Medical Forms

Emergency Information Form for Children with Special Health Needs

The American College of Emergency Physicians and the American Academy of Pediatrics are pleased to present the Emergency Information Form (EIF), which can be downloaded from the menu at the bottom of this page.

This important document will assure prompt and appropriate care for Children with Special Health Care Needs (CSHCN). Now, when these patients present to emergency departments or health care professionals with an acute illness or injury, physicians, parents, EMS professionals, and nurses will be able to use the EIF as a tool to transfer critical information.

The EIF will ensure that a child's complicated medical history is concisely summarized and available when it is needed most - when the child presents with an acute health problem at a time when neither parent nor pediatrician is immediately available.

AAP and ACEP believe the EIF is an important tool that will help facilitate the transfer of relevant information for Children with Special Health Care Needs.

EIF Documents

Main Points

  • Children with chronic medical conditions are the most rapidly growing group of children under age 18 who need emergency medical care.

  • Emergency physicians specialize in caring for the emergency medical conditions of children and adults.

  • Children with special needs present unique challenges, because their underlying conditions can place them at special risk of complications.

  • To help parents make sure vital medical information is available in an emergency, the American College of Emergency Physicians and the American Academy of Pediatrics developed the "Emergency Information Form for Children With Special Health Needs."

Q. How many children in the United States have special health care needs?
A. Up to 13 percent of children under the age of 18, or 9.4 million children, are living with chronic medical conditions. Referred to as "children with special health care needs," these patients include children with cerebral palsy, spina bifida, asthma, hemophilia, autism, diabetes, and various genetic disorders. Children with special health care needs live in about 20 percent of U.S. households with children.
Q. What should parents of special needs children do?
A. Parents should have their child's physicians complete the "Emergency Information Form for Children With Special Health Needs" and bring it with them to the emergency department. They also should provide copies to all their child's caregivers.
Q. What challenges face the medical community in treating children with special health care needs?
A.

When these children have an acute illness or injury, their underlying conditions can place them at greater risk for complications than children without chronic medical conditions. Many children with special needs have problems that may be completely undetectable by a physician treating the child for the first time.

Parents also may not always be available to relay important medical information about their conditions in an emergency, which means emergency physicians may have to uncover a preexisting condition or work through a number of options to determine the best treatment plan.

Even children with easily recognized problems might be difficult to treat when a physician is unfamiliar with their medical histories. For example, a standard medication for most children might complicate the medical condition of a special needs child by causing an allergic reaction or a negative interaction with another medication the child is taking.

Rapid diagnostic and therapeutic advances make it difficult for even the most dedicated practitioners to be completely aware of what every advancement means for every disease in every child. For example, a child may require a new or experimental therapy known only to the child's specialists. In addition, some children with special health care needs do not respond to standard treatments for their diseases, but have individualized regiments developed for them through years of treatment by their own physicians.

Q. How has the medical community responded to meet the need for medical information in an emergency for these children?
A. ACEP and AAP developed the "Emergency Information Form for Children With Special Health Needs." Completing this form and making it available to medical personnel in emergency situations will ensure prompt and appropriate care for children with special health care needs. It will ensure that a child's complicated medical history is concisely summarized and available when needed most - when the child comes to an emergency department with an acute health problem, especially when a parent or the child's physician is not immediately available. Parents should complete the form with their child's physician or medical specialist.
Q. Why is the form needed?
A. Parents or caregivers may not always be there to relay important medical information in an emergency. Also, when a child is sick or injured, many parents have difficulty objectively reporting their child's long, complex medical history. Parents of children with special needs must have a mechanism in place to relay essential medical information about their child to emergency health care providers, regardless of their presence or immediate capabilities. The "Emergency Information Form for Children With Special Health Needs" was designed to be such a mechanism.
Q. Can medical jewelry help in an emergency?
A. Yes. Children with special health care needs should wear medical jewelry to provide vital information in an emergency. The MedicAlert® Foundation disseminates medical identification bracelets internationally and has been a strong proponent of the "Emergency Information Form for Children With Special Health Needs." The organization has agreed to serve as a central repository for any child who registers with its program. MedicAlert''s 24-Hour Emergency Response Center will keep the form on file so that health care professionals can retrieve needed information anywhere in the world, 24 hours a day.

Bookmark and Share