Emergency Medical Information Sheet: What Paramedics Look For

An emergency medical information sheet is one page that answers the questions a paramedic asks in the first few minutes: who this person is, what conditions they have, what they take, what they're allergic to, what's normal for them, whether there's a POLST or DNR (and where it is), and who to call. For an older parent, the line most blank forms leave out is the baseline: how they usually think, talk and move, so a crew can tell what's new. Post it on the fridge, keep it to one page, and update it the day a medication changes.

Below is the order EMS crews work through on arrival, the exact fields to put on the page, what to leave off, and how the sheet differs from a POLST or DNR, which is a separate official form.

What paramedics ask when they walk in

Crews don't ask questions in a random order. Many work from a standard history checklist called SAMPLE. The National Model EMS Clinical Guidelines, written by the National Association of State EMS Officials (NASEMSO) for states and local agencies to build their protocols on, list it in their universal care section:

• Symptoms
• Allergies: medication, environmental and foods
• Medications: prescription and over the counter, and bring the containers to the ER if possible
• Past medical history, including looking for medical alert tags, portable medical records and advance directives, and for devices such as a pacemaker, insulin pump or dialysis access
• Last oral intake
• Events leading up to the 911 call

Notice the phrase "portable medical records." That is what this sheet is. The same guidelines also tell crews, for a possible stroke, to pin down the time the person was "last known well" and whether they take warfarin or any other blood thinner. For confusion, fainting, seizures or stroke, crews are told to bring the witness along or get a phone number the ER can call.

Your parent may be able to answer all of this on a good day. On a bad one, they may be short of breath, frightened, or not making sense. Henry County, Virginia's public safety department asks the hard questions on its EMS patient information form page: if you're having a hard time breathing, or having stroke symptoms, will you be able to tell the crew your medications, allergies and conditions? And if someone lives with you, will they be calm enough to find it?

Why "baseline" matters so much for an older parent

None of the county forms we looked at has a line for this, and it's the one thing families know better than anyone.

NASEMSO's guideline for altered mental status lists, as key considerations, the history from bystanders and caregivers and the person's "baseline functional status." In plain terms: is this confusion new, or is this how Dad always is?

A paramedic meeting your mother for the first time has no way to know whether she normally balances her checkbook to the penny or normally isn't sure what year it is. That matters because of delirium, which the American Geriatrics Society's Health in Aging tip sheet describes as a sudden change in mental status that can start within a few hours.

Family is the best detector. A 2018 Health in Aging summary of a review in the Journal of the American Geriatrics Society reported that caregivers are generally able to spot delirium symptoms more easily than health care professionals who don't know the person. The sheet carries that knowledge into the room when you aren't there.

So write the baseline down, in a sentence or two a stranger can use. These are made-up examples, to show the level of detail:

• "Fully oriented and chatty. Pays her own bills. Any confusion is NOT normal for her."
• "Mild dementia. Knows family by name, sometimes unsure of the date. Calmer if you sit down to talk with her."
• "Walks with a cane indoors, walker outside. Can't manage stairs alone since spring."
• "Very hard of hearing in the left ear. Wears hearing aids; speak on the right side."

Mobility matters for the same reason. The CDC's stroke warning signs include sudden weakness on one side and sudden trouble walking or keeping balance, and the CDC asks you to note the time symptoms first appear. A crew can only call weakness "sudden" if someone tells them what normal looked like.

The exact fields for the one-page sheet

This table pulls together what NASEMSO's history covers, what local EMS forms ask for (Henry County, Virginia; Albuquerque Fire Rescue's Vial of Life form; Fountain Valley, California's paramedic information sheet), Sunstar Paramedics' guide to preparing for an emergency in Pinellas County, Florida, and the Mayo Clinic's list of emergency health information to keep.

Two things the table can't show. First, put the things that change the treatment in the top third of the page: allergies, blood thinners, devices, code status pointer and baseline. Second, Albuquerque Fire Rescue asks people to fill out its form in English, because first responders will be the ones reading it. If your parent's first language is another one, write the sheet in English and note their language in the language field.

If the medications won't fit, don't shrink the type to a size nobody can read. Point to the attachment in the medication row and staple a full, dated medication list behind the sheet.

