First-aid kit: check. But where oh where are those insurance papers, contact lists and medical records?
First-aid kit: check. But where oh where are those insurance papers, contact lists and medical records?
mtomczak/Dreamstime

Every well-stocked home has a first-aid kit. But what items should you have on-hand if you're headed for the hospital?

1. Basic Patient Information Form

[Print or Download a Blank Form Here]

For each family member, create a document that includes their:

  • Full name
  • Date of birth
  • Gender
  • Address and phone
  • Emergency contact name, daytime phone, evening phone and relationship to patient. Remember, you may or may not be with the person needing medical attention. Make sure doctors know where to reach you!
  • Medical alerts. List any allergies, or conditions like diabetes or heart disease, that medical staff should be aware of.

IF a family member doesn't have any health conditions or enough information to create a Medical Summary Sheet (see below), summarize your medical history on this form.

If the form is for a child or minor, include all of the above, plus:

  • Full names for the parent(s) or legal guardian(s)
  • Contact information for the parent(s) or legal guardian(s)
  • Any specialized information about your child, such as communication issues or disabilities
  • Indication of if/how the child is covered by health insurance. The details of the insurance can be on a separate form. See Insurance Information below.

It may be wise to keep up to three copies for each Patient Information document. In a medical emergency, you may need to provide this information to emergency medical technicians, the emergency room attendants or hospital admitting staff. Don't be surprised if you have to fill out individual forms once you arrive at a facility. Each facility has its own format. Your Family Medical Emergency Grab 'n Go Kit is designed to help you with the information, not necessarily replace forms that may be required.

2
Medical History Summary Sheet

[Print or Download a Blank Form Here]

One of the most important documents that a family can keep handy is a Medical History Summary for each family member. This document helps the doctor see assess a patient's health over time. It's also helpful to have this information written out in a way that you can compare siblings, to perhaps see patterns evolving in their health.  Most importantly, this document sets the stage and informs any decisions regarding medical treatment needed for that family member.

This document is not meant to replace your doctor's files, but to be used as a quick reference, and reminder to you.  It's more important that you cover everything in that person's medical history. For each family member, include information about the following:

  • Condition(s) for which the patient is being treated by a physician. Use your own words. If you know the medical term, use it, but it's best not to guess.
  • Prescription medications being taken now or in the last six months. Include the drug name, dosage (amount) and what condition it is being taken for.  (This information is usually on the bottle or package.)
  • Frequently taken (more than once per week) non-prescription medications.  Include cough medicines, vitamins, diet pills, pain relievers, herbs, supplements, or allergy medicine you buy off the shelf at the drug store or supermarket.
  • Known allergies.
  • Any medical problems, tests or treatments, such as a broken bone, major surgery or examinations.  Include dates. Think of this list as a summary of health milestones in the person's life.

Work closely with your doctor and mention that you are compiling this list.  He or she may have additional information that they consider important enough for you to include on this summary sheet. Include notes such as "tender joints," or "high blood pressure," as communicated to you by the doctor.

For this sheet to be useful to you, your doctor or anyone responding to a medical emergency, the information must be up-to-date.  Make it a routine to pull this sheet out after a doctor's visit and add any new information. As a parent, prepare the list with the knowledge that you might not be present when it is accessed. Mothers are keepers of their child’s histories: developmental, medical and emotional. If you are unavailable, what do medical professionals need to know about your child/children?

3
Doctor Contact Information

[Print or Download a Blank Form Here]

In case the emergency staff needs to get in touch with the patient’s doctor, or call in a specialist, create a single list of all primary care physicians and specialists the patient may be seeing at the time of the emergency.  Include each doctor's:

  • Full name 
  • Specialty, if not your general family doctor
  • Office, hospital or practice for which they work
  • Address, phone number and email, if they use that as a mode of communication with patients
  • Assistant's name and number, if known
  • Any conditions for which the patient sees the physician (for example, monthly checkups for asthma control)
4
Emergency Contact Information Sheet

[Print or Download a Blank Form Here]

An Emergency Contact Information Sheet kept in your Family Medical Emergency Grab 'n Go Kit can come in handy when you or the attending medical staff need to reach all family members in the event of an emergency. Remember, you can assign a member of your family or create a family phone tree to make these calls.

