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Handling Emergency Medical Information
May 14, 2006

I am a social worker, and work with individuals with mental retardation / developmental disabilities. I have an HIV+ client that attends our sheltered workshop. For all attendees, we keep an emergency medical form, which lists diagnoses and medications in event of an emergency (as they typically cannot remember and accurately report this information). Up until now, we have not included HIV-related information on this form, since a high number of staff have access to it (i.e. transportation / administrative staff). Additionally, it is a rural area with a high level of stigma towards HIV+ individuals. I am concerned that in the event of an emergency, medical staff will not have access to my clients medical information, which could possibly affect the evaluation / care needed and received. Any advice on ensuring confidentiality while also guaranteeing competent medical care in event of emergency?

Response from Ms. Breuer

Excellent question. And you do not need to list any of your client's HIV information, because the answer to the question, "What should people do differently if they knew?" is "Nothing."

If your client is bleeding, that blood is potentially infectious. At this point in medical/social history, there is no excuse for doing first aid sloppily if you think the bleeding victim is HIV negative and carefully if you think s/he is positive. As you and your colleagues probably know, the standard procedure is to treat ALL human blood as if it's infectious and use adequate barrier protection.

Apart from that, no emergency medical personnel would treat your client differently (or better) if they knew his/her status. They protect themselves from infectious diseases all the time, as part of their jobs. The greatest danger to your client's care is stigma.

The only step I would encourage would be making sure there's a note in the file advising medical personnel (NOT EMS personnel) to contact the treating physician for information about medications in the event of a need for prescription meds. Period.

I appreciate your concern, and wish everyone were as alert to the client's privacy rights.



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