What to leave off

A sheet on the fridge is readable by anyone who walks into the kitchen: the plumber, a new aide, a neighbor's teenager. Some county forms still ask for things that don't belong there. Henry County's form and Albuquerque's both have a box for a Social Security number, and Henry County's form also says it is up to each person to decide what to put on it.

Leave these off the posted copy:

• Social Security number. Nothing in the SAMPLE history needs it, and it's an identity theft risk on a page anyone in the kitchen can read. If the hospital asks for it later, a family member can give it.
• Medicare and insurance ID numbers. Medicare.gov says to protect your Medicare Number like a credit card and give it only to health care providers, insurers and plans, or trusted Medicare helpers such as a State Health Insurance Assistance Program counselor. Write the plan names on the sheet and keep copies of the cards in the binder or the ER envelope.
• Bank or account numbers, passwords, PINs. None of them help a crew.
• Where the spare key is hidden, or the alarm code. A sheet that says "key under the blue pot" is a note to burglars.
• A paragraph of history. The appendix from 2009 can live in the binder. One page means one page.

Henry County's form has a nice touch: it folds over with the person's name on the outside, so the health details stay covered until someone needs them. You can do the same with any sheet.

How the sheet differs from a POLST or DNR

Here's the mix-up that matters most. Your sheet is not a medical order. Writing "DNR" on it does not make a crew withhold CPR.

The National Institute on Aging explains that an out-of-hospital DNR order alerts emergency personnel to someone's wishes outside a hospital, and that POLST and MOLST forms are medical orders health care professionals can act on immediately in an emergency. NIA suggests talking with a doctor about advance directives, and checking with your state health department about whether POLST forms are available where your parent lives. Either way, the order comes from a clinician, on a form the state recognizes.

States are strict about this. Texas's health department, in its guide to honoring an out-of-hospital DNR order, says EMS can only honor a properly filled out out-of-hospital DNR order or a DNR ID device (Texas also accepts valid DNR forms from other states). EMS won't consider other written documents, even ones from a doctor; the crew will contact its medical director and start emergency care. The Texas DNR FAQ adds that paper copies count like originals, but a photo of the form on a cell phone is not an acceptable substitute. NASEMSO's model guidelines likewise list conforming to the state's specifications among the checks for a valid DNR or POLST.

Other states have their own forms and rules. Our guide to the POLST form covers what it is, who signs it and what each state calls it.

What the sheet does is point. The National POLST organization says to keep the POLST at home in a visible place, such as on the refrigerator, beside the bed or in the medicine cabinet, because emergency personnel look there, and to tell family where it is. So the code status line on your sheet should say exactly where the real form is, or say plainly that there isn't one. "Unknown" is an honest answer too, and a reason to ask your parent's doctor.

Is there an official emergency information form?

For children, yes. The American Academy of Pediatrics and the American College of Emergency Physicians developed an Emergency Information Form for children with special health care needs, a way to pass a child's critical health information to emergency physicians. The current version was developed alongside revised joint AAP and ACEP policy published in March 2023.

For older adults, there doesn't appear to be a national equivalent. ACEP's advice for the public is general: its ER checklist says to fill out medical history forms (conditions, allergies, medications, doctors), keep up-to-date copies at home, in the car, in first aid kits and in the wallet, and suggests seniors keep theirs in the refrigerator, where EMS staff know to look.

What you will find is local forms. Many county EMS agencies, fire departments and sheriff's offices hand out their own, often as a Vial of Life or File of Life kit. If your parent's county has one, use it, since local crews know the format. Then add the baseline and mobility lines in the margin if the form has no room for them. Our guide to the Vial of Life covers where kits come from and how the door decal works.

Where to post it

The fridge first. ACEP, Henry County, Fountain Valley and the File of Life programs all point there. Put it on the front of the door at eye level, not under a pile of grandkid drawings.

Then a few more copies:

• A copy that can leave with the ambulance. Henry County suggests making two copies, one to travel with EMS and one to stay at home. An envelope clipped beside the fridge copy works.
• Wallet or purse. ACEP suggests it; a folded copy goes wherever your parent does.
• The binder or grab bag. Keep one with the papers you'd take to the hospital. Our list of what to bring to the ER for an elderly parent covers the rest of that bag.
• Your phone. A photo or PDF lets you read the medication list to a nurse from three states away. It does not replace a paper DNR copy where your parent's state wants paper.