List each person you want to contact, their relationship to you or the patient, and all phone numbers that might be available for that person. You don't want your entire address book here, but you never know when or where a medical emergency may take place. While you might know your neighbor’s phone number off the top of your head, in an emergency, can you find their cell phone?  Write it down. Many of us manage our lives with our cell phones, but most medical facilities prohibit the use of cell phones in their buildings. One piece of paper with a handful of numbers can be a lifesaver. Include contact information for the following individuals:

  • Any person (including employers) that will need to be notified of the emergency
  • Anyone who will need to take up a critical family responsibility -- like picking up child or sibling from school
  • Think of your own circumstances (better now than during an emergency!).  Who would you call?
  • Work, office
  • School
  • Baby-sitter
  • Pet sitter
  • Relatives
  • Neighbor or friend

Also include contact information for any regular appointments or responsibilities you have that might be interrupted by an emergency, such as gym or play dates, or special work shifts.

5
Insurance Information

[Print or Download a Blank Form Here]

Though many health insurance providers give members a card to carry in their wallets, it is a good idea to have this information right in your Family Medical Emergency Grab 'n Go Kit. Some people carry more than one insurance policy, so for each, be sure to include:

  • Insurance provider name(s)
  • Indication of which provider is considered your "primary insurer"
  • Policy, group or membership numbers (usually provided on your card)
  • A customer service phone number for each provider
  • A list of family members covered under each policy
6
Living Will or Advanced Directives

[Print or Download a Blank Form Here]

Many of us find the topic of death and dying hard to talk about, or even approach, with our loved ones.  Yet, in the event of an emergency situation, you may be faced with several decisions that are best handled after having given them considerable thought and attention in advance.  You and (adult) members of your family should discuss everyone’s wishes, and see that these are documented in the event that you can’t speak for yourself.

Advanced Directives and Living Wills are legal documents that describe the medical treatments or decisions that you would prefer under exceptional circumstances when you can’t speak for yourself.  To create a document of “advanced directives,” you should consider these questions:

  • Do you want to donate viable organs or tissue for transplant?
  • Do you want to donate your body to medical research or education?
  • Do you have a preference for burial or cremation?
  • Do you have an idea where you’d like your remains to be placed?
  • What are your thoughts for a memorial or religious service?

Finally, you should think about the following questions and document your answers:

  • Are there situations that you would consider worse than death?
  • What if you could no longer recognize or interact with friends or family?
  • What if you required some apparatus, like a breathing machine or feeding tube, to keep you alive?
  • Are there any religious or spiritual matters to consider should you be unable to represent yourself in decision-making?

Depending on your answer to some of these “quality of life issues,” you may want to request a “Do not resuscitate” order - or DNR.  This means that if your heart stops, or you stop breathing, emergency medical staff or hospital staff will not attempt to revive you using CPR.

Advanced directives and living wills are legal documents and the laws vary state to state. Your doctor may have a form to use in your state, or you can contact your local health department.  There are also forms available online and for sale in software packages. However your documents are created, they should be properly witnessed and notarized for your protection.

Remember, these documents should be revisited over time to make sure they still reflect your feelings accurately.

7
Waiting Room Bag

Unless you're prone to frequent ER visits, you don't need to have a pre-packed bag. Instead, compile a checklist of things to bring to the hospital for each family member.  Briefly discuss in your family meeting what you must have at all times. Most children have one comfort item, which is a necessity in the case of an emergency. Remember daily medications/monitors, glasses or contact lenses, and other necessary devices.

For example:

  • Dad: cell phone, Blackberry for work, diabetes medication or monitor
  • Cindy Lu: shaggy dog toy, retainer, inhaler
  • Mom: reading glasses, cell phone, address book

If young children will be accompanying you to the ER, take along some coloring books, or word puzzles, to occupy them while they are waiting. Hand-held audio players or video games are OK, too, but remember to pack headphones and batteries.

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