There is no privacy concern, using them is optional and the patient has the choice. There are greater privacy concerns in hospitals like OR schedules on whiteboards and chart racks left in hallways.

everything is within the hospital walls. Privacy is going way overboard. Besides...these tags AREN'T ATTRIBUTABLE to any particular NAME.

Let's have bands for the hospital staff... not all of them, just the ones who are at risk of doing something radical like cutting off a man's penis during a circumcision. That doctor's band should be shock orange with flashing LED's in it warning patients about the potential of getting more than a trim!

I think the color black would be more suited to the DNR patients. Or maybe blue.

@GreatWhiteNorth: Sorry folks... my little guy hasn't come out since reading the earlier story about the circumcision... and it's been hours!

If you're wondering, I believe D.N.R. means Do Not Resuscitate.

Sounds like a cheeky solution. Like the hospitals want to hold on to their dear color-coding systems, but not have to deal with misinterpretations between systems. Hey, you have charts, machines, gadgets, and plenty of other monitoring and information systems throughout the hospital. Why should anything resolve down to bracelet scrutiny?

Make them white, teach nurses to read.

I'm allergic to Demerol, a pain killer. When I was in for surgery they put a red bracelet with the name of the medication.

The doctor and 3 different nurses, each independently said "we'll also give you some Demerol." I had to keep reminding them that I am allergic to Demerol.

There is a small privacy concern, but I think the larger concern is the anecdote about kids trading them like trading cards. That could be a potential nightmare when the kid allergic to various antibiotics swaps the bracelet with the kid that can't accept a blood transfusion.

Slap bar codes on them and give nurses a reader.

@zigziggityzoo:
That is correct.

i think they should use the colored ones, just not display what they mean to the public. as long as the staff knows then its ok. most hospitals use codes over the P.A. that people dont know.

Give me privacy or give me death! Wait...Not both, I can't make do with both!

I think ultimately the care of the patient should come first, so if standardizing bracelets improves the quality of care and reduces the chance for screwups I say go for it. If the patient is a DNR or has an allergy, that info is usually posted in a manner that any visitor could see, so privacy concerns are sort of moot. Also, in the case of something like family not knowing the end-of-life choices the patient has made, uh, they're going to find out eventually. I'm just saying.

As a health & safety professional, I think these are a great idea. As has already been said, there are much bigger privacy concerns (white boards, poor chart practices).

Also: most of the DNR and No Transfusion patients would have made a choice to do that for non-medical reasons such as personal beliefs (CoC:Scientist for the Transfusions). The only issue I would see is if someone was a DNR, but did not want some family or friends to know that (yes, it happens, guilt is a powerful thing).

Why not put RFID chips into all of the bracelets and then give the staff powerful readers that allow them to see the patient's medical history, needs, and credit card information from across the room.

Wahh... if someone doesn't care about their medical condition they can always tear their armband off. If they don't want to live but don't mind the possibility of a concerned doctor making an effort anyway, they are welcome to tear off their wristband too.

I once found out that a fellow patient I shared a room with was HIV positive because of exactly this type of thing. Luckily, I'm educated enough to know that it's not a concern and I didn't let the other patient find out I was aware, but what if I'd been a troublemaker?

@davere: My grandfather was allergic to penicillin and related drugs. He used to say "I don't want to go to the hospital, they'll kill me!"

I wish I had a job with the joint comission because I'd love to get paid TONS of money to nit pick total bullcrap while people are doing real work. Their concerns about patient confidentiality are often absurd.

@nagumi: That also raises a concern of bias on the parts of some medical personnel. I've seen nurses think twice about blood when they suspected someone was HIV+. This despite all the "universal precautions" training we try to beat into them.

What bothers me is the children trading them. How would some poor overworked nurse even think to check for that?

Also, the whole "family not consulted" thing is a potential problem. It's bad enough now that people don't respect your wishes, or can't find the paperwork. My ex's mother had a heart attack and was without oxygen long enough to cause massive brain damage before they found her. She was put on a respirator for a week expressly against her wishes because no one could find the DNR papers. One look at her, and you knew it was futile. But they had to do it.

My family will throw a fit over my final wishes, I know. I want DNR and to donate myself to the body farm. If they don't do it, I will haunt them.