Some families also tape a small note by the front door that says "Medical information on fridge." That's a judgment call. It helps a crew, and it also tells every visitor where to look. Fold the sheet, name side out, either way.

A sheet nobody knows about is only half a sheet. Mention it to whoever might be first through the door: a sibling who lives nearby, the aide who comes on Tuesdays, the neighbor holding a key. If your parent lives alone, the sheet belongs in the same plan as the key holder and the daily check-in; our emergency plan for a parent living alone walks through that.

Keeping it to one page

One page is a design choice, not a rule from EMS. It's what a paramedic can read standing in a kitchen. A few ways to hold the line:

• Short phrases, not sentences, except for the baseline.
• List current conditions; leave settled history (that tonsillectomy) for the binder.
• Name contacts once. If your brother is both health care agent and emergency contact, write him once and label him as both. Our emergency contact list for seniors has the fuller version for the house.
• Move overflow to attachments: the medication list, a copy of a recent EKG if the doctor gives you one (Albuquerque's instructions suggest adding an EKG copy), and nothing else.

When to update the sheet

A crew has no way to know the sheet is stale. They will read whatever dose is printed there, which is why the date at the top matters.

Henry County's form tells people to update it whenever there's a change in medication, medical history, power of attorney or DNR. Madison County, Virginia's EMS agency suggests updating and reviewing its File of Life form every six months. A workable routine:

1. Update it the same day anything changes: a new prescription, a stopped one, a dose change, a new diagnosis, a new doctor.
2. Redo it after every hospital stay or ER visit, using the discharge medication list.
3. Review the whole page every six months, say when the clocks change in spring and fall.
4. Change the date at the top every time.
5. Replace every copy, including the wallet and the envelope, and throw out the old ones.

Step 5 is the one that slips. Three copies with three different medication lists is a mess for whoever finds them.

When you're the one standing there

If you're in the kitchen when the crew arrives, hand them the sheet and add the one thing it can't hold: when your parent was last their usual self, as a clock time. "She was fine at 12:30, we talked on the phone" is far more useful than "earlier today," and it's the "last known well" time NASEMSO tells crews to pin down for a possible stroke. Then grab the pill bottles if you can, since the guidelines ask crews to bring containers to the ER.

The sheet gets your parent treated. Whether the hospital will discuss their care with you over the phone later is a separate question, and the answer often depends on a HIPAA authorization for your parent, and that's easier to sign on an ordinary weekday than in a waiting room.

Frequently asked questions

What information do paramedics need about an elderly person?

Name and date of birth, current conditions, medications with doses (especially blood thinners), allergies, implanted devices, what's normal for them (thinking, speech, mobility), whether a POLST or DNR exists and where it is, emergency contacts and the health care agent, doctors and pharmacy, and insurance plan names. For a possible stroke, they also want the time your parent was last known well.

Should I write "DNR" on my parent's emergency information sheet?

Only as a pointer, such as "POLST: original on fridge, copy in her purse." The sheet itself isn't a medical order, and EMS follows the official form your parent's state recognizes, signed by a clinician. In Texas, for example, EMS only honors an out-of-hospital DNR order or a DNR ID device, not other papers, and not a photo on a phone.

Where should an elderly person keep emergency medical information?

On the front of the refrigerator, where EMS crews know to look, with a second copy ready to go with the ambulance, a folded copy in the wallet, and one in the binder or ER bag. Tell family, neighbors and aides where it is.

Should a Social Security number go on an emergency medical form?

Leave it off the posted copy. Paramedics don't need it to treat your parent, and anyone in the house can read a sheet on the fridge. Some county forms do have a box for it; you can leave that box blank.

How often should an emergency medical information sheet be updated?

The same day a medication, diagnosis, doctor or legal document changes, after every hospital stay, and at least every six months. Put the date at the top and replace every copy.

Getting the page made

You can build this sheet yourself with the table above, your parent's pill bottles and a phone call to the pharmacy. Or let Emergency Binder Now do the organizing: about 25 minutes of guided questions, and it builds a printable binder for your parent from the answers. Page 3 is a one-page Emergency Information Sheet to hand to paramedics or the ER, and anything you skip shows up later as something still to find. See a sample binder to check the sheet against this list.

This is general information, not medical or legal advice. EMS protocols and DNR and POLST rules vary by state and county, so check with your parent's doctor and local EMS agency, and ask their doctor or pharmacist about anything to do with their medications.