I have been reading various articles lately about people who are tattooing their medical directives/allergies/alerts to some area of their body.  Like "No CPR" on their chest, or the medical alerts on their wrists instead of wearing a bracelet.  What is the position of your department on this issue?  Would you follow the request of someone who has no CPR/DNR tattooed on their chest?  I would be very interested to know your thoughts.  

In some ways this is a good idea especially for alerts and allergies, but it would have to be in a consistent place on a person.  As for the directives that is a hard one because in order for a directive to be valid it must be signed by the doctor.

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Personally I will work a person until the physical DNR is presented.  CYA

What is your opinion on alerts and allergies being tattooed?

I would send somebody to start looking for the orange card or sheet with the signature on it. It's nice to have advance warning if they are a DNR. As far as allergies that is going a little to fare there are some people that it will take an entire limb for the allergies.

I was amazed when I read that article. I asked our Medical Chief and he said that we would still require the signature but to see the alerts and allergies would be a great help in case the person was not able to communicate it.  He also said that if this is something that people are going to do there should be a standard location for that information.

Until I have paperwork saying DNR, it's pushies and puffies!

 

As for the medical alerts,if that how the person wants to display it,good for them, but its going to have to in the right area.

Where would you look and how would you even know to look for something like that?

Intresting you brought this up, I've never heard about it until the other night in my EMT class. Like someone else said, I don't know how much you can trust a tattoo..i'd still like actual paperwork or family words on the patient. 

A valid DNR is signed by a physician, so a "No CPR" tattoo isn't going to mean squat. Having allergies, or medical Hx tattooed is interesting, but personally I think it is stupid. First off, where would you even have this, because everyone is different and I'm not going to spend time searching for tattoos.

 

There are already other alternatives there for both a DNR and history, such as pendants, bracelets, etc......of which most responders are trained to look for. Another thing is a File for Life folder, which I find very helpful as long as it is updated and is much cheaper than getting tattoos.

 

 

Now if one truly wants to make things easier with a tattoo, get their signature tattooed for the stupid HIPPA forms. 

As for the DNR's...yah..I'm still doing CPR until the paperwork is shown.

As for the tattoo..I have a friend who had her medic-alert bracelet tattooed on her wrist...where the bracelet would have been. Looks just like it...only bigger, and with her diabetic info under it.

We here, as medical responders, are to look for the medic-alert when doing the primary....the tattoo counts.

We here, as medical responders, are to look for the medic-alert when doing the primary....the tattoo counts.

 

To a point. Any good EMT should be checking a blood glucose on any person who is altered, which should answer the diabetic question and to base clinical decisions off of that. So for me, the other pertinent history would be about an implanted pacemaker.....any other history for someone who is unresponsive doesn't really matter enough for someone to get it tattooed to themselves. Even the pacemaker isn't as big of issue, but helps to know about pad placement if needed.

 

I personally think it would be a waste of money and ugly and basically stupid to be marking personal history in the form of a tattoo. Most pertinent history could be obtained by talking to the patient, or family.....looking at the medications or list can be a big clue for patient history.....and for those where there really is no other associated info and nobody around who knows the pt.......an EKG and chem Bg will give you a very good starting point.

 

Allergies may have a place for the hospital, most EMS providers don't carry meds that trigger allergies, like antibiotics. Sure seen many people with allergies to weaked pain meds and those with allergies to aspirin....but in most cases if asking it is an adverse reaction, not a true allergy.

 

So yeah in the end for me, I think tattooing such history is a waste of money and a dumb idea. Get a pendant or bracelet.

I have to admit, after reading that statement again, that was a pretty dumb thing to say. oops.

So, if I understand you correctly, and please correct me if I'm wrong, are you saying that you feel that the medic-alert bracelet is unneccessary? That any good emt will do the blood sugar check is pretty much a given, I agree, but wouldn't the awareness of such a condition make things go a little faster for those not trained to emt level? Meaning, if we, as non-emt's, come across a patient who may just need a little sugar to get them back up again,wouldn't that bracelet have served its purpose and saved time?

Sure, I get it that some people don't agree with tattoos, and that's all well and good, but some do like them and think it's a good idea.....that's their choice. At the same time, there are those who have jobs that cannot wear jewelery such as bracelets or pendants, and feel this would be a good alternative. Can't fault them for that.

 

Not saying the medic-alert is unneccessary at all......I do find them quite helpful. I'm simply saying that having tattoos and further searching for said tattoos is unneccessary. A bracelet or pendant tend to stand out, whereas tattoos can blend with other tats, may not be located in the same area (really who wants to go around showing off their medical history for the world to see?).

 

So when it comes down to it, a good EMT can ascertain some basics by doing some simple checks. The more one is in the field and the more experience they get, it can become easier to pick out symptoms. For example, there was a call for a person who fell out of his bed and had a cut to his foot. On arrival, the pt was flailing, diaphoretic, and had snoring respirations......classic hypoglycemia signs. A simple chem confirmed it, rather than trying to search for pendants, bracelets, or even tattoos.

 

Basically, my comments are to promote better skills awareness of the provider (since most of us here are that) as opposed to worrying about medical tattoos, or even pendants or bracelets. I understand it is up to the individual if they so choose to get such medic alert jewelry or even a tat, and no you can't fault them for that, it is their choice.

 

Realistically, most field decisions are going to be based off more with findings than medic alerts. What I mean is that one should not have to rely on a pendant etc to treat CHF, Hypoglycemia, etc. History is important, no doubt, but such alerts to me would be moreso for the hospital.....such as allergies.....than it would be for a responder. Medications can also be an easy way to ascertain history. How many times have you come across a pt who denies a medical Hx and they are on Atenolol, etc, for hypertension? You ask if they have HTN and many say no....well of course not, that is why you are taking the med, to control that. Medications such as nitro, Lasix, statins, etc should guide towards a cardiac history. Inhalers, corticosteroids etc on lung issues.

 

After all the reason for a response may have nothing to do with what is on such medic alert jewelry or tat, so don't concentrate too much on them. A DNR is really the only one that would make a difference in the field and a tattoo is not a valid DNR.

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