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.
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.
Very well said, John.
And like you pointed out, just because the pt. has some sort of medical awareness symbol on them does not mean that it should be ruled that this is what is wrong. Always fallow protocall when assessing each patient, and look for many clues instead of relying on one.
I was reading about this in a JEMS magazine first and then it was later brought up again so I thought I would toss it out to you guys and see what your departments stance is.
Thank you both I appreciate the responses that you have given.
Obviously the "right" areas for them would be on the wrist,like a bracelet,or somewhere on their chest/neck area like a necklace. I am going to bring this up at are monthly meeting tonight and see if we can set SOP's/SOG's for this situation, and if we can't, maybe see what our Reginal EMS Council can do about it.
Please let me know how this goes. Thank you.