Identity Crisis


Blake Vaughan describes her job as “kind of like the ER detective.”

Her formal title is emergency department crisis specialist at Cedars-Sinai Medical Center. But sleuthing is a big part of her job.

A registered nurse, Vaughan deals with trauma patients admitted to the bustling emergency department, offering personal support, including notification of relatives.

But it’s when the patient is unconscious or confused and unable to communicate that the detective work begins.


“The focus of everyone else is medical stabilization, and my focus is to make sure someone knows the patient is here,” she said. “You go through the gamut to find someone to call. You check their pockets, their wallets, you call the bank, the credit companies, any clues you have.”

And even when the patient might have a wallet loaded with cards, including a driver’s license--the state’s official identity document--it may not produce the bit of information she needs.

“We need to know, who knows you? The police can start at a home address, but what if the person lives alone?”

This is increasingly a problem for many people working in urban hospitals where neighborhoods are changing, common roots have disappeared and many languages may be spoken.


Armed with proper identification, patients not only could be identified but also receive better medical treatment from emergency workers. Are there preexisting medical conditions that the hospital should be aware of, such as pregnancy or heart problems? Is the patient allergic to certain medications? Is the patient under a physician’s care or on medication?

Vaughan, who works with a beeper and a cellular phone, has followed up on clues as slim as an e-mail address, which turned up a fiance in Florida, and a telephone number, which produced some relatives in Mexico. And so far, she has always been successful in locating a family member.

“I’m pretty diligent,” she said. “I keep going, although sometimes it takes several hours.”

The job would be a lot easier, says Vaughan, if everybody carried a simple card with two basic bits of information: their name, and a name and number for notification in case of an emergency.


“That’s the little card that comes in new wallets, and most people throw it out,” she said. “If they would just fill it out and keep it updated, that’s just a small thing that makes a very big difference.”

Other emergency room staffers agree, noting that well people could learn from those with medical conditions, such as diabetes, who have learned to wear identification that can save their lives in an emergency.

“We’d like to see everyone wearing that information,” said Kim Jones, manager of emergency services at Huntington Memorial Hospital in Pasadena, also a trauma center.

“There are companies who make ID bracelets as well as wallet cards, but I don’t see them as often as I would like. And finding someone to call can take a lot of investigation. Sometimes we don’t find out who that person is until the family reports them missing.”


Jones recalled a recent case of a man who had been out walking and suffered cardiac arrest. He died and wasn’t identified until his boss started calling hospitals.

“We had to tell his parents three days later,” she said. “If we had known, we could have called right away.”

The temperate climate of Southern California, which encourages a year-round surplus of joggers, roller-bladers, bikers, hikers and dog walkers, also produces accidents--and victims with no ID.

“No one wants to think about an emergency when they leave home, but let’s face it--things happen,” Jones said.


Children, with their tendency to get banged up or lost, are especially vulnerable, she said. Her 10-year-old son has a wrist ID with a skateboarder on it.

“He thinks it’s cool--the schools put out ads for all kinds of designs. It’s only $7, and it might save your kid’s life,” Jones said.

Emergency room workers will be the first to acknowledge that any identification, short of a body tattoo, can get lost. Wallets get separated, clothes and jewelry may be torn off, and the card tucked in a pocket can disappear.

Nevertheless, an ounce of prevention could save a lot of ER detective work. And a shopper might be surprised to learn that the medical ID market, once limited to a clunky dog-tag pendant, has blossomed with a variety of new ID forms and technologies that can be tailored to age, need and lifestyle.


“I created an upscale line because people didn’t want jewelry that screamed out, ‘I have an illness,’ ” said Linda Sweedler of San Diego. Her fine-jewelry Goldware line includes bracelets and pendants in 14K gold (which starts at $185) and sterling silver ($30 and up).

Necklaces, bracelets and anklets also come in less expensive materials. Leather key chains are coupled with silver medical IDs and tags that attach to sneaker laces, which are suggested for joggers and bikers as well as children, who never carry identification.

That was why Lauri Johnson of Canton, N.C., created her Identi-Find iron-on clothing labels in 1984. Her grandson was 3 then and “liked to play hide-and-seek in department stores,” she said. “We received a notice to renew our dog tags, and I realized that we label everything, even our luggage, and we should do the same with our loved ones.”

On the high-tech side, Steve Landsman, president of ID Technology Inc. in Baltimore, has substituted laser imaging technology for the traditional engraving (“it’s more permanent”) on his necklace, key ring and tennis-shoe tags. And because some people don’t want to wear any jewelry, he has created a very thin malleable metal ID that “molds itself right around your watchband.”


Noting that about 450,000 people are brought into emergency rooms every year unconscious and without identification, Jeff Haber, president of SOS America in Massapequa, N.Y., said there is a large need for IDs. His company makes a crush-proof, fireproof, waterproof compact capsule protecting a 12-inch accordion-folded, non-soluble paper stripe that provides emergency medical facts and personal information that can be updated.

“We named ourselves SOS to encourage everyone to participate,” he said. “It just makes sense for all people to carry ID with them 24 hours a day.”