The following recommendations are based on multiple sources. One of the sources is the literature analysis of the topic, mainly using the guidelines based on research or particular experiences. Another source was a workshop with emergency rescue services representatives, therapists and other specialists working with the target group and a physically impaired participant. They shared their experiences and expertize and gave feedback to the information from the literature sources. Another source was a qualitative study carried out within the frame of the EUNAD projects. The University of Southern Denmark is the implementing institution.

 
Emergency Preparedness

• Make general recommendations for PD individuals in case of evacuation.
• Implement ways to make it easier for first responders to access important information concerning the disability, i.e. QR codes connected to the individual or individual medicine cards (used in some countries).
• When planning a new building, consider making it easier for PD individuals to escape.
• Extend the knowledge of how to evacuate PD individuals in situations of crisis.
• Implement emergency preparedness training.
• Extend the knowledge of differences in treating PD individuals and non-PD individuals.
• Information campaigns should provide information to professionals and the general population on how to offer help to PD individuals in evacuation situations.
• Make work places in the public sector responsible for disabled employees and, as far as possible, make individual evacuation plans.
• Include the PD individuals in the test evacuations.
• Implement first aid and fire rehearsal evacuations in elementary school that includes how to handle the most common disabilities.
• Ensure education for elementary school children regarding disabilities.

Emergency Response

• Be informed about the evacuations possibilities.
• Remember there is a person behind the handicap and show empathy.
• When evacuating a PD individual, inform them about what is going to happen.
• Bring the wheelchair, if possible.
• Remember that not all disabilities are visible.
• A physically disabled individual may appear to be mentally disabled, even when this is not the case. Verify the state of disability and always treat with dignity.
• Beware of increased risk of bone breakage or muscle weakness - inappropriate handling causes risk of injury.
• Involve disabled individuals more in treatments, rights and plans.
• Remember that some individuals cannot support or uphold their own body.
• Ask about specific needs and how to help with the transportation.
• Respect the autonomy of the PD individual.
• Show respect and do not overtake the individuals own competence.
• Respect an alternative reaction. Individuals with disabilities have often learned to live with their physicals limitations and might react unexpectedly.
• Provide information that is timely, reasonable, and true and contact or communicate with relevant caregivers if needed.
• Assign specific individuals to communicate with the patients and be aware of special needs.
• Prepare an emergency preparedness kit (e.g. gloves, support bandages, etc.).
• Encourage the physically disabled to talk to friends and family about what to do in a crisis.

Recovery (Psychosocial)

Make psychological counselling for individuals with disabilities and their relatives easier accessible.

Implications for rehabilitation

• Medical and psychosocial services should be properly prepared to assist PD individuals.
• For the healthcare and psychosocial services guidelines should be produced and the professional services in both healthcare and the municipality offices should start a collaboration to operate fully optimal for the PD populations.
• Regarding rehabilitation after disasters, evidence-based information about how to service the needs of PD populations should be disseminated to professionals, and preferably incorporated into training programs and evacuation plans.

Guidelines for communication and interaction with people with physical disabilities

We apply the same basic principles as with people with cognitive and perception difficulties:

• It often helps to ask the individual how to help with transport and what his specific needs are.
• To stabilize people it helps to provide information (timely, reasonable and true) and contact and communication with close persons. We arrange contact with a close person.
• When communicating with a person with physical disability, we always keep his human dignity and respect.
• We offer help, ask what we can do and what the person can do it selves. 
• We strive for the individual's own activity, we do not overtake his own competence.
• We adapt to his abilities.
  We do express sorry for the person, we respect differences in movement. Disabled have often learned to live with their disabilities.

Specific recommendations

• We treat the person as any other person.
• A physically handicapped person may appear to be mentally disabled even if he is not. We have to verify the state of disability and always maintain the human dignity.
• We ask what an individual can do it selves and how we can help.
• We let the disabled person tell us, how to deal with him during transport.
• Beware of increased bone breakage or muscle weakness - inappropriate handling is a risk of injury. 
• Some people do not hold the body without support.
• For wheelchairs, follow the wheelchair user´s recommendations.
• Wheelchair handling - fold and unfold a wheelchair: apply brakes, remove cushion (if any), adjust the footrest, rotate them out or remove them, hold the midpoint of the seat at the front and back, pull upwards and fold the wheelchair. To unfold push the seat. Beware of finger injuries when handling.
• Transport of wheelchair down the stairs: 1. Take the wheelchair in a frontward manner down the steps; 2. Grip the handles firmly and tilt the wheelchair, balancing on the rear wheels; 3. Move the wheelchair to the top of the first step; 4. Use your body as brake while gently lowering the wheelchair; 5. Control the descend with your body, keeping the rear wheels tight against the stair edge and roll the wheelchair forward and down the step; 6. Don't let the chair drop unevenly or too quickly. A second person helps at the front of the wheelchair. We can carry a light person with the wheelchair down the stairs.
• Getting up the stairs likewise (the wheelchair is back to the stairs).
• On uneven, stony or sandy terrain we carry a wheelchair with a person backwards. (When pushing forward, the wheels crash).
• If we want to drop a person out of the wheelchair, we have to ask how we can grasp him or her. § Before setting a person on the wheelchair, we apply brakes and remove the armrest.
• Electric wheelchairs are heavy (weighs 100kg or more), so we transport them better without the wheelchair user. The motors can be disconnected and the wheelchair can be pushed mechanically.
• When moving from an electric to a mechanical wheelchair next to it, the armrests can be removed.
• The necessary width of the toilet door should be ensured as well as the height of the washbasin.

Implications for rehabilitation

• Being physically disabled can make it hard to evacuate fast and without complications during times of disaster.
• Medical and psychosocial services should be properly prepared to assist physically disabled (PD) individuals.
• In a relatively small sample, this study highlights difficulties faced by PD individuals in Denmark when accessing healthcare and psychosocial services. These centered on a lack of guidelines and lack of fully optimal professional services in both healthcare and the municipality offices.
• Regarding rehabilitation after disasters, evidence-based information about how to service the needs of PD populations should be disseminated to professionals, and preferably incorporated into training programs and evacuation plans.