@chrisjames: How insulting to nurses. The bracelets are just an alert. The absence of a red band would never mean "no allergies" but the presence of one means "Check the chart and ask the patient about allergies".

The primary error that caused the death occurred when the color of the band was chosen.

@EnglishC6H6 is British Benzene: True, though I believe her chart was clearly labelled in big letters (on a red sticker) in order to let staff know so they WOULD take extra precautions. I also found out a close friend in the ward had Hep B. She herself didn't know, but I did because I knew what "HEPB" means on a chart. Now, I wasn't snooping. It was in big letters on a colored sticker, meant to stand out.

@quail: Actually, I really like that idea.

The hospital I work at uses stickers put on the pt ID bracelet to signify this type of thing for example a fall risk is a yellow smiley face sticker, that way the entire staff knows and it is not a privacy issue. We also have plasma screens that code everything we need to know about a pt via icons that makes sense but are not obvious. For example an L next to the room number indicates that the patients needs labs drawn, M, pt has new medication orders, small picture of a heart, pt needs EKG....etc. There are plenty of ways to do it, but uniformity is of utmost importanace because many providers works at a few facilities.

@davere: Demerol is crappy anyway, primarily because of side effects. Morphine is still the standard of pain medications. Nazi scientists invented Demerol as a morphine substitute because they had difficulty getting opium poppies.

Do they have a color that means "Don't Cut off My Dick"??

TJC does a lot of good work for patients. It might seem like they are nitpicking sometimes but hospitals make a frightening number of mistakes every year. When it comes to people's lives (and penises) I don't think it's possible to be too picky.

The worry over privacy but they also worry over whether you get the right treatment when you roll in the ER with chest pain.

@Corporate_guy: the issue being that not every healthcare provider who needs to get the message is a nurse and when a pt is coding you dont want to waste time whipping out a scanner to figure out that they have an allergy to an ACLS drug.

My baby is currently inpatient, long term, being treated for cancer. She is 5 months old, and expected to be hospitalised for the next year. We have been in hospitals most of her life.

At every hospital we've been to, the ID wristbands must be scanned with a 3-prong positive ID before ANY action is taken. That is, the wristband must match up, the room number must match up, and the patient (or for us, parent) must confirm the child's name, DOB and medical number. So, the nurses DO read, TYVM, and DO take the time to be incredibly careful.

But, think practically. Nurses have a lot of patients, urgent steps need to be taken, prioritizing needs to occur. The nurses provide great care to my little one, and anything that helps them do their job, helps my daughter heal. They can do the necessary to ensure they are treating correctly quickly, and get on to helping my baby feel better.

Also, having spent months at children's hospitals (including St. Jude), and spending a lot of time hanging out with kids, I have never seen them trade bracelets. Nor have I seen people eyeballing each other's bracelets to get personal info.

How about changing the whole system of doctors on call and interns and let them get the rest they need.

@padams89:
The problem with that is that every parent/patient figures out the symbols. So it's all the same in the end. I actually prefer symbols/colors over words because I think the reaction time would be better, don't you?

@ironchef: But presumably they are wrapped around a particular wrist, which is attached via various body parts to an identifiable head which a person could direct words or a glance to. Like it says above, I don't think people would want their "Do Not Resuscitate" or "Spastic Colon" status to be broadcast within eyeshot.

This isn't exactly a new trick. Pay attention the next time you go to your doctors office. They'll put you in a room on outside the door they place your chart and there's typically color coded markers they can swing out. It standardizes communications so that the Dr and nurses don't have to verbally communicate.

As for the bands you should be able to show them to any hospital worker that you have on and ask what they mean. If there's confusion theres an issue. If HIPAA regulations don't have an issue with it I'm not going to either.

I hope there isn't a patent on these...I can see the latest tween craze of wearing those bracelets...now, if I can just figure out how to make them and sell them...I could pr0fit! ;-)

If Hospitals were worried about "privacy concerns" then they would make gowns that don't have your ass hanging out for all the world to see.

