By RANDY GRIFFITH
An injured patient’s medical history and current medications can be vital information to trauma workers, but details often are not available.
“Only 15 percent(of the time), do we get all the medication accurate when they first come through the door,” Dr. S. Lee Miller, director of trauma services, said from Memorial Medical Center in Johnstown.
Miller led a study of 234 patients admitted to Memorial’s Level 1 trauma center, comparing accuracy of medication histories obtained in the emergency department with results tabulated by a clinical pharmacist after admission.
Results of the study, published in the Annals of Emergency Medicine, suggest that inaccuracies are common.
But Miller stresses patients have the power to prevent most errors.
“We do a really poor job at getting medication history,” Miller said. “But the problem is not the hospital staff. Most people don’t remember.”
Even if they are conscious and alert, patients often can’t name all their prescriptions, along with the dosage and frequency, he said. Family members usually are even less reliable sources.
“It is not the facility that causes patients’ medication reconciliation errors,” Miller said.
“It is that doctors must rely on the patient or family to have a medication list available with them – which is not often the case,”
Modern technology and convenience complicate the situation because patients rarely have one local druggist to confirm their information.
Many patients use more than one pharmacy, and things such as mail order prescriptions, Internet sales and Canadian drugs complicate the process.
“There is no easy way to find out,” Miller said.
Even patients’ primary care doctors often have no record of prescriptions from the cardiologist or endocrinologist.
“One of the problems we have with in-patients is making sure they get the same medication they have been getting as out-patients,” Miller said.
“The trauma physician never had a relationship with the patient before they come into the emergency room.”
Electronic medical records may help in the future, Miller said, urging the development of a national database.
But in the meantime, patients should become proactive, he said.
“Carry a list of all medications: Yours, your spouse’s and your children’s,” he said. “Keep it updated. Make sure your primary care doctor knows all the medicine you are taking.”
