This emergency form can save children’s lives
This emergency form can save children’s lives
The ED will benefit greatly from the Emergency Information Form (EIF), which can put life-saving medical information about children with special needs at your fingertips, says Alfred Sacchetti, MD, FACEP, an ED attending physician at Our Lady of Lourdes Medical Center in Camden, NJ.
The form was developed jointly by the Elk Grove Village, IL-based American Academy of Pediatrics (AAP) and the Dallas-based American College of Emergency Physicians.
For the form to help, it must be on file, stresses Robert Wiebe, MD, director of the ED at Children’s Medical Center of Dallas. "The child’s pediatrician or specialist will need to do the work of putting it together, so the most important thing is to distribute the form to the parents," he says. "The parents need to push from the consumer end and make sure the doctor fills it out."
Here are some benefits of having an EIF on file:
o You are alerted to "invisible" conditions. The form can alert you to rare pediatric diseases that have no obvious symptoms or solutions, says Sacchetti. "Often, there is absolutely no physical way to tell what is going on with these kids," he notes.
The form also alerts you to individual care needs. "For example, children with generalized grand mal seizures aren’t responsive to benzodiazepine and need to be treated with lidocaine," Sacchetti says.
o You are alerted to breakthroughs in therapy. ED clinicians may not immediately be aware of cutting-edge changes in medicine, notes Sacchetti. "A lot of subspecialists are very parochial, and they circulate their advances only within their unique area," he adds.
The form might list specific medications that are newly approved, he says. "You know what the textbooks say to treat the child with, but there may be a brand new treatment which cardiologists have been using for the last three months." For example, the standard treatment for tetralogy of Fallot, a congenital heart defect, is a morphine-neosynephrine combination, but a newer treatment is available, says Sacchetti. "Esmolol is a short-acting beta blocker which can be used for hypercyanotic spells in these children," he notes.
High-tech devices such as activity sensitive pacemakers require specialized knowledge, he says. "This device senses when the child is active and speeds up the heart rate. If the child is only examined in a supine position, the physician would not be able to detect this function."
o You can anticipate complications in advance. The form can help you prepare for specific problems that will occur in certain children, says Wiebe. For example, a sickle cell patient with a history of previous stroke who is on hypertransfusion therapy is likely to have complications that can be anticipated, he says.
o The forms can be accessed 24 hours a day. MedicAlert Foundation in Turlock, CA, acts as a universal repository for information on children with special needs, says Sacchetti. ED staff can call the MedicAlert 24-Hour Emergency Call Center to find out if a child has an EIF on file, and the form can be faxed immediately within minutes, he explains. [The hotline number is (800) 625-3780, and the collect call number is (209) 634-4917.]
o The information allows you to treat the child in a short period of time. The form may include instructions that can save a child’s life while you are waiting to hear from the specialist, explains Sacchetti. "They may not call back for 15 minutes," he says.
In the ED, that 15 minutes may be a matter of life or death, Sacchetti stresses. Other physicians refer children with special needs to specialists, he points out. "In emergency medicine, we don’t have that luxury. If a child shows up blue, you have to intervene and don’t have time to refer to a subspecialty. You’ve got to do something now."
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