Use this form to ID children with special needs

How would you like to know a child’s medical history, pediatrician, and allergies minutes after they walk in the door of your ED? A new Emergency Information Form (EIF) for Children with Special Needs, developed by the Elk Grove Village, IL-based American Academy of Pediatrics and the Dallas-based American College of Emergency Physicians (ACEP), puts all that information at your fingertips. (See copy of form, pp. 87-88.)

The form will help you to obtain accurate and relevant medical information when it can’t be readily obtained from a parent or physician. "These are complicated kids, and if you are unaware of their previous medical history, you can get into trouble in ways you wouldn’t expect," says Michael Gerardi, MD, FAAP, FACEP, vice chairman of the department of emergency medicine at Morristown (NJ) Memorial Hospital and chair of ACEP’s pediatric emergency medicine committee.

Medical records are notoriously hard to find, notes Gerardi. "This takes all the mystery out of the case, without spending half hour tracking down a specialist."

MedicAlert, a Turlock, CA-based emergency medical information service, will serve as a central repository for the EIF, so the form won’t have to be on file in your ED, stresses Alicia Hugg, MA, RN, manager of professional programs for MedicAlert. "Health care professionals can retrieve the needed information by fax from anywhere in the world, 24 hours a day."

However, the advantage of MedicAlert is that the EIF is stored in a central location in case the child is away from home or with people who might take him/her to an ED in which there is no EIF on file.

The form could potentially save lives in the ED, since you probably have limited knowledge of their unique medical history, notes Hugg, adding that the form is especially useful for children with physically unrecognizable conditions such as allergies.

To determine if a child has an EIF on file, providers can call MedicAlert Foundation toll-free from anywhere in the world and request the EIF for that child [The hotline number is (800) 625-3780, and the collect call number is (209) 634-4917.] The EIF is faxed within minutes to the health care professional.

The child’s primary care provider, subspecialist, or parent should update the form every year or two, with information such as the performance of a major procedure or significant changes in a patient’s condition, Hugg explains. However, if a child does have an EIF on file, be proactive in adding medical information to the form which the parent, ED, or specialty physician might have overlooked, she recommends.

"A child or parent may have related details to the nurse which weren’t obvious to the examining doctor," she says. For example, under the form’s "Management Data" heading, a child or parent might cite a certain food allergy, but might forget to state the child is also allergic to a certain medication.

The form gives you essential information, including the name of the child’s pediatrician, telephone contact numbers, and specific instructions for interventions to take if the child has unusual symptoms, says Gerardi. "If the child doesn’t have the form with them, and it’s at school, MedicAlert will fax it to us," he says.

Often, in times of crisis, parents can’t remember important details, Gerardi says. "They are not medical professionals, and under stress they may not remember the order of their child’s surgeries, or whether it’s the right or left side, or the name of a drug the child is taking," he says.

The form includes contact numbers of the child’s guardian, so it can expedite the process of getting the parent to the ED if the child is injured at a school trip or friend’s house, Gerardi notes.

For children with special needs who don’t yet have an EIF, information from both the physicians and parents is needed to complete the form, says Gerardi. "Parents can fill out about 80% of the information, and pediatricians fill out the rest."

ED nurses should be advocates of the EIF, says Gerardi. "Hand out blank forms for parents to fill out, and ask them to bring the forms back to the ED," he advises. "We are collecting the forms from parents now, and we keep them on file at all the different EDs in our system."

If parents plan on taking their child to one or two local EDs, it would be helpful for the EIF to be on file at those EDs, notes Gerardi. It would eliminate the steps of contacting MedicAlert, he says.

Have pads of the forms available in the ED, so you can hand them out with discharge instructions, recommends Gerardi. You can reproduce the form without permission since the information is not copyrighted.

The EIF is a simple tool that provides expert advice and information in a timely fashion, stresses Gerardi. "It is an exciting innovation that will benefit everyone involved in an acute emergency: the patient, the parents, the prehospital providers, and the nurses, physicians, and consultants in the ED," he says.