana autism.

Pono au e haʻi aku i koʻu mau hoalauna i kēia manawa he autistic kaʻu keiki a ʻohana paha a he pilikia auwana?

ʻAe, ʻo ka hoʻolauna ʻana i nā hoalauna e hoʻopakele i nā ola. Manaʻo ka National Autism Association e paʻi i kahi "Neighbor Alert Letter" maʻalahi me ka kiʻi ʻakaʻaka o kāu keiki, kona inoa, kāna mea punahele punahele (ʻoiai inā he hoalauna ʻoe me ka loko o hope, loko, a trampoline paha), a me kāu helu kelepona. E hāʻawi aku i kou mau hoalauna a ʻōlelo: "He maʻi maʻi kā kā mākou keiki, makemake nui i ka wai, ʻaʻole maopopo i ka pōʻino a pane ʻole paha ke kāhea ʻia.

He palekana paha ka hoʻohana ʻana i kahi pākeʻe paona e hoʻomaha i ke keiki i ka wā o ka hoʻoheheʻe ikaika?

Inā noi ke keiki iā ia a koho paha e kolo ma lalo o ia mea, a hiki iā ia ke hoʻokuʻu iā ia iho i kēlā me kēia manawa. ʻAʻole pono e hoʻohana ʻia kahi pākeʻe kaumaha (ʻaʻole ʻoi aku ma mua o 10 pakeneka o ke kaumaha o ke kino o ke kanaka, a ʻaʻole pono e hoʻohana ʻia i nā kamaliʻi a i ʻole nā ​​keiki liʻiliʻi ma lalo o 2 mau makahiki) ʻaʻole pono e hoʻohana ʻia e wīwī, hoʻopaʻa i lalo, a pahele paha i kahi keiki e hakakā nei i ka wā e hoʻoheheʻe ai, a ʻaʻole pono e uhi i ke poʻo, ka maka, a me ka ʻāʻī. ʻO ke kaumaha kaumaha ma luna o ke kanaka huhū e hoʻoulu ai i ka makaʻu a lawe i ka pōʻino make o ka paʻi umauma a me ka ʻeha.

He aha kaʻu e waiho ai i loko o kahi "Autism Elopement Emergency Folder" ma ka home ma mua o ka hiki ʻana mai o kahi ulia pōpilikia?

E mālama i kahi mea hoʻopaʻa uila a i ʻole ka waihona kelepona kikohoʻe ma kou puka mua e loaʻa ana: (1) ʻEkolu mau kiʻi poʻo o kou ʻohana i hala koke iho nei, akaka a maopopo loa. (2) ʻO ko lākou kiʻekiʻe pololei, ke kaumaha, ka lauoho/ka waihoʻoluʻu maka, nā hōʻailona hānau, a me nā kāmaʻa maʻamau; (3) He paʻi palapala ʻāina Google i paʻi mua ʻia e hōʻike ana i kēlā me kēia loko ʻauʻau, loko paʻa, kahawai, ala kaʻaahi, a me kahi hale kūʻai punahele i loko o 1.6 mau mile (1 mile) mai kou hale; (4) E hoʻokomo i nā kikoʻī no kēlā me kēia GPS hiki ke hoʻohana ʻia a i ʻole ka mea nānā lekiō; a me (5) Nā memo kikoʻī no ka poʻe ʻimi inā pane lākou i ko lākou inoa, he aha nā leo kani e hoʻoweliweli iā lākou e peʻe ai, a he aha ke mele punahele, nā meaʻai, a i ʻole nā ​​​​huaʻōlelo e huki palekana iā lākou.

Nānā ʻia nā kumu

  • American Academy of Pediatrics (AAP, United States): Clinical Report: Wandering/Elopement in Children With Autism Spectrum Disorder and Preventive Guidance on Drowning Prevention.
  • National Autism Association (NAA Big Red Safety Box and AWAARE Coalition, United States): Lethal Outcomes in Autism Spectrum Disorder Wandering/Elopement and First-Responder Water-First Search Protocols.
  • National Autistic Society (NAS, United Kingdom): Meltdowns and Shutdowns: Kākoʻo ʻana i nā keiki autistic a me nā mākua e hoʻohana ana i ka Low-Arousal De-Escalation.
  • National Institute for Health and Care Excellence (NICE Guideline CG142 and CG170, United Kingdom): Autism Spectrum Disorder in Under 19s and Adults: Safe Management of Behavior That Challenges and Avoidance of Restrictive Physical Interventions.
  • ʻO Bo Hejlskov Elvén (Studio 3 Clinical Low-Arousal Training Framework, International): *Hoʻokele i nā ʻano pilikia ma ka Autism a me nā Kino kīnā ʻole me ka ʻole o ka hoʻopaʻa ʻana.
  • ʻAhahui Nui o nā Aliʻi Makai (IACP) a me ke Keʻena ʻOihana Hoʻokolokolo o ʻAmelika Hui Pū ʻIa o ka Luna Hoʻokolokolo Kokua: Ka pane hoʻokō kānāwai i nā poʻe nalo me ka Autism a me ka Alzheimer (Project Lifesaver and CIT De-Escalation Standards).

Inā huki ʻia ka mea nalo mai ka wai me ka pane ʻole, ʻo ka CPR koke me ka hanu hoʻopakele ʻekolu mau manawa ola. Manaʻo ikaika mākou e lawe i kahi CPR makua a me nā keiki keiki a me ka papa kōkua mua mai ke Keʻa ʻulaʻula, St John Ambulance, a i ʻole kāu mea lawelawe pilikia kūloko.

Nā alakaʻi pili