EMT's, paramedics, ER folks: do you actually check for those Medical ID bracelets?

[nanette1985]

I hear a lot of stories from my diabetic friends about how nobody checked their ID to discover that they were diabetic when there was an emergency. I wear an ID myself and I wonder about this.

Do you check for that type of thing?

 

[MedicBob]

Yes. Depending on where you wear it and what clothing you have on. Also, if you can talk to me I generally don't look.

 

[Pliablemoose]

Yes

 

[nanette1985]

Yes. Depending on where you wear it and what clothing you have on. Also, if you can talk to me I generally don't look.

What's the best place to wear it? I wear a bracelet on my left wrist; I also have a big tag on my key chain for redundancy and I keep a card/chip in my wallet with my insurance & medicaid cards.

Thanks.

 

[Sukhoi]

On a related subject, is it important to know my blood type? Should I have it recorded in my wallet? Or do hospitals have enough of the O- that it doesn't really matter if I know, and/or they can just do a quick test to figure out which I have?

 

[Mo0o]

On a related subject, is it important to know my blood type? Should I have it recorded in my wallet? Or do hospitals have enough of the O- that it doesn't really matter if I know, and/or they can just do a quick test to figure out which I have?

They can type you pretty quickly at the major trauma centers and they all have O-neg at the blood banks ready to go. Usually if you're having major hemorrhage they start with just saline or LR anyways and then give you the blood.

 

[alkemyst]

I was in a discussion about these a while ago. The consensus was like above, if one is coherent and in communication with the caregiver they don't look.

Also many will be in communication with the patient: "I am about to give you X."

Most are trained to check for some sort of medical alert tag/bracelet if the patient is unconscious.

However, there are always workers out there that don't understand the impact their job has.

 

[alkemyst]

On a related subject, is it important to know my blood type? Should I have it recorded in my wallet? Or do hospitals have enough of the O- that it doesn't really matter if I know, and/or they can just do a quick test to figure out which I have?

If you need blood they will type you. Being you are O- the important thing you will want to display is whether or not you have recieved O+ blood already.

You can get one infusion of it and then you are now "sensitive", you don't want a second one.

O- is risky...it's going to be the rarest at a blood bank and some hospitals may not even keep it on hand.

You may want to look in at creating a stock of it for yourself locally.

 

[Mo0o]

If you need blood they will type you. Being you are O- the important thing you will want to display is whether or not you have recieved O+ blood already.

You can get one infusion of it and then you are now "sensitive", you don't want a second one.

O- is risky...it's going to be the rarest at a blood bank and some hospitals may not even keep it on hand.

You may want to look in at creating a stock of it for yourself locally.

I think what he was asking is whether hospitals or blood banks would have enough O-neg that they wouldnt need to check his blood and can just give him O-neg, not that he was O-neg himself.

 

[Kaervak]

I always check. However we check your blood sugar level as part of our baseline vitals anyway whether you're conscious or not. One less variable for us to deal with.

 

[Pliablemoose]

I always check. However we check your blood sugar level as part of our baseline vitals anyway whether you're conscious or not. One less variable for us to deal with.

Yep, had a patient crash yesterday, nurse & a fellow were talking about taking him to the ER for a workup, I overheard what they were doing, checked his blood sugar & it was 38, I had him fixed in a couple of more minutes with an amp of d50. They thought he was having a stroke.

I mentioned to them that we were likely going to find a horse in this herd of horses, not a zebra

 

[Sukhoi]

I think what he was asking is whether hospitals or blood banks would have enough O-neg that they wouldnt need to check his blood and can just give him O-neg, not that he was O-neg himself.

Yes, that is correct. Thanks for the info.

 

[alkemyst]

Yes, that is correct. Thanks for the info.

I doubt they'd do that...O- is rare

 

[Powermoloch]

they have to..it's part of an assessment

 

[nanette1985]

Yep, had a patient crash yesterday, nurse & a fellow were talking about taking him to the ER for a workup, I overheard what they were doing, checked his blood sugar & it was 38, I had him fixed in a couple of more minutes with an amp of d50. They thought he was having a stroke.

I mentioned to them that we were likely going to find a horse in this herd of horses, not a zebra

What's D50 (glucose), as opposed to glucagon? I've heard of it but am not really familiar with it. I've gotten glucagon in the ER for my hypos.

 

[mcmilljb]

What's D50 (glucose), as opposed to glucagon? I've heard of it but am not really familiar with it. I've gotten glucagon in the ER for my hypos.

A solution containing dextrose (D-glucose) at 50% of the solution.

Glucagon is a hormone.
http://en.wikipedia.org/wiki/Glucagon

 

[uli2000]

If you need blood they will type you. Being you are O- the important thing you will want to display is whether or not you have recieved O+ blood already.

You can get one infusion of it and then you are now "sensitive", you don't want a second one.