I wonder how many patients realise that purple "DNR" braclet means "Do Not Resusitate" just before they go into cardiac arrest and try to gnaw it off.

last time i was in the hospital they wrote my medication allergy list on the bracelet. nurses saw my arm a lot more often than they picked up my chart.
[warning - the pic is not pretty: [farm4.static.flickr.com] ] [yes, i have a cameraphone and i was REALLY bored that day]

on the privacy side of things? i was pretty much only able to get within a few feet of the bed unless i went over and unplugged my IV stand and walked it with me but my chart was on the wall at eye level in the doorway [an alcove sort of thing] where it was the very first thing anyone saw walking in.
anyone could have read it from the doorway while i slept unaware. or just walked up and looked at it against my protests while i was attached to the wall via the IV.

doesn't make me panic. while i don't like the government snooping into my stuff, i'd rather have a little less privacy and not have someone accidentally give me penicillin or darvocet. i have to be alive to care about my privacy

RhymePhile: In the field, emergency medical responders will use a black tag to denote someone as "dead, or soon to be" in major multiple casualty incidents (think: bus accident where on the scene triage is required). It's a little macabre. Especially since the symbol on the tag is a stylized shovel/cross.

My rather dark sense of humor enjoys it, but I'm not looking forward to slapping one of those on someone just because I can't get an airway open. :(

@BeeBoo: That validates the point. Color-coding is causing a mix-up.

Okay, the real problem is human error, and redundancy is always the best solution for that. However, the case implies that they're already using the colors to circumvent the redundant information, or that it wasn't indicated elsewhere to begin with.

You can take all sorts of offense at the comment, but still, they must read. Take a little caution when it comes to people's lives. Not even the urgency of crisis is excuse enough to reduce complex health issues to color.

As long as they don't say things like "herpes", or "chlamydia", or "gonorrhea" I think were ok.

Why not just read the patient's chart? That is why patients have charts, right? To tell the nurses and doctors what is going on with the patient. Why not just include all of that on the wrist band that they are already wearing? Seems less complicated. Have some kind of ONE colored sticky note stuck on the chart that has all the allergies and alerts. I like the colored band idea, but if it is going to be confusing they should think simple is better.

@Mr.SithNinja: I doubt many of them, you normally only get a DNR if you request it, and that request is put into writing. They don't just slap it on you because you've coded 3 times in the last week.

@JeremyWayne: I think the idea behind the bands is to simplify things because in an emergency, the personnel may not have time to read the chart to find that sticky note, and let's not forget that sticky notes can be misplaced.

@chrisjames: It's not the color coding that's causing the mix-up, it's the lack of universal agreement on what the colors mean. Imagine if STOP signs came in yellow, red, or blue depending on what county you were in.

Health care professionals frequently work in different settings. In an emergency situation, many of the people involved are not familiar with the patient--they are called to the scene. Having a passing pulmonologist think that a red bracelet means "no transfusions" when it really means "DNR" could cause CPR to be initiated anyway if the DNR sign had fallen off the wall and under the bed and he is wandering down the hallway and hears a patient in respiratory distress..

And yes, in a crisis, you DO want to reduce such complex issues to color and provide instant information. That is the way to reduce error. That is why emergency exit signs are red and yellow means caution.

The bracelets are just a visual alert system, one piece of the puzzle, and they are NEVER meant to convey the definitive instruction or information.

@nagumi: That was my point, we train to "Universal Precautions". Which means "Always assume every bodily fluid is infectious and treat it as such."

I'm trying to get my people to see that Hep. C is really scary crap. I've also had a biologist exposed to tularemia ("Rabbit Fever") which no one expected. HIV is not the only thing out there that should scare the crap out of people, but it's what everyone thinks of.

More Americans die in hospitals than anywhere else...stay away!

I don't think this is a bigger risk to privacy than simply being in the hospital to start with -- nurses and doctors can talk about your private business too loudly or while you're in the hallway, your families can find out things you didn't want them to know anyway, your chart is there for anybody to read, etc. And it seems like a very useful safeguard. As today's penisectomy story made clear, you can't be too careful.

@davere: My own doctor can not even remember what I am allergic to. I have to remind him every time he gives me a prescription.

@theblackdog: What? You don't think people ever change their mind at the last second? ;-) I want to get my hands on some of those and randomly put them on people while they sleep. You can just imagine their reaction when they wake up....