Emergency Preparedness for
Children with Special Health Care Needs
Instructions for Parents

Dear Parent:

Children with special health care needs have very unique medical histories and require very special medical treatment. If an emergency physician does not have access to this important information, these children are in danger of delayed treatment, unnecessary tests, and even serious errors. It is extremely important, then, that parents and physicians work together to give emergency physicians access to the special information they need to properly care for children with very special health care needs.

To address this problem, the American Academy of Pediatrics and the American College of Emergency Physicians have developed the Emergency Information Form (Adobe Acrobat PDF File). This simple form is used to record health information for children with special health care needs and should kept in multiple locations for easy access by physicians and emergency medical personnel.

To complete this important form, follow these easy instructions:

1. GET THE FORM: Get the Emergency Information Form from the child�s primary care physician, specialist, or the local emergency room. [Access the form on-line (PDF file)]

2. FILL IT OUT: Begin filling out the form to the best of your ability. Take the form to the child�s primary care physician or specialist and ask them to finish filling out the form.

3. KEEP IT: Keep 1 copy of the form in each of the following places:

a. DOCTORS: On file with each of the child�s physicians, including specialists.

b. ER: On file with the local emergency rooms where the child is most likely to be treated in the case of an emergency.

c. HOME: At the child�s home in a place where it can be easily found, such as the refrigerator.

d. VEHICLES: In each parent�s vehicle (ie, glove compartment).

e. WORK: At each parent�s workplace.

f. PURSE/WALLET: In each parent�s purse or wallet.

g. SCHOOL: On file with the child�s school, such as in the school nurse�s office.

h. CHILD�S BELONGINGS: With the child�s belongings when traveling.

i. EMERGENCY CONTACT PERSON: At the home of the emergency contact person listed on the form.

4. REGISTER: Consider registering the child, if he or she is not already registered, with MedicAlert®. Send MedicAlert® a copy of the form so that they can keep it stored in their central database, which is easily accessible by emergency medical personnel.

5. UPDATE: It is extremely important that you update the form every 2-3 years, and after any of the following events:

a. Important changes in the child�s condition.

b. The performance of any major procedure.

c. Important changes in the treatment plan.

d. Changes in physicians.

Now, if your child ever has an emergency, the emergency medical personnel will have easy access to your child�s very unique medical history, allowing them to provide your child with the best medical care available.

Thank you for your cooperation!

Very truly yours,

American Academy of Pediatrics
American College of Emergency Physicians

Emergency Medical Services for Children