Emergency Information Form for Children With Special Health Care Needs

Revised April 2010

Reaffirmed October 2008, October 2002

Originally approved December 1998

Emergency physicians and pediatricians provide medical care to many children with special needs because of chronic, complex medical illnesses. Care of these children may be complicated by the lack of patient history information, and unusual and uncommon disease processes.

To optimize emergency care of children with special needs, the American College of Emergency Physicians supports these principles:

• A mechanism should be available to quickly identify the child with special health care needs when that child presents for emergency care.

• Records of each child's special needs should be maintained in an accessible and usable format.

• The exact form in which relevant information is stored may vary depending on individual physician and patient preference.

• A universally accepted form should be disseminated for use by prehospital providers, parents, physicians, and other child advocates. Figure 1 depicts the recommended form Emergency Information Form for Children With Special Needs.*

* A similar policy suggesting use of this form has been adopted by the American Academy of Pediatrics.