medic alert bracelets : do you use one?

Started by AdminCM, September 03, 2011, 06:45:05 PM

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This is one of the most striking posts ever on the subject of medic-alert bracelets:

usc1972 Posted: 06/14/09 at 08:36 pm   


I work as an ER nurse in a Level 1 trauma center in a fairly major city. I don't have any food allergies personally, but follow this, and some other health related boards to read patient perspectives. That said, I would like to offer my unsolicited, but hopefully helpful, advice on medic alert jewelery.

Overall, I think they are a fantastic idea. Not only do they provide information about children who are too young to explain for themselves, but they can also give medics and doctors a starting point when someone wearing one is found unresponsive.

The trend that I disagree with is their "fashionization." Medic alert bracelets work because they stand out and are obvious in nature. Wrist bands, beaded jewelery, watches with medic alert face plates or band links, shoe tags and other such "disguises" will likely go unnoticed.

To make my point, let me give some background on how traumas work. One of the trends in medicine today is to lean heavily on CT scans. With "traumas" (And depending on the hospital or doctor, this can include any passenger in an accident where the cars were damaged to a certain degree, regardless of apparent injuries.) the gold standard is a full body CT to rule out any internal bleeding. When metal goes through a scanner it creates a starburst pattern, and many slices are unreadable. To that end, standard protocall is to remove all jewelery from patients before they go to the scanner, which is usually within ten minutes of arrival.

Many types of piercing studs don't simply unscrew, necklace clasps are often tiny and unreachable under spinal immobalization collars, and hands often swell around rings. To this end, we keep fairly large bolt cutters on the walls of the trauma rooms and often rip or cut off jewelry without a second glance. Medic alert bracelets are noticeable, and everyone is trained to look for them. For everything else, all bets are off. This is often done by techs, running down the halls beside the gurneys on the way to scans. Just because it seems obvious while sitting relaxed in your living room, don't assume it will be if covered in blood and yanked off while running down a hallway.

Another reason that medic alert bracelets in children are particularly useful is because it is *extremely* common that victims of a car accident will be split up and taken to different hospitals. Ambulances will not always know where they are going until they have called their report to a regional medical command center and been told, based on the acuity of the patient, specific injuries and how busy various hospitals are that day. Many hospitals lack resources, particularly at night, and will divert anything even possibly critical to a larger facility. This is especially true of children, who are often sent to facilities with pediatric specialties. In my area there are up to 15 other hospitals that divert patients to us which means that depending on where an accident occurred (and not even accounting for helicopter transport) family members could be split between any of five or so of these facilities.

What makes this even more complicated: It is very common for patients to come in who either cannot be accurately identified or have their name listed on the board. (Those who are drunk or high, unconscious, elderly with dementia, psychiatric cases, new births who have not been named, unaccomponied children too young to give information, social service cases, and prisoners.) Before any lab work can be done or radiology studies performed, national hospital regulations require an individual identifier. Thus, trauma patients who cannot be registered before treatment are often included in this group. All of these people are assigned trauma or John Doe numbers.

So, if you are in an accident, even if you are conscious, your child may be at another hospital and known only as "Doe, Johnny #20407HY." And not only do hospital staff not know where other patients are sent, even if they could call the other hospitals, they cannot relay information due to HIPAA regulations. **The point of this was not to scare everyone, but to illustrate that medic alert bracelets can be useful in much more common and likely situations than simply parents being unconscious.**

Finally, a note on the shoe tags...ARRGH! Dont! I would say that maybe 50% of our patients from accident scenes don't even come in with their shoes on. If they do, we almost immediately pull or cut them off and throw them in a corner, to maybe be matched up with their owner again later.

I know it's a drag, but honestly, the more mundane and obviously placed you can make medic alert jewelery, the better. The classic bracelet is the best, then the classic necklace. The rest, I wouldn't even bother with.

I hope this is helpful to someone. Thanks for letting me read your board, and please feel free to ask if anyone has any questions related to ER practices 

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