Personal Medical Records Availability Key Following Disaster
By Bonnie Portis, CHHS Extern
After action reports stemming from both natural and man-made disasters over the past decade have demonstrated a recurring problem – the inability of medical providers to ensure adequate continuity of care for hospital patients and those who have chronic health conditions or other functional needs when patient records are destroyed or unavailable. The lesson? Having personal medical information on-hand can be a life saver in the event of a disaster.
In 2005, the rising floodwaters of Hurricanes Katrina and Rita resulted in the total failure of healthcare facilities and their infrastructure. In the wake of this catastrophe, those victims lucky enough to be evacuated for treatment were often separated from family and important medical records along the way. Over 200,000 people with chronic health conditions and other functional needs, displaced and cut-off by the flooding, were left without access to needed medications, medical care, and treatment/prescription records. Immediate challenges included the identification and management of chronic medical conditions in large numbers of evacuees with special health care needs. Unfortunately, this scenario has played out repeatedly and globally, most recently as a consequence of Hurricane Sandy in 2012, and according to disaster managers, it will happen again.
Rapid medical assessment, or triage, can be compromised when medical providers have no access to medical or treatment records. With the significant possibility that treatment records may be unavailable, it is not surprising that people with chronic health conditions and other functional needs requiring continuing treatment and those who are unable to communicate their pertinent medical histories to providers could be particularly susceptible to delays in medical treatment during an emergency. For these individuals, even a temporary lapse in treatment may have a detrimental effect on survival.
Medical providers are trained to check each patient for any type of medical alert tag, bracelet, or any other indication of a pre-existing medical condition. When it comes to this population, individual preparedness for emergencies is of paramount importance and should include provision for ensuring appropriate treatment and continuity of needed care for themselves and for those unable to do so for themselves, such as children and those with memory impairment, such as Alzheimer’s.
The CDC, NIH, healthcare organizations, and physicians all recommend medical IDs for this population of patients – individuals with any of the following chronic health conditions and other functional needs should consider wearing a medical alert tag and/or carrying important medical information on their person:
- Food, drug or insect allergies
- Cardiac problems (angina, arrhythmias, atrial fibrillation, pacemakers)
- Pulmonary conditions (asthma/COPD)
- Kidney disease
- Diabetes, blood disorders
- Alzheimer’s/memory impairment
- Conditions that require treatment with blood thinners/ anticoagulants (Coumadin/Warfarin)
- Emphysema/breathing disorders
- Rare diseases
- Epilepsy/seizure disorder
- Hearing, visual, or mental health issues
- Stroke risk
- Sickle Cell Anemia
- Tourette Syndrome
Additionally, the following groups of individuals should consider wearing a medical alert tag or keeping important medical information with them:
- Recent surgical patients
- Organ transplant patients
- Clinical trial participants
- Children with certain medical conditions
- People taking multiple medications
There are a number of options to ensure timely communication of medical history even if a person is unconscious and in the midst of the chaos and confusion of a disaster. Medical alert applications can place a medical icon on a smartphone’s screen and the application itself contains emergency medical information. Additionally, any jewelry can now serve a dual purpose – most have some form of a classic caduceus and star of life on them alerting a medical provider to a pre-existing condition. Patients with extensive medical histories or those on multiple medications often carry waterproof medical cards or logs in a wallet or purse. Wearable medical USB drives are becoming increasingly common – they are small data storage devices which can be plugged into any computer/laptop and the data can be read and retrieved. Most are designed to be waterproof. Patients with complicated conditions and whose information changes frequently can subscribe to a service which stores medical information – the patient wears an alert bracelet, necklace, shoe tag, or similar device which lists primary conditions in addition to an ID number and a telephone number. When the number is called, the patient’s full medical record, including all conditions, diagnoses, medications, and emergency contacts can be accessed immediately.
Emergency preparedness for individuals with chronic conditions and other functional needs requires additional steps to ensure appropriate continuity of care. In addition to including any needed medications in a go-kit, anyone with specialized health care needs should consider the many options available for medical record and on-going treatment information availability, and medical identification in the event of an emergency.
CHHS Senior Policy Analyst JoAnne Knapp also contributed to this blog.