Feature - Communications
Unconscious Patients Can Talk by: Blair Bigham, MSc ACPf and Cheri Nijssen-Jordan MD FRCPC MBA
The reflection of your strobe lights off the snowflakes is almost blinding. It’s cold and dark and windy, the most chilling shift of your set. You have been dispatched to that small house on the large corner lot, you know, the one you didn’t think anyone actually lived in. As you pull up to the driveway a ghost‐like figure appears in front of you, waving arms to draw your attention, confi‐ dently standing behind the mailbox as if it offers protection from your vehicle. You slowly pull along side, cautious of the slick roads that make your ambu‐ lance more difficult to navigate than a transatlantic cargo ship. You plow your stretcher up to the front porch and lug your gear into the house. The man who flagged you down blurts about how he came to collect rent from his tenant only to find her passed out on the floor of the kitchen. She must be dead, you assume. As he leads you through the narrow front hall, you get a glimpse of the patient and quickly abandon your initial impression: this patient is alive, but for how long is anyone’s guess. “What happened here” you ask, but the landlord doesn’t know. The typical questions all come up without answers... medications, allergies, past problems... “She’s a really nice lady” he tells you. Great. You turn to your
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patient and, for a moment, consider asking them aloud what led them to be on the kitchen floor. Alas, we all know unconscious patients can’t talk. Oh, but they can. For 50 years the Canadian Medic Alert Foundation has been offering patients and paramedics alike the opportunity to communicate during emergencies. Every college stu‐ dent is taught to check an unconscious patient’s body for the iconic MedicAlert ®emblem to gain insight into the patient’s plight. Known most‐ ly for displaying allergies, MedicAlert offers much more: diseases, devices, medications and special information are all available on the back of the bracelet, necklace, or watch bearing the MedicAlert emblem, and a wallet card is supplied to each MedicAlert member. Also available is the little‐ known phone number paramedics can call. Answered within 5 seconds, this number connects you to the patient’s MedicAlert emergency medical file 24 hours a day, 7 days a week, 365 days a year. An agent will quickly share every‐ thing you want to know about your patient, and even offer to fax their file to your receiving hospital.
With these services it’s no wonder over one million Canadian’s trust MedicAlert with their emergency med‐
ical profiles. Surprisingly, though, there are a number of stories where health care providers – paramedics included – have failed to recognize the Medic Alert bracelet. Sometimes the consequences are tragic. Other times, misfortune is avoided only by pure chance. Recently, much attention has been dedicated to patient safety. Ensuring that health care providers uti‐ lize all available information to make the best decisions for patients has been a topic of great national focus, and in the same spirit we present case studies involving the MedicAlert emblem with the hope that paramedics can improve system safety through dili‐ gence and advocacy.
Case Study 1: The Good
An unconscious elderly patient was picked up by paramedics a block away from a children’s emergency depart‐ ment and brought in to be resuscitated as it was the nearest hospital. The med‐ ical staff and paramedics both noted that the patient was wearing a MedicAlert bracelet which identified him as having diabetes mellitus. Glucose was immediately administered and the patient awakened and was able to be discharged home within hours.
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