Road ID – Perspective from a Cyclist and Paramedic

I try to keep many details of my personal life out of the blog.  Mostly, I do this to keep the topics ‘compartmentalized’ and keep the focus on cycling, training, and racing.  Sometimes my personal and cycling life come together to inform a topic, as in today’s post.

For those of you who don’t know, I’m a Paramedic in my day job.  I’ve been working on an ambulance full time for about eight years.  I’m also an optimistic person and positive thinker, but when I heard of , I thought it was a gimmick and wouldn’t go anywhere.  After a few years of increasing popularity and high profile endorsements, Road ID is obviously here to stay.  But that doesn’t mean it is worth your money.

The Sales Pitch:

Disclaimer: I am not a lawyer or doctor.  I can only speak with certainty in regards to the , although from my understanding, our procedures are similar to other areas of the United States.

The main problem with the above advertisement is consent.  If we encounter a patient as above, ‘overheated, passed out…disoriented’, they would not be allowed to refuse medical care.  If a patient is unable to understand the nature of their illness and associated risks with refusing medical treatment, they are treated under implied consent.  Implied consent is a legal standard which assumes consent is implied under the rationale that the patient would have consented to emergency treatment when faced with a life-threatening event.

The next problem with the above advertisement, is that someone’s spouse generally has no immediate legal authority.  There may be a Living Will or Durable Medical Power of Attorney, but these documents are much too complex for EMS providers to use during an emergency.  (We are advised to contact a base physician if we’re presented with these documents in conflict with our care, a situation I have not yet encountered.)  You may also recall the case of . The long running case focused on what her wishes would have been, not the desires of her husband or family.

In Practice:

I decided to write this post when I read about a fellow blogger involved in a .  He wrote that the EMTs hadn’t seen a Road ID before, and were surprised to see his.  Another commenter on his blog mentioned the same thing.  In fact, Road ID has had to start an awareness campaign specifically for First Responders.

The main reason for lack of awareness from First Responders is the irrelevance of the Road ID information.  Since many critically sick and injured patients are unconscious, emergency treatments are designed to be safe and effective in almost all instances, regardless of medical history and/or medications.  Sure, having demographic information (age, phone, address) is helpful, but the hospital is happy to save the life of “John Doe” and figure the rest out later.

Emergency Contact Information:

This is one area where Road ID may be helpful, if only slightly.    You may have heard of a pesky medical privacy law, .  The law states that “Protected Health Information” (including the fact you are at a particular hospital) can’t be disclosed with authorization “in writing”.  Does wearing a Road ID which states “In case of emergency contact 555-1212″ constitute authorization in writing?  Probably yes, but due to HIPAA, the hospital is wary to contact anyone except in the most dire of circumstances.  I can tell you that as a Paramedic, I won’t be calling anyone’s number on a bracelet.  Due to medical privacy, I won’t call anyone unless specifically requested, and I usually don’t have time for that sort of thing anyway.

I’ll touch briefly on keeping an entry “ICE” (In Case of Emergency) in your cell phone.  Most hospital staff are aware of this, and I know of it being used in a very rare and dire circumstance in the ICU for an unidentified patient.  This may be useful, but recently dialed numbers will also probably work just as well if such a situation arises.  The police are also very good at finding out who people are and can use resources such as the registered owner of the cell phone, etc.

Medical Information:

There may be rare instances where a key piece of medical knowledge may be helpful for First Responders.  But keep in mind that Paramedics encounter patients with heart problems, diabetes, and seizures every day who do not wear Medical Alert tags or Road ID, and they are used to dealing with these problems without any assistance.

Perhaps if you are seriously allergic to a common emergency drug, or have a rare disease which may alter the course of your treatment, a Medical Alert tag would be a good option.  But trust me, if you are diabetic and pass out of the side of the road with hypoglycemia, the Paramedics will figure it out without the help of your Road ID.

Summary:

The Road ID may give peace of mind, but you may not be getting the value you expect out of it.  First Responders are used to encountering patients without any information and have treatment guidelines which are effective for nearly all emergency situations.  If you believe that contacting your family immediately is of the utmost importance if you’re critically injured, Road ID may be helpful.

Personally, I just carry my cellphone and $20 under the insole of my shoe.

About Russell

I have been racing bicycles for a decade. This blog will chronicle my efforts as a Category 1 road racer lining up with the pros.
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8 Responses to Road ID – Perspective from a Cyclist and Paramedic

  1. says:

    I always carry my phone which has the ICE number for my wife…that said, it seems blood type woud be a handy thing to have on there and a few other important facts. I also carry an old driver’s license and a back up Blue Cross card. On the other hand, the braclet seems to rely on the ignorant fear of many people – the notion that the docs will treat you better if they know you’re covered as you stated. Count me wirh rhe ignorantly afraid, though I may change my attitude after reading your post. It’s food for thought.

