I think something non-traditional might be very difficult to spot. I, for one, didn't even know they were available, as I've never seen one. So, I wouldn't know to check and that's probably true for most medics or first responders. This would be especially true in a traumatic injury situation where you might be being extricated from a crumpled car and separated from your bag or perhaps lost the shoe with the tag on it (etc). We have had patients with very specific needs actually come to the station (or write a letter) explaining their needs or medical situation. This information is usually posted in the crew room. Of course you have to hope the medic who's pulling a 24 hour shift remembers to associate your name and address with whatever specific problems you have at 4am. I suppose there's really no perfect answer. At the risk of sounding like a broken record, if you are unresponsive, something is very wrong. In that case, we are worried about the basics: Do you have an airway? If so, are you breathing? Do you have a pulse? If so what's your blood pressure? What's your oxygen saturation? What's your Blood Glucose level? Are you bleeding uncontrollably somewhere? Do you have a traumatic brain injury/CVA? Have you had a seizure? In each of those cases we will deal with the problem, but having CF is not going to affect that care and any concerns about CF would be trumped by whatever is causing your unresponsiveness. If it's a respiratory issue, airway and breathing are our #1 and #2 concerns (hence ABC; Airway Breathing and Circulation). So, let's say you have a nasty bronchospasm. I'm going to get your room air oxygen saturation and then stick you on high flow O2 (15LPM) or even assist your respiration with a bag valve mask. If you're bad enough to require assistance one of 2 things is going to happen. If your service has CPAP that is also capable of delivering aerosols, you'll get 5mg of albuterol simultaneously with the CPAP (assuming you don't have a tension pneumo or other contraindication to positive pressure ventilation and assuming that you are conscious, but just can't speak due to respiratory distress). If they don't, I would give the albuterol first and see how you do. At the same time you'll also be getting 1:1000 Epi sub-q or terbutaline sub-q. IV acccess will be obtained and you'll get 125mg Solu-medrol. Then we go back to airway, have things improved? If not, I'm going to be on the phone with a doc discussing whether we should go with something like mag sulfate or more albuterol or rapid sequence endotracheal intubation (a lot of this depends on how long of a transport we have). I really have been racking my brain to think of a situation where a medic alert bracelet might be really beneficial in a pre-hospital setting. I can't come up with much other than an allergy to an extremely common medication, like the ones listed in my previous post. I think they became popular back in the day when EMS was in it's infancy. EMS is not an old profession, at least not civilian EMS. It was invented, as it were, in the late 1700's in Europe for carrying wounded soldiers, scoop and run medicine. As it evolved, ambulance attendants got some training but it was still largely scoop and run. Often the job fell to undertakers who had vehicles that could transport a patient lying prone. It really wasn't until the 60's (at least in the US, Europe and Canada have us beat) that EMS started to become what we know it as today. Even at that, early medics were mostly concerned with cardiac arrest and trauma. This was the time when a medic alert bracelet could make a difference. The medic was some guy who took a 2 week course given by a physician, so not a ton of education. These days, it takes at least 2 years and many of us have 4 year degrees. We are required to take continuing education classes with a varying amount of required hours per year and every 2 years we take ACLS and PALS. Sure, there are bad medics, just like some docs are bad at what they do. You also might live in an area where they only staff EMT's who are only able to deliver basic care (No IVs, no drugs, no EKG etc.). OK, I'll quit rambling. Let me know if that answered your question.
