If a non-responsive patient is brought in with ID but no emergency contact card, how does the er find out who to contact? Is there some kind of search they can do based on the driver's license, etc.? If someone is brought in without any ID whatsoever, then what is done? Fingerprints, or something like that?

-- Jennifer M. (jenbird@earthlink.net), February 27, 2001

Answers

I remember one time they had Carter go through high school yearbooks looking for a photo of a teenage boy who'd been brought in. I guess that's one way! I don't know if all states do this, but in my state, they take your thumbprint when you get your driver's license. So if the person's old enough to drive, checking prints might be another way to go.

-- Maureen (shepcaff@ix.netcom.com), February 27, 2001.

I would assume that first they check hospital records, then the phone book and directory assistance. The phone company gives out unlisted numbers for emergencies. There would be a lot of John Does in the short run.

But, the doctor would not do the search. A records clerk is trained to do this and their time is less expensive. Most major hospitals would have a staff that could do this. But, ER does not seem to have this position. It is far more dramatic to have Carter do the searching than Randi, but unrealistic.

-- Zorbo (RDomino1@aol.com), February 27, 2001.

Most pieces of official identification ask you to provide some kind of emergency contact information -- the provincial health plan has this data built in to everyone's health record, so there's at least a place to start. Even without that information, having a name and address (as you would with a driver's license) is good enough to begin looking. There are also a whole host of registries and databases with cross-references, so it's not as hard as you might think.

With ID-less dead people, it's a little different. There's necessarily going to be an investigation; out here, it's the coroner's service who does it, and as a matter of course they take fingerprints and forward them to Ident for analysis. This takes time, though, and relatives and/or friends are usually located either through media reports ("an unidentified man was found.. blah blah blah.. he is described as very hairy, tall, with large feet and a strong woodsy odor"; people see this and call the coroner's office or the cops: "That sounds like my brother Sasquatch, missing for the past two days!"), or through interviewing witnesses at the scene, neighbors, that kind of thing.

The best description of the identification process you're going to find, and probably the most universally true, is in Geberth's Practical Homicide Investigation. Although it doesn't apply to unconscious people who later get better (and who then can tell us who to call), it's useful for understanding the process by which dead people are identified, and their next-of-kin contacted.

It is very rare to have someone who remains a John Doe forever, though it does happen. Zorbo's right in that there are people who work for the hospitals who can hunt down next-of-kin, but it's not a clinical care issue and therefore not something most physicians get involved with.

-- Mike Sugimoto (phloem@fumbling.com), February 27, 2001.

In the pre-hospital environment, at least where I live, the police are very helpful with such things.

-- Lynn (lynn@wordsmyth.org), February 27, 2001.

"my brother Sasquatch..." Mike, I think you have a twisted sense of humor. That must be why I love you so much...

-- (princesslinda15b@netscape.net), February 27, 2001.

well, im not expert, but im thinking this: car accident = license plate, driver's license a kid in school = the school knows a random kid = might have a backpack with schoolwork with name on it, something with a school logo, library card, any sort of jewelry with name on it, clothing might have name on it, etc random adult = adults usually carry ID, but i think this might be the most difficult... just a thought...

-- River (luvwilngrce@yahoo.com), February 28, 2001.

River, in the situation mentioned above, where Carter used the yearbook (and misidentified the victim), schools were closed (he got the yearbook from a custodian, I think) and the student didn't have ID because he'd been going to play sports (basketball, I think). It was a case where there wasn't much to go on. I believe he was a hit and run victim, however, and in reality I'd think the police would search for next of kin, not the ER. But that wouldn't be nearly as interesting and this is TV...

-- Diana (dilynne@juno.com), February 28, 2001.