A transfusion medicine physician in Maryland writes to ask the readership about the practicality of medical alert bracelets for patients with clinically significant antibodies. She writes that they are currently giving wallet cards to patients if antibodies are identified during their hospital stay, and that some patients are requesting medical alert bracelets as well.

She is concerned that having a Med Alert bracelet may hinder the process of receiving blood quickly in an emergency and points out that medical alert bracelets have traditionally been used for life threatening allergies or histories of anaphylaxis. She wonders whether they should be given if the risk is lesser, (as most persons can survive delayed hemolysis). Further, she points out that unphenotyped blood may be the best choice in a true emergency.

She asks whether having a bracelet might make the emergency room physicians think that emergency release blood is out of the question, or if bracelets are a good thing to give out when desired. And, if MedAlert bracelets are used, what information should they have in the limited engravement space? Should it say merely the patient's name and the antibody? Should it clarify that the information is to alert Blood Banks?

She is also wondering why some hospitals have decided NOT to give cards or letters to patients who have common alloantibodies. She asks if this is because they consider antibodies a Blood Bank issue? Is alarming the patient an issue?

Editor's note: The previous e-Network Forum discussion, Informing patients when pre-transfusion testing shows that their blood contains red cell antibodies, is germane to the current topic.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator

W. Tait Stevens, MD
CBBS e-Network Forum Assistant Editor & Moderator