Health Information & Advocacy Center
Health Navigation Menu
Health information form can save precious time in an emergency
By Beth Casper
Nick Tomasko has been to the emergency room more times than he is years old.
The 4-year-old was born with microcephaly, epilepsy, asthma, and developmental delays. Before the family could figure out the best types and doses of medication and an appropriate diet, Nick was experiencing 10 to 12 seizures a day. If Nick comes down with a cold, it often triggers his asthma, which then triggers a seizure. In the spring, his allergies act up and the family is often on alert for additional medical problems.
For Nick's mom, Dawn, every trip to the emergency room is an ordeal in itself. Aside from worrying about Nick's immediate needs, she is in charge of informing all of the doctors and nurses of his diagnoses and medical care. It could take 20 minutes or more for her to list all of his medications, doses, allergies, and previous history--20 minutes when Nick isn't receiving the best medical help he needs.
"Nick is on a list of drugs everyday and the doses often change," Dawn said. "When you are in an emergency type situation, trying to remember doses of drugs is difficult. It's hard to go through that list in your head when you are concentrating on his immediate health."
To make matters more complicated for Dawn, Nick is on a special, very strict diet to control his seizures. He doesn't eat any carbohydrates or simple sugars. That's difficult for medical staff to adjust to because their first instinct is to hook Nick up to an IV and give him dextrose, the principal form of carbohydrate used by the body. For Nick, the dextrose solution could have severe consequences.
A single piece of paper, however, is helping to make emergency room visits easier for the Tomasko family.
An emergency information form developed by the American Academy of Pediatrics and the American College of Emergency Physicians includes a place to record contact information for the child, the child's physicians, diagnoses, base-line findings, allergies, procedures to be avoided, medications, and common presenting problems with specific suggested managements for the child.
"It allows me to spend more time by Nick's side," Dawn said. "I can hand the nurses the form instead of standing there answering questions while Nick waits for treatment."
Dawn updates the form frequently to reflect Nick's changing medications and doses. She highlights the most important information, such as "severe peanut allergy" and "ketogenic diet" and lists the rest of the information in an easy-to-read format. At a glance, nurses and doctors can see Nick's medical history and needs.
"Parents are seen as more credible when they present information in the way that doctors and nurses are used to seeing it," added Carolyn Allshouse, project coordinator of the Health Information and Advocacy Center at PACER. "This is an excellent way of communicating with medical staff."
The last time Nick was in the hospital, a nurse told Dawn that she felt bad because she wasn't able to get Nick to say "hi" to her.
"So I had to add to the emergency information form that Nick is nonverbal," Dawn said, laughing. "Here I had this nurse feeling bad because she couldn't get Nick to talk, and she didn't realize that no one gets him to talk."
Families can download the emergency information form (pdf) or the interactive emergency information form (Word) at http://www.pacer.org/health/index.asp or call Amy Dawson at 952-838-9000 to have one mailed to them.
PACER's site offers many PDF files for download, which require 
