It’s a common question that comes up among Facebook support groups for brain tumor patients with panhypopituitarism — what to put on my medical alert bracelet? The answers seem to vary and with limited space on these bracelets and the importance of conveying conditions efficiently in an emergency situation, we asked the doctors what should be on ID bracelets that would be most accurately interpreted by EMTs, paramedics and hospital emergency staff.
The question was posed to Dr. Shana McCormack, neuroendocrinologist at Children’s Hospital of Philadelphia. She gave some guidelines for best practices.
Always have a simple, 1-page emergency letter to refer back to with contact information for the usual endocrine team. Download a letter template or a wallet size card.
Don’t rely on a separate emergency letter alone. Include the most actionable information on the ID bracelet, and avoid abbreviations if possible, since they are not universally recognized.
What to Include
For the most common panyhypopituitarism conditions that need to be conveyed to an emergency responder, the formulation should read as follows:
Adrenal Insufficiency: Stress Steroids
There is currently a global effort to rename diabetes insipidus to arginine vasopressin deficiency. In the United States, the diagnosis code (ICD-10) remains the original name of diabetes insipidus and is what is still recognized in emergency departments. This practice may change in the future but, for now, we will continue the recommendation to use the wording above.
Additional information, if needed would include (if applicable):
Allergies (eg: Tree Nut)
Other “key” problems which may include hypoglycemia, seizure d/o, anti-coagulants, etc. Get doctor feedback on which are relevant here, no need to list all, just the ones that may really need action in the field or immediately in the ER.
According to Dr. McCormack, “The rest of panhypopituitarism is less relevant immediately, and for sure does not need to be on a medic-alert (e.g., hypothyroid, GH deficiency are not needed). Since panhypopituitarism takes up a lot of room, if you can fit in the adrenal insufficiency & diabetes insipidus as those obviate the need to list panhypopituitarism.”