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Who’s Speaking for You When You Can’t Speak for Yourself?

By Elizabeth Carruthers, RN MSN CNOR CBN CHHC

Medical alert identifiers (MAI) are extremely important for the post-operative weight loss surgery (WLS) patient. In WLS, your gastrointestinal anatomy is altered. In emergency situations, it is important that these changes in your anatomy are communicated clearly to emergency medical personnel. Without this knowledge, your rescuers could unknowingly cause more harm than good.

For example, in an emergency, the stomach may need to be decompressed to prevent gastric secretions from entering the lungs. This is usually done by inserting a nasogastric tube (NGT) into the stomach. In the WLS patient, the stomach is fashioned into a smaller pouch. Blind insertion of the NGT could lead to a perforation of the pouch or esophagus. This is a life and death situation requiring immediate surgery and a prolonged ICU stay.

In another example, in the gastric band patient, the port could mistakenly be taken as IV access (i.e. chemotherapy port). Instilling large amounts of fluid through the gastric band port will inflate the band possibly damaging the band and/or constricting the stomach pouch closed. This could lead to secretions being forced upward into the esophagus and becoming a potential source of complications.

Whatever MAI is chosen, the medical alert symbol must be prominently displayed. Bracelets are the most common and come in many designs, styles, and materials (i.e. stainless steel, beads, leather, Velcro). Other MAIs include necklaces and wallet cards. The best place to put a wallet card is behind your driver’s license for quick identification. The basic information required includes your type of WLS, your surgeon’s name, and office number. For additional medical/surgery history, be sure to write “see medical information card in wallet”.


Cell phones are also an important MAI. “I.C.E.” stands for In Case of Emergency. In your cell phone, write ICE in front of your emergency contacts to signify the people you want contacted by emergency personnel. EMTs are trained to look at the wrists and necks for MAIs and are also trained to check people’s cell phones for medical information.

Always remember it is important to be prepared.