    Fortunately, I ride on some serious back woods roads and therefore feel quite safe. The only two close calls I experienced

    • says:

      I don’t mean to play devil’s advocate too much here but keep in mind that giving a critically injured patient the wrong type of blood would almost certainly kill them.

      Most hospitals won’t give matched blood products unless the “Type and Cross” (which takes about 45 minutes in total, but only 5-10 to identify basic blood type) was performed in their lab in the past 3 days. The risk of using the wrong blood is so severe that they will use Type O- (universal donor) in an emergency if blood is required immediately.

      I can tell you for certain the Ambulance/Emergency Department/Trauma Surgeon/etc, don’t care one bit about ability to pay or insurance for immediately life saving interventions (Or other interventions for that matter. Emergency staff are usually unaware of a patient’s billing status anyway.)

  2. says:

    Very interesting! Have heard of, but not overly considered road id. I am sure that there are merits for and against. I often don’t ride with a wallet, so having a name to find in the system may be nice. I have a photocopy of my drivers licence – although I am sure it is completely unreadable! The legalities of it all are interesting, mind you – if I am crashed on the road and incoherent – they will most likely not be my concern at the time! I guess, if I really wanted my name known, I could go to the hard ware store, pick up a dog tag, get it engraved and attach to my under the saddle bag!
    BTW – hopefully I never need your services, but a big thanks goes out to you – glad to know you guys are out there if we need ya.

  3. Ryan says:

    Being a medic i agree with you completely. They way that ad sounds its amazing that EMS has ever been able to save anybody who was disoriented. I have yet to ever check anybody for a Road ID, and everybody has gotten the treatment they needed, and the people who needed to be contacted got contacted.

    From what I remember when I was looking at the Road ID site a year ago or so they had an online profile you could update with your medical info. Something I would never have the time to check, or even trust if I did.

    Its just an ad playing on the stereotype that over the top drama shows have made on EMS that they are a bunch of untrained, incompetent, fly by the seat of their pants alcoholics with major personal problems, and there is a good chance that you could end up disoriented and untreated at a race if you don’t have that band on!

    • says:

      I’m with you all the way up till you take a company’s desire to sell a bracelet personally. The people at Road ID don’t care about EMS Techs (my brother is one – and a fire fighter). They just want to sell some bracelets.

      That said, I have heard of quite a few horror stories where runners, struck while runnong, go days without being identified (in the local papers). I want my wife notified if I’m hurt. I’d rather not have her worry for days about where I’m at or if I’m dead, so i carry my id and my phone so the hospital personel can make the necessary arrangements- the EMS tech story is a little cheesy on its premise…but you guys don’t have attorneys and associations to protect you so maybe that’s why they played that angle.

  4. Zach says:

    I haven’t thought about the utility of road id, but I agree with you. There’s not really much you’d do different and ppl don’t go contacting folks, though I’d think the contact number is implied consent.

    As far as the ice note in the phone, I don’t know anyone who doesn’t have a phone lock.

    Also agree in whole you don’t need to know much to begin the standardized protocol to save someone’s life, and road Id wont change anything. If its in a position to make much of a difference, your not that injured.

    • Zach says:

      Sorry to double post but didn’t see other comments (phone).

      We have zero clue or care if someone is insured, drs pay is not linked to insurance at a hospital with a trauma level status, that’s why it exists.
      Your blood type doesn’t matter either, protocols are in place so ttheres no decisions to be made and no stupid mistakes. no one would give u a blood type off a bracelet ever. You’d need to be t/c’d first, and it’s just not necessary.

    • says:

      What a hot bed we have here… In terms of initial contact I can understand the EMT’s position, but once your not dead and at the hospital there are a lot of things that can and do go wrong that the Road ID can help with or possibly a medic-alert bracelet.

      Take, for instance, ID. I find it hard to believe that a hospital is better off not knowing who I am if I come in after being smacked by a car. My wife’s gotta call the cops – after 24 hours, of course – because of another no thought law, to report me missing, then once the cops get a minute away from chasing down bad guys, they can start looking for me at all five of the local hospitals in the area…

      Or a nurse can tap ICE into my phone (because I still put the ice info in there even though most people have phone locks” and i don’t use the lock when I ride or run) and contact the cops with a John Doe and an ICE number.

      The first scenario takes…uh, carry the one… 30 plus hours.
      The second scenario… What, ten minutes?

      The idea behind the Road ID, again, is to help make identification easy and quick…and all while not requiring a user to carry a wallet on a run..

      How about allergies? You give my dad a Tylonol, we’re good. Give him an aspirin and he’s dead. That seems like it might be good info to have without finding it the hard way.

      Better to have it and not need it than need it and not have it, I always say.

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