# Medical ID's



## bunkie (Sep 19, 2009)

I wear a medical ID bracelet. One of my instructors said that I should have it as a necklace, that its what *he* always checks for. And that any EMT *he's* ever known, almost always checks for a necklace first.

So now I'm wondering, what do you check for? Which is best?


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## Lifeguards For Life (Sep 20, 2009)

Your instructor says probably checks the kneck first, because when you do a rapd physical exam, its a head to toe exam. When I first approach a patient, medical alert tags is something i scan for real quick. The medical alert bracelets are quite common, if not more widely used. you'll be just fine with your bracelet. In my class we were even told to check for medical alert anklets


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## Akulahawk (Sep 20, 2009)

When doing an exam, I'll look for necklace, wrist, and anklet alert tags, even as I'm walking up to you. Chances are pretty good that I'll find it within a few seconds. If you have one... just wear it.


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## Lifeguards For Life (Sep 20, 2009)

Akulahawk said:


> When doing an exam, I'll look for necklace, wrist, and anklet alert tags, even as I'm walking up to you. Chances are pretty good that I'll find it within a few seconds. If you have one... just wear it.



thats one of the things i didnt like about practicing patient assessment in basic class, verbalizing checking each extremity for an alert tag. i agree that in all reality you should notice during your scene size up survey, if not then in your initial assessment. it shouldnt wait untill your physical assessment(not that algorithms like this actually last 10 seconds in the field)


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## BruceD (Sep 20, 2009)

I dunno about a necklace.... What if you were wearing it around your neck and your head came off?  The medic alert could easily get lost before I got on scene...


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## Akulahawk (Sep 20, 2009)

well, in the case of decapitation... (regardless of medic alert tags) I'd just have to determine death and move on...


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## wvditchdoc (Sep 20, 2009)

BruceD said:


> I dunno about a necklace.... What if you were wearing it around your neck and your head came off? The medic alert could easily get lost before I got on scene...


 
That is why the other Alert Tag should go in the laces of your boot. O wait that is for Dog Tags...



Akulahawk said:


> well, in the case of decapitation... (regardless of medic alert tags) I'd just have to determine death and move on...


 
:lol:


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## fiddlesticks (Sep 20, 2009)

well it dosnt really matter what you wear cause  if the pt assessment is done well, your going to find it anyway. keep in mind some ppl have tattoos as a medical alert now( inside arm or wrist). so always keep an eye open and take a good history.


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## BruceD (Sep 20, 2009)

Akulahawk said:


> well, in the case of decapitation... (regardless of medic alert tags) I'd just have to determine death and move on...



But what if they had a particular allergy to decapitation and you missed it due to loss of the tag?  Wouldn't you feel like a right fool?  

I wonder if Epi is first line rx for decapitation analphylaxis...

Sometimes, occasionally, I wonder if my work hours are too long or if my sense of humor was always this twisted and morbid.


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## bunkie (Sep 20, 2009)

Akulahawk said:


> When doing an exam, I'll look for necklace, wrist, and anklet alert tags, *even as I'm walking up to you.* Chances are pretty good that I'll find it within a few seconds. If you have one... just wear it.



That's me as well. I'm looking for it before I get to the PT.


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## Akulahawk (Sep 20, 2009)

BruceD said:


> But what if they had a particular allergy to decapitation and you missed it due to loss of the tag?  Wouldn't you feel like a right fool?
> 
> I wonder if Epi is first line rx for decapitation analphylaxis...
> 
> Sometimes, occasionally, I wonder if my work hours are too long or if my sense of humor was always this twisted and morbid.


well, we lost our grant for emergent sewing-machine re-capitation last week... That Singer was really good...

Maybe staples would work? Hmmm, I sense a new grant proposal...


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## Aidey (Sep 21, 2009)

I personally would find one on the wrist first. Pulse is nearly always checked before the head to toe exam.


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## Sasha (Sep 21, 2009)

It doesn't really matter where they check first, as long as they check all places that could have a medicial alert tag. Someone who only checks the wrist or only checks the neck is foolish and asking for trouble.

Personallly I check both wrists of every patient first, but it's habit from working IFT and looking for ID and allergy braclets and vascular alerts.


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## bunkie (Sep 21, 2009)

Aidey said:


> I personally would find one on the wrist first. Pulse is nearly always checked before the head to toe exam.



*nods* In initial assessment. Thats more the train of thought I was having as well. Alright, not spending another 50 bucks on a new tag. Thanks guys.


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## surub (Sep 23, 2009)

As Sasha said, don't limit yourself only to the neck and wrist when checking for a ID tag. Just be on your toes ready to observe anything that helps your assessment.


