The Emergency Information Form: A focused clinical summary for emergency preparedness for Children with Special Healthcare Needs

Abstract

Background: Pediatric patients with special health care needs present unique challenges in emergency care. A generalized definition of children with special healthcare needs (CSHCN) refers to patients who require, or potentially may require, increased resources compared to a typical pediatric patient. These complex healthcare needs pose unique challenges for first responders and emergency practitioners. Therefore, these patients may benefit from a concise summary of important health-related information that is easily accessible during emergency settings.

Methods: Key sections of Emergency Information Forms (EIFs) outline demographic information, physician contact information (primary and specialty care), diagnoses, past medical and procedural history, allergies, medications, and immunizations. In addition to these elements, the sample EIF from the American College of Emergency Physicians and the American Academy of Pediatrics added components such as “Procedures to be avoided” and “Common presenting problems” with suggested approaches to management.

Results: This EIF format was subsequently implemented in an electronic format to facilitate instant access and was analyzed in various emergency or disaster settings and simulations. A review of these studies demonstrated subjective and objective benefits for both parents of CSHCN and emergency providers. 

Conclusions: There are numerous barriers to widespread implementation of EIFs: privacy and security concerns, interoperability, and integration into different practice patterns and electronic medical records. However, there is increasing opinion-based and data-driven support of the concept and utility of emergency-focused clinical summaries. The EIF can also be used for complex adults with rare or congenital medical diagnoses to enhance emergency preparedness.  The push for enhanced, instant access to integrated health information has created an environment in the post-EHR era to facilitate broader EIF utilization and implementation. Additional studies and analysis of larger scale use of EIFs are needed to further elaborate their specific benefits for patients with complex health care needs.