How much would a Doctor care about what is on a medical alert bracelet in an emergency situation?
If I wore a bracelet that had my blood type on it, would a doctor blindly follow the information if I needed blood, and give me whatever type was listed on the bracelet? Are there rules about what you can and cannot put on one, or rules on what information a doctor can and cannot use? Could you get someone killed, by poisoning them, and slipping a bracelet on that says DNR or that they are allergic to the antidote?
In addition to the bracelets, are there any other types of alerts doctors would consider. For example, if I had a tattoo on my chest that said I am allergic to penicillin, would that matter?
It seems like this could put the doctor at risk for a number of things going wrong with the patients care.
Blood Type: definitely not, your blood has to be crossmatched with a unit of blood prior to tranfusion, because there are several antibodies in addition to AB/Rh that can cause a transfusion reaction
DNR: definitely not, it isn’t valid unless it’s on a specific official form or the patient him/herself or HCPOA tells me
I wouldn’t trust a medical alert bracelet for anything more than guidance in the case of an unresponsive patient. If it says ‘diabetic’ I’m going to assume they are and treat accordingly. But if it says ‘allergic to N-acetylcysteine’ and they come in with acetaminophen toxicity, I’m going to weigh the risks and probably give them the antidote. As for something like ‘allergic to penicillin’, I would probably heed that warning because there is usually an alternative to PCN insofar as treatment of infections.
As far as I know there are no rules that govern their use, but I’ve always used them as a guideline. I remember one patient who had a medic-alert necklace that said ‘difficult to intubate’. In that case, had I needed to put a tube in his throat, I would have had backup methods readily available.
Those bracelets are intended more for EMS crews than doctors. A doctor in an ER has access to a lot more resources and information than a paramedic or emergency medical tech out in the field somewhere, and every bit of information they can get helps.
According to a cousin of mine who worked as an EMT for several years, they were VERY happy when they saw someone wearing one. At least once she feels that a child’s life was saved because he was wearing a diabetic medical alert bracelet. So pretty much what Gary “Wombat” Robson said.
The alert bracelets are important but not as much as having clean underwear with no holes (thanks mom). Underwear standards are the first level of triage in any ER.
But that sounds as if you’re still trusting the bracelet to give the right AB0 and Rh.
I know that the Spanish protocols call for checking for bracelets/medals, accessing the patient’s history if possible (they are in the computer, nowadays, but if the patient is from another country or even another region it may not be possible to access them; if it’s accessible, the information in the history will be more up-to-date than the bracelet) and using portable blood type tests to determine AB0 and Rh - they do not believe the type listed in the bracelet.
Sorry if wasn’t clear. I wouldn’t trust the bracelet and blindly transfuse them with whatever blood type it said. They would have to be type and crossmatched anyway because the bracelet isn’t going to tell us anything about their reaction to a particular unit of blood regardless.