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## bunkie (Sep 23, 2009)

They even make them as anklets these days. :wacko: Personally, I want mine in the most obvious place, but whatever floats your boat I suppose.


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## Seaglass (Sep 23, 2009)

bunkie said:


> They even make them as anklets these days. :wacko: Personally, I want mine in the most obvious place, but whatever floats your boat I suppose.



When it's really obvious, people tend to grab for it and ask all sorts of obnoxious personal questions. That's why I completely refused to wear one as a teenager, and still often leave it off. 

My instructor also had us check pockets and wallets, but nobody really does that. If you have the time, your patient probably isn't all that critical...


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## bunkie (Sep 23, 2009)

Seaglass said:


> When it's really obvious, people tend to grab for it and ask all sorts of obnoxious personal questions. That's why I completely refused to wear one as a teenager, and still often leave it off.
> 
> My instructor also had us check pockets and wallets, but nobody really does that. If you have the time, your patient probably isn't all that critical...



Mine isn't so obvious people notice it, fortunately. And I really dont mind educating people on my condition. Mine, with a black symbol instead of red.


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## Seaglass (Sep 24, 2009)

bunkie said:


> Mine isn't so obvious people notice it, fortunately. And I really dont mind educating people on my condition. Mine, with a black symbol instead of red.



People always seem to notice mine... I've tried a lot of different types. It's gotten better as I've gotten older, so I'm hoping it'll stop eventually. Two of my jobs are also in the sort of macho places where weakness and illness are personality defects, so drawing any attention to it is pretty counterproductive. 

I've ordered a medic alert watch for work. At least then I won't have to wear a watch and a bracelet.


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## ViniG (Sep 24, 2009)

I've always checked the neck and wrists for bracelets.


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## bunkie (Sep 25, 2009)

Seaglass said:


> People always seem to notice mine... I've tried a lot of different types. It's gotten better as I've gotten older, so I'm hoping it'll stop eventually. Two of my jobs are also in the sort of macho places where weakness and illness are personality defects, so drawing any attention to it is pretty counterproductive.
> 
> I've ordered a medic alert watch for work. At least then I won't have to wear a watch and a bracelet.



That's really awful. I'm so sorry to hear that.  That both saddens me for you and completely pisses me off. If they walked a mile in our shoes they'd be blubbering freaking babies.


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## Seaglass (Sep 25, 2009)

bunkie said:


> That's really awful. I'm so sorry to hear that.  That both saddens me for you and completely pisses me off. If they walked a mile in our shoes they'd be blubbering freaking babies.



Aw, thanks! It's really not as bad as all that, though; I'd quit if the job wasn't otherwise worth it. I've gotten pretty good at quietly creating my own accommodations, over the years.


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## bunkie (Sep 25, 2009)

Seaglass said:


> Aw, thanks! It's really not as bad as all that, though; I'd quit if the job wasn't otherwise worth it. I've gotten pretty good at quietly creating my own accommodations, over the years.



Well, its just more satisfying when you prove wrong their preconceived, ignorant notions about your strengths or weaknesses. ^_^


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## Seaglass (Sep 25, 2009)

bunkie said:


> Well, its just more satisfying when you prove wrong their preconceived, ignorant notions about your strengths or weaknesses. ^_^



Exactly. And maybe it'll be a little bit harder for me than someone with a perfect health record, but I can always prove myself eventually. Even there--the fire guys started trying to talk me into taking FFI/II a couple weeks ago.


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## bunkie (Sep 25, 2009)

Seaglass said:


> Exactly. And maybe it'll be a little bit harder for me than someone with a perfect health record, but I can always prove myself eventually. Even there--the fire guys started trying to talk me into taking FFI/II a couple weeks ago.



I think this deserves a giant, _you go girl!_ ^_^


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## Seaglass (Sep 25, 2009)

bunkie said:


> I think this deserves a giant, _you go girl!_ ^_^



Thanks! I'm really kinda proud of it. Don't know whether I will or not yet. I've been considering it awhile, but I'd rather go to medic school first. Since seats are really limited there, though, I might have a few free months... and it's the best way to start serious technical rescue training in my system.


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## cfink911 (Sep 25, 2009)

Necklaces are often times harder to see due to the necklines of shirts.
Bracelets, at least in warmer weather or indoors would be easier to see since most people would have on short sleeves.

Either is fine though, since both are right where you'd be checking a pulse anyway.

Fink


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## bunkie (Sep 26, 2009)

Seaglass said:


> Thanks! I'm really kinda proud of it. Don't know whether I will or not yet. I've been considering it awhile, but I'd rather go to medic school first. Since seats are really limited there, though, I might have a few free months... and it's the best way to start serious technical rescue training in my system.



