“Check for medical alert tags or bracelets.”
Your EMT instructor probably made you repeat this phrase dozens of times through the course of your EMT class. Checking for medical alert bracelets is a staple of the EMT medical and trauma stations. It’s right up there with, “I’m wearing my BSI. The scene appears to be safe.” and “Checking for DCAP BTLS TIC.”
If our medical education is any indicator, the emergency medical community has fully embraced the medical alert bracelet concept. Now that these types of wearable medical histories have become common, it was predictable that they would evolve. Which brings me to the meat of today’s post.
Has anyone else noticed that checking for medical alert information has become increasingly complex and technical? Like so many other things in our society, the world of fashion and technology have both added utility and complexity to the search for wearable medical information. In the future, our EMT students may be reciting a more complicated dialogue that sounds something like, “Look for medical alert bracelets, hidden USB devices, smart phones, jewelry with inscriptions and medical tattoo art.”
Whatever happens next, we in the emergency field need to become aware of some of the alternative ways that patients are communicating their medical histories. Like it or not, medical alert methods are evolving and these wearable medical histories occasionally contain valuable patient information. If our patients are willing to carry their medical histories with them everywhere they go, we should make an attempt to look for them.
Here are a few of the non-traditional medical alert methods you may encounter:
Smart Phone Applications
Putting medical and emergency information into your cell phone predates the smart phone. Placing emergency contact info and medical notes in your contact list under the contact name ICE (In Case of Emergency) has been a common piece of urban folklore for at least a decade. The cell phone companies caught on a bit more recently and started adding emergency contact options that default to the top of the contact list.
Whether the phone is a smart phone or a dumb phone, emergency information may be hidden in the phone contacts or the app menu. Medical alert applications can place a medical icon on the apps menu screen and the app itself will contain the patients medical information and emergency contact info. Some apps will also give the user an option to instantly call emergency services or text a list of predesignated contacts.
Medical Alert Jewelry
From hemp bands and beaded necklaces to gold dress bracelets and crucifixes, any jewelry can now serve a dual purpose as a medical alert bracelet. Most (but not all) of these alternate forms of medical ID have some form of a classic caduceus and star of life on them, but they still require a closer look.
Often times, our secondary assessment in our unconscious patients is short and to the point. Thin gold bracelets and leather bands could easily be dismissed as everyday jewelry. If knowing the patients medical history is high on the priority list, slow down and take a closer look at anything that patient has added to their body as a fashion wearable. You might find medical information hidden somewhere on it.
Wallet Cards, Health Logs and Passports
There are any number of medical cards and logs that patients with extensive medical histories are being encouraged to fill out and carry with them. Once upon a time, searching through a patients billfold, purse or wallet might have been taboo, but today it may very well contain valuable information. (It should still be done in the presence of at least one other person.)
Health information cards can be ordinary paper stock or flexible plastic. They can be the size of a credit card or as large as a traditional passport book. Ideally, the patient will have left the information in an obvious or easily accessible area. However, anyone who has ever had a patient go digging through their wallet or purse for their pre-written medications list knows, these things can often be difficult for the patient to find. (And they know what it looks like.)
Stickers, Vials and Magnets
Here in Colorado, the vial of life program became very popular about ten years ago. Patients were encouraged to place their medical histories in a vial and place it in the refrigerator somewhere obvious. Medical personnel were educated to look for the vial when they were searching for medication (primarily Insulin) in the refrigerator. Some folks also placed a sticker on the outside of the fridge alerting responders that a vial was placed inside.
Some folks are still encouraged to leave detailed medical histories in the refrigerator, though I’ve encountered none outside of the formal vial-of-life program. However, stickers warning of medial histories and allergies can be purchased on the internet and stuck in any number of places, from doors and wheelchairs to car windows. Don’t be surprised if you find a sticker on your patients personal effects announcing a peanut allergy or seizure history.
Doing an end-run around the whole look-inside-the-refrigerator program, refrigerator magnets can also be purchased and placed on the outside of the fridge with the info in plain sight.
Wearable USB Devices
My first encounter with the new wearable USB devices is what inspired me to write this post. While loading a fully immobilized patient into my rig, she held up her arm in response to my medical history question. I inspected the black, plastic wrist band looking for some indication of her medical history, allergies etc. only to find a small USB plug hidden inside the band.
The patient fully expected that I would have a USB reader handy and I would plug her bracelet into my computer and find out everything I needed to know. I told her that, if I had the time, I would plug her bracelet into my Toughbook and take a look at the info. The tech geek in me really wanted to see what would pop up. Alas, our transport time was too short and I never got to see just what would happen if the device was plugged in. Maybe next time. Somehow, I’m certain there will be a next time.
Medical Alert Tattoos
With the resurgence of tattoo popularity, the idea of medically significant tattoos is increasing in popularity as well. It’s now becoming common for military personnel to tattoo vital medical info (blood type, allergies) on their upper chest, arms or wrist. Some of these tattoos are even expressing advanced directive information like, “No CPR.”
Individuals choosing the medical tattoo route are being cautioned to use a universal medical symbol like the star of life and place the tattoo away from other body art in an area commonly assessed for bracelets or necklaces. Some of the tattoos even resemble the medical alert bracelets themselves with a tattooed chain or band. Others integrate the medical history with art such as a caduceus or a skull and bones.
If the art suggests a medical theme, it may be worth the time to take a closer look at the writing and see if the patient has left you a medical history clue in their body art.
Now it’s your turn. What types of medical alert devices have you encountered? Have you used any of the electronic forms of medical alert devices? How did they work? Leave a comment and let us know.