Equipped to Survive: A trip to the ER

Here are some thoughts on "surviving" a trip to your hospitals Emergency Room. Not necessarily YOUR trip, but a trip of a loved one.

As many of you know, my Mom just died after a long illness (lung cancer), and my Dad is not in the greatest of health. Over the last 18 months or so, I've probably been in the ER with one or the other nearly a dozen times. (Latest was yesterday - Dad is OK).

First - BE PREPARED to take them to the ER, or have them taken to the ER. By prepared, the Ambulance crew is going to want a few things: Their Name, Birth date (age), what medications they are taking, and known illnesses. Having this information written down ahead of time is going to save the crew a LOT of time, and they will be real happy to get it. Also, on the list - put down the names and phone numbers of their doctors (BTW, do this for yourself, your spouse and kids too).

Sometimes a simple "Oh - he has a pacemaker" can prevent them from scheduling an MRI. Or a "Hey, he has Paget's syndrome" can prevent days of worry over shadows found on his bones during a cat scan (No - it's NOT bone cancer)

So, where do you KEEP this information? Mom's Hospice folks as well as the NYC EMS crews ALL have said the same thing - put it in an envelope, and stick it to their refrigerator - with BIG letters. If they call 911, and can't tell the crew what is going on, the crew is going to check the kitchen for medicines - particularly the refrigerator for drugs that need to be kept cold. When they see the envelope - they WILL check it. It's SOP for the crews. IF there is a DNR - keep it outside the envelope, in plain site. (BTW in NY state, DNR orders have to be renewed I think it's every 30 days, and approved by an MD)

You should also keep a copy of this information where YOU can get at it. Towards the end with Mom, I actually kept copies with me at ALL times. You could get the call that they need you at the ER when you're NOT at home.

I hope all of you keep your basic medical information with you - in your wallet - your MD, your drug list, and any known problems. It can save some real problems if YOU end up in the hospital, and can make life easier even if it's just a visit to a new MD - just hand him the paper.

Just when I thought I was prepared for anything...

Thanks for the great adivce(the envelope in the fridge is a really interesting idea). I'm gonna have to start thinking about doing this for my wife and I.

Sorry about your mother and father. Good luck during these hard times.

S= Symptoms and signes
A= Allergies
M= Medication
P= Patients historie (known illnesses, etc.)
L= Last meal
E= Event (what has happened)

kc2ixe -

+1 on everything you said. Received the same advice (DNR on the 'fridge etc.) when faced with near-identical situation in California earlier this year. Helped to keep things organized and under control, particularly when there are multiple siblings involved.

Related: Unpleasant though it is, when the family member is terminally-ill, good idea early-on to locate and review other documents like wills, trusts (and pour-over will), life insurance policies, deeds, bank account/safe deposit info, durable POA etc. to make sure a) you locate everything, and b) all are legally up to par.

You mentioned hospice. A plug for those folks — they do amazing work.

Dan

Sorry about your folks. We went thru that three times in three years, so I can feel your pain. Be advised that, at least in our case, a hospital may not recognize a DNR unless it is done on THEIR form. Done by an attorney did not impress one hospital we dealt with at all, it was their form or nothing. Just one more thing to make an unpleasant situation a little more unpleasant...

I'm sorry as well about your parents.

You're absolutely right about keeping medical information handy.

We had had folks in our hospital being evac'd out of NOLA after Katrina with only the clothes on their back.

Even if they could tell us who their docs were, the docs offices were destroyed as were any records and many older folks can only tell you; "I take a sugar pill, and my fluid pill, and the little white pill for my heart...." and that kind of report is the best you can hope for in the best of conditions. Add stress to the mix and you can only guess what kind of history you'll get.

I used the business card format in Word to make a medical information card for myself, wife, and child importing a photo onto it as well.

Included on the photo side is name, allergies, any metal implants, Physician and number, and list of meds and emergency contact numbers and last tetanus booster.

On the back is our meeting places for outside the neighborhood, city, state to act as a reminder where we are to meet.

The cards are kept with our drivers licenses in our wallets.

+1 on those docs - they were, and still are in the file cabinet behind me - and since I was a teen, knew where they were in the house - in the fireproof bankers file cabinet

Could you show a picture of one of these cards? Or generic version without your actual info?