How long do each of them last? Can you handle a double load for a little while?


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## rescue99 (Sep 26, 2009)

bunkie said:


> That's me as well. I'm looking for it before I get to the PT.



Don't forget the medic alert tats! Seen a few arms.


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## cfink911 (Sep 26, 2009)

Seaglass said:


> Thanks! I'm really kinda proud of it. Don't know whether I will or not yet. I've been considering it awhile, but I'd rather go to medic school first. Since seats are really limited there, though, I might have a few free months... and it's the best way to start serious technical rescue training in my system.



That's how it is around here also, I made so many good connections in FFI/II it was insane.
Great classes for sure.

To be a female and be a full-time paid Firefighter/EMT around here is a rare thing.
There is only one at the FD I'm going to test for and one at a department just south of here and that's it.

It seems like the women who test for it and don't get it end up going to the PD and they usually end up hating it.

I say go for it, it will be a lot of work for a few months but in the end, it will all be worth it.

Fink


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## Seaglass (Sep 26, 2009)

rescue99 said:


> Don't forget the medic alert tats! Seen a few arms.



Ditto... and worse places. I know a girl who got hers on her shoulderblade, and a guy with his on his chest. 



			
				bunkie said:
			
		

> How long do each of them last? Can you handle a double load for a little while?



FFI/II is about five months. Medic is a lot more complicated of an answer, but I'm estimating about a year. Some of my college courses might allow me to test out of some medic classes, making it shorter. I probably wouldn't take both at once unless I wind up otherwise unemployed. Most likely, I'd take FFI/II while waiting for the next round of medic classes.



			
				cfink911 said:
			
		

> That's how it is around here also, I made so many good connections in FFI/II it was insane.
> Great classes for sure.
> 
> To be a female and be a full-time paid Firefighter/EMT around here is a rare thing.
> ...



Thanks for the advice! They're uncommon here too, but that's changing fast. I didn't even think women could be firefighters until I was 15 or 16 because I never saw any, but now almost every station around here has at least one. I even encountered a station recently in another system that can put up an all-female career engine crew of firemedics and FF/EMTs.

At any rate, the soonest medic or fire courses I can catch start nine months from now. So, I have some time to figure it out. Whether I stay vollie or shoot for career at my department is all going to depend on whether I get into gradschool, too. Whatever I wind up doing, I doubt I'd go for PD... there are a few jobs there I'd like, but I'd hate the majority of the work.


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## Akulahawk (Sep 26, 2009)

rescue99 said:


> Don't forget the medic alert tats! Seen a few arms.


Medic Alert tats can be useful, but I will ignore a DNR tat as it's not approved for that purpose here...

Our criteria for honoring DNR requests is:


> A State EMS Authority POLST form.
> A written, signed order or electronic order in the patient's medical record;
> A completed Prehospital DNR Request  Form stating, "Do Not Resuscitate,"  "No Code," or "No CPR";
> A written order stating, "Do Not Resuscitate," "No Code," or "No CPR" signed  by a physician, with the patient's name and date the order was signed;
> ...


If any of the above is identified (and in the case of #5, the agent declines resus) we are to stop... Notice that a Medic Alert Tatoo is NOT approved... for DNR purposes. I would not consider it as a DNR medallion.


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## JPINFV (Sep 26, 2009)

One thing to keep in mind is that Medic Alert is a brand name for medical bracelets. Before Medic Alert will issue a DNR bracelet, they require that DNR paperwork is completed and turned in to them. Hence why a Medic Alert bracelet is generally accecpted whereas other medallions (I've seen protocols specify "Medic Alert" and not just a general medallion) or tattoos might not be.

http://www.medicalert.com/Main/AdvanceDirectives.aspx#dnr


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## Akulahawk (Sep 26, 2009)

JPINFV said:


> One thing to keep in mind is that Medic Alert is a brand name for medical bracelets. Before Medic Alert will issue a DNR bracelet, they require that DNR paperwork is completed and turned in to them. Hence why a Medic Alert bracelet is generally accecpted whereas other medallions (I've seen protocols specify "Medic Alert" and not just a general medallion) or tattoos might not be.
> 
> http://www.medicalert.com/Main/AdvanceDirectives.aspx#dnr


Exactly. A "Medic Alert" medallion for DNR isn't issued without that paperwork... which is why I'll generally ignore any medallions that aren't specifically "Medic Alert". Furthermore, if you decide that you actually DO want to be resuscitated, it's a heck of a lot easier to remove the medallion than the tattoo.