O- is risky...it's going to be the rarest at a blood bank and some hospitals may not even keep it on hand.

You may want to look in at creating a stock of it for yourself locally.

O- is nowhere near the rarest. That would be AB-.

And as to OPs question, if they are alert and can give history, they we usually dont check it. I have to say, working in a very small town rural hospital, we dont always check them, because someone usually knows whoever it is and will know some of their medical hx. Hell, sometimes I know who it is when EMS calls in vitals over the radio just by age alone and ETA (estimate distance).

 

[nanette1985]

A solution containing dextrose (D-glucose) at 50% of the solution.

Glucagon is a hormone.
http://en.wikipedia.org/wiki/Glucagon

Two different ways of changing BG levels - which is better, when & why? Safer? cheaper? Obviously I care about this stuff . . .

 

[uli2000]

Yep, had a patient crash yesterday, nurse & a fellow were talking about taking him to the ER for a workup, I overheard what they were doing, checked his blood sugar & it was 38, I had him fixed in a couple of more minutes with an amp of d50. They thought he was having a stroke.

I mentioned to them that we were likely going to find a horse in this herd of horses, not a zebra

It just seems like some people automatically assume its something traumatic or that it's something rare they heard about in rounds last week instead of actually checking the patient. We have a doc who head to toe CTs everybody it seems no matter what they come in for. This is also the guy who misses pneumos (big ones, like 30-40%) on chest films.

 

[alkemyst]

O- is nowhere near the rarest. That would be AB-.

And as to OPs question, if they are alert and can give history, they we usually dont check it. I have to say, working in a very small town rural hospital, we dont always check them, because someone usually knows whoever it is and will know some of their medical hx. Hell, sometimes I know who it is when EMS calls in vitals over the radio just by age alone and ETA (estimate distance).

As a recipient he's going to need O-.

AB- can take any other - type from a donor or any positive type one time usually.

 

[mcmilljb]

Two different ways of changing BG levels - which is better, when & why? Safer? cheaper? Obviously I care about this stuff . . .

Whatever your doctor recommends is what you should use if you keep one available. I do think there is one important thing to note about the glucagon products, they are in a powder form so you would need to have sterile water available to reconstitute before injection.

 

[Pliablemoose]

It just seems like some people automatically assume its something traumatic or that it's something rare they heard about in rounds last week instead of actually checking the patient. We have a doc who head to toe CTs everybody it seems no matter what they come in for. This is also the guy who misses pneumos (big ones, like 30-40%) on chest films.

 

[Mark R]

On a related subject, is it important to know my blood type? Should I have it recorded in my wallet? Or do hospitals have enough of the O- that it doesn't really matter if I know, and/or they can just do a quick test to figure out which I have?

Knowing you blood type is not particularly relevant. Hospitals NEVER go on anything except their own blood group testing. In an emergency, the blood transfusion lab can type blood in 2-3 minutes, and dispense group-matched blood.

Some hospitals keep an emergency batch of O- for dire emergencies. However, where I've worked this has been the exception. The more normal setup is 'no sample, no blood, no exceptions'.

 

[FirNaTine]

Two different ways of changing BG levels - which is better, when & why? Safer? cheaper? Obviously I care about this stuff . . .

D50 is a solution of 50% Dextrose and water. It does not need to undergo any metabolism for your body to use it. It can be directly injected through an IV and fix hypoglycemia immediately. It is cheap, and safe with one big caution. Because it is a hypertonic solution it will dehydrate and cause tissue death if it escapes the vein. See http://en.wikipedia.org/wiki/Tonicity#Hypertonicity

So to use D50 you need to be able to obtain IV access, and certain people are difficult to access for various reasons.

(There is also a risk of neurologic problems, but that is a result of vitamin deficiency mostly in alcoholics making them unable to process it properly. That can be easily avoided with a vitamin injection with the D50)


Glucagon, like it was mentioned earlier, is a hormone that is injected into muscle. A person can be trained at home to mix it and inject it relatively easily. So some diabetics have it at home. You only have to be able to hit a muscle to safely inject it.

The downside with glucagon is that it takes longer to raise the sugar, because it signals your body to release glucose from glycogen stores instead of directly putting sugar into the blood like D50 does. It also requires adequate body stores of glycogen (storage form of glucose that is in liver/ muscle). If the low sugar is from an accidentally giving yourself a few too many units of insulin those stores might be there.

But you can also have scenarios where you deplete glycogen along with the low blood sugar, so glucagon will not work in those scenarios. An example would be prolonged illness with fever. Your metabolic demands increase, and most people will not keep up with the demand and actually may consume less while ill. So you would need to give IV D50 to raise their sugar.

The USUAL process is give D50 if IV access is readily available, glucagon if not.

 

[umbrella39]

When you come into the ER one of the first things that happens is you get an ID bracelet at which point even if you are unconscious someone is going to see your wrist.