Thanks for the great post. Sorry to hear about your folks.
What you suggest is great advice. As an ER nurse I really appreciate it when people do this. It makes my job and your care much faster, easier and more appropriate as it is very easy to forget important items when stressed. And a visit to the ER can be very stressful.
Most people tell us that their information is "on the computer" Well it may be but in many cases we would like to start the patient's care immediately rather than spend 15 to 20 minutes reading through page after page of doctor's notes on the computer. And if you are not normally seen at our facility it can take well over an hour to contact your regular hospital and have the records faxed.
I always tell patients and family members to wright everything down and have all family members carry a copy but most never heed my advice, perhaps they will listen to you. I hope so.

"...I used the business card format..."

Now that is a great idea! I have all of our medical history that we can remember typed onto a plain old piece of paper, given our ages and past history, it is a FULL page for each of us. Not sure we can get it all on a business card, even with a tiny font, but for you youngsters that is a 'why didn't I think of that?" idea...

I carry something like this that I found free online Free ID

It covers the basics and has been a huge help the number of times we've gone to the ER and I can just hand them the info instead of trying to remember it all in a stressful situation

(I have no interest in the linked site other than having used it)

For lots of info, how about this:

Get a small address book with a cardboard cover. Pull out the guts and discard.

Type up your information, and print it into a long, skinny (to fit the cover) set of pages, tape the ends together in the right place, then accordion-pleat the paper and glue one end into the back cover. When opened the whole long stream of info would hang down.

Write 'Medical History' on the cover in a size to be seen. You could tie a piece of heavy-duty thread around it and fasten with a knot. (All medical personnel have scissors, and I'll bet every LEO has a multi-tool. Of course, if you could find a clear plastic sleeve it would fit into, that would be good, too.

Just an idea.

Sue

Hey, OldBaldGuy, maybe that PocketMod thing would work for you instead of a business card.

Some of my patients come in frequently from nursing homes, and even though we have documented on a living will their wishes and they have been DNR status on previous admissions, they are still a full code until the doctor writes that magic "DNR" order for that current admission.

The living will or advanced medical directive is only documentation of the patient's wishes and the patient is always a full code until the physician writes "Do No Resucitate" for that admission.

I've had patients that changed their minds and wanted to be full codes on subsequent admissions.

Keep in mind that a DNR order (at least in LA) becomes null and void if one family member objects (even an estranged adult child that hasn't had contact in years).

I've had that happen and it wasn't pretty.

It was one of those Jerry Springer smack-down moments with the crash cart in the middle until we got family out of the room.

Because of that I'm really pro-active in making sure that all family members involved are on the same page (which takes some doing).

Tell your family (even the ones you don't like because they're the ones that are going to cause the problems) what you're wishes are regardless of your age (MVA's happen) and put it in writing.

The living wills aren't a legally binding contract but they are hard proof for your loved ones of what you want or don't want done.

(Picture a distraut wife in the ICU waiting area in the middle of the night saying "I remember Skippy talking about that but I can't remember exactly what he said...." )

It sure can save a lot of grief and guilt for the loved ones in making the decision to have the physician make someone DNR.

I've had families that felt that by agreeing to have their mom made DNR that they were signing her death warrant which is of course not the case.

They were simply sparing their mom a lot of torture when the end result was going to be the same.

Looks interesting, thanks...

Yeah - Mom, Dad and I all knew Mom's wishes. I'm sure the aide could have tried CPR on Mom, but why? We all knew that even with total 100% life support effort, we might have extended her 'life' a few days, at most

I had more than one aide, and the MD, Nurse and Social worker from Hospice all tell me the same thing "Your Mom took her illness with as much grace as any person we ever saw" (all three were in tears). Mom NEVER complained, never "why me" - when she was told she had incurable lung cancer, she IMMEDIATELY looked at me and said "promise me one thing - You'll NEVER lie to me about what is happening" - My reply was that I wasn't in a habit of lieing to her, and I wasn't going to start now. Mom knew what was happening, and accepted it - she said "don't try to cure me - setup my treatment so that I have as much GOOD time as I can, so I can enjoy my family" When my time comes, I hope it's with 1/2 as much class

Sounds like your mom was a pretty cool lady...

I think so - last night was a bit of a "need to talk" - only the 2nd or third time I've let it out since she died - thanks everyone for listening.

Anytime...