The DNR medallion referenced in the protocol above is that Medic Alert medallion.


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## JPINFV (Sep 26, 2009)

I wasn't just replying to you, but to the thread in general. Medic Alert needs to be careful before their name becomes a genericized trademark.


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## bunkie (Sep 26, 2009)

I wanted to get a tattoo in place of my bracelet, but theres too much crap to tat.


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## Lifeguards For Life (Sep 26, 2009)

bunkie said:


> I wanted to get a tattoo in place of my bracelet, but theres too much crap to tat.



I think a surprising amount of providers would miss a tattoo replacing a medical alert bracelet. a lot of people get tunnel vision and if you were un responsive, many may not take the time to read a small print tattoo


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## Seaglass (Sep 27, 2009)

bunkie said:


> I wanted to get a tattoo in place of my bracelet, but theres too much crap to tat.



Ha--I thought about a tat partially because I have too much for my bracelet. But that's why Medic Alert has the phone subscription service. I've realized my bracelet still has too much small print, and I've been trying to narrow it down. Thinking of going with "do not administer drugs, hx in pocket and phone," and listing the conditions that are most likely to be directly relevant.


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## bunkie (Sep 28, 2009)

Seaglass said:


> Ha--I thought about a tat partially because I have too much for my bracelet. But that's why Medic Alert has the phone subscription service. I've realized my bracelet still has too much small print, and I've been trying to narrow it down. Thinking of going with "do not administer drugs, hx in pocket and phone," and listing the conditions that are most likely to be directly relevant.



I just hope someone thinks to flip mine over. Which is something I've pointed out to class mates. Check the back! I have my main condition on the front and all the other things as well as my name/contact info on the back side. :wacko: Some of the even open up with little pieces of paper you write it all on and slip it inside, but they aren't water tight. <_< You can join me in a ten inch long med hx tat


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## Medic One (Sep 28, 2009)

I usually look for both....

I am still waiting to see "DNR" tatoo on someones chest or place hand here to do CPR on a sternum.

I mean the junkies usually tell me "I saved this vein for EMS...... use this vein please" and sure as you know what it is always a good vein!!


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## medichopeful (Sep 28, 2009)

Tattooed on the forehead is a pretty obvious place


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## bunkie (Sep 29, 2009)

medichopeful said:


> Tattooed on the forehead is a pretty obvious place



Again, this goes back to if the pt has lost their head...


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## jamesfont (Oct 1, 2010)

I was taught to look for either a medi id bracelet, a medical alert necklace, and also a tattoo.  There are the druggies who do crap like that and I've seen it more than once.  Now the clowns that tattoo their med stat somewhere the sun don't shine are obviously not being very smart.  But the search for bracelet or necklace is the very first thing we do.


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## akflightmedic (Oct 1, 2010)

I may be a pathetic medic I guess, because admittedly looking for any sort of bracelet, chain, etc is one of the LAST things I do if at all.

If the person is unconscious, my assessment is going to lead me to identifying problems and ways to treat them. 

It might even better if I do not have a tunnel vision diagnosis (bracelet, chain) as a thorough exam will lead me to suspect everything and rule out everything.

If they are alert, then they can tell me what they want me to know.

I am being serious here, can anyone please list a condition which is treatable prehospitally that they would not have known otherwise from an exam? Something which only the chain would give the vital clue to what is occurring and prompt action?


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## reaper (Oct 1, 2010)

Your not alone. I do not think I have ever looked for any type of Medical alert ID.

Assessment, assessment,assessment!


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## wyoskibum (Oct 1, 2010)

I get more information about patient Hx looking in the medicine cabinet that from a Medi-Alert.  

I've also worked in systems that provide a "File of Life" form that patients or their providers can fill out and has a magnetic envelope to put on the refridgerator.


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## Aidey (Oct 1, 2010)

akflightmedic said:


> I may be a pathetic medic I guess, because admittedly looking for any sort of bracelet, chain, etc is one of the LAST things I do if at all.
> 
> If the person is unconscious, my assessment is going to lead me to identifying problems and ways to treat them.
> 
> ...




The bracelets I find most helpful are the ones on the elderly that say "Please call xxx-xxxx if Susie is found". 

I am a magnet for escape artists.


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## spike91 (Oct 6, 2010)

You're not necessarily going to be exposing the chest area during a medical assessment. Not to mention if you're up north and its during the winter, I'm honestly more likely going to find your wrist one as opposed to the necklace.


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## Charmeck (Oct 15, 2010)

The future of alert tags are those small computer chips like domestic animals have.  EMS providers will carry a reader of sorts.


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