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Not vaxing and the ER - Page 2

post #21 of 41
Thread Starter 

Regarding electronic records, is it not a privacy issue? Do hospitals have to right to look up your vax (or any other medical) history without your or your doctor's consent? Perhaps I can see the necessity in the case of certain illnesses, but in an unrelated visit such as what I had, if electronic records were available, would they have the right to look up vax history "just because"?

post #22 of 41
Quote:
Originally Posted by Chloebelle View Post

Regarding electronic records, is it not a privacy issue? Do hospitals have to right to look up your vax (or any other medical) history without your or your doctor's consent? Perhaps I can see the necessity in the case of certain illnesses, but in an unrelated visit such as what I had, if electronic records were available, would they have the right to look up vax history "just because"?


To my understanding, yes, it will all be available. I think there are some privacy concerns being voiced, but mostly I've just heard the advantages being aired. This is the link from the gov't. The first paragraph reads:

 

Physicians will have access to their patient's complete medical information including medical history, medication profile, lab test results and immunization history, from their EMR.

 

http://www.health.gov.bc.ca/ehealth/emr_gov_physicians.html

post #23 of 41

Tetanus is typically only a concern when there is a puncture wound, not just a cut or abrasion (otherwise everyone who isn't vaccinated or who hadn't been vax'd in a while would be getting it).  Also young children (in developed countries) are one of the groups least likely to contract tetanus (unlike the elderly) b/c their bodies are more efficient about getting rid of the spores/bacteria.  Plus if the wound isn't deep & gets adequate medical care, the spores most likely never have a chance to germinate or the bacteria don't multiply.

 

I would contact my pediatrician (who supports my vax decisions) before I went to the ER, unless my child wasn't breathing or in another life-threatening situation & discuss the symptoms & vax situation with him 1st.  Then I think I would only disclose DS not being vax'd if the illness/injury/symptoms warranted it, otherwise whether or not my child is vax'd is irrelevant.

post #24 of 41
Quote:
Originally Posted by Annie Mac View Post





Chloebelle, you absolutely have no reason to lie. In BC, there is no law requiring you to vax your kids -- for school, for daycare, nothing. If the nurse disagrees with you, whatever. It's not her place to give an opinion, and you can tell her that. A PP mentioned that lying could result in a misdiagnosis, ie tests not being run for a vpd & I would agree with that. Since there is no risk to telling the truth, and there might be a risk to lying, the choice is obvious.



I agree with this.  I live in New Brunswick and have been to the ER several times with my unvaxxed 3 year old and they have never asked about vax.  But I did cut my finger a while back and of course they brought up tetanus and if I was up to date.  I was 100% unconcerned that I was at risk for tetanus and I haven't had a shot in over 10 years so I asked the Dr.  "are you concerned that this cut is at risk for tetanus?" and he said no.  So I said that there was no reason to even talk about tetanus and that was that.  I don't think I would feel comfortable lying about vaccines.  We chose this path and have to deal with the crappy attitude people give us sometimes. 

 

post #25 of 41
Quote:
Originally Posted by awallrising View Post

I would contact my pediatrician (who supports my vax decisions) before I went to the ER, unless my child wasn't breathing or in another life-threatening situation & discuss the symptoms & vax situation with him 1st.  Then I think I would only disclose DS not being vax'd if the illness/injury/symptoms warranted it, otherwise whether or not my child is vax'd is irrelevant.


This sounds like a solution for a perfect world. Where I live in New Brunswick I can't even find a family Dr. accepting new patients, let alone one who supports my choices. I have to use the ER as a family Dr. sometimes greensad.gif.
post #26 of 41


Quote:

Originally Posted by Marnica View Post

I actually kind of disagree with this. In certain scenarios, lying would increase the chances of an MD missing a proper diagnosis. For example, if you took your child to the ER for lethargy, sudden onset of high fever and a rash and neck stiffness, but told them that they were fully vaccinated, a doc might me inclined to rule out meningitis (even though there are dozens of strains of bacteria and viruses that can result in meningitis) without doing proper testing. On the flip side, if you tell them that a child is unvaxed, they often want to do unneccesary testing ( even if the evidence does not point to that diagnosis. ie high fever, lethargy and no rash or stiffness) I don't think vax status should be a part of differential diagnosis, but unfortunately it is sometimes.

 


 


I need to second this.  Even though it is likely that vaccine status is totally irrelevant, I do not want to lie to a doctor ever. What if vaccine status DOES become an issue at some point and you have to explain how you lied the first time you were asked?  You have not only lost all credibility with the doctors, but you are now risking your child's health. It might be uncomfortable, but I strongly believe that honesty is the ONLY policy.  We are making the decision to delay and possibly never vax based on real risks not junk science.  If I was not certain of that, I would have made a different choice.  I will convey that we have made our decision and that if they want more information they can get in touch with our ped, who supports our decision. 

 

post #27 of 41
Thread Starter 

It's not the doctors I'm worried about. It's those admitting nurses who take your information and give you the 3rd degree about vaccinations when you're there with a child who has a candy up their nose or a cut on the head. Do I really need to go through that??? Both doctor's I encountered in the ER had been kind and friendly and if for any reason they asked about my children's vaccine history, I would have felt a heck of a lot more comfortable discussing my decisions to not vax with them as opposed to grumpy nurses who look at me like I'm a child abuser. 

IDK, honestly, if there's a next time, I'd probably just say "yes" when they ask if the vaxes are up to date... unless I'm in the mood for an argument :)

post #28 of 41

I posted this on an earlier forum, but thought I'd pass it along here:  My son was injured as a 2yo.  His toe was smashed- broken bone with an open sore.  Since there's a relatively high chance of a bone infection in the case of a bone break with an open sore, the MD was very concerned that he was unvaxed, specifically against tetanus.  She basically scared the crap out of me, saying that if we didn't give him the vax right away, she could end up having to remove his toe or even his whole foot.  So I said OK, let's do just the tetanus.  Then she started in with how they have to give the combo shot, and additionally an extra immune booster shot since he didn't have any other vax's floating around in his system.  I told her I was uncomfortable with that and I'd have to talk to the ped first.  Long story short, the ped was thoroughly unconcerned about there being any chance that he'd been exposed to tetanus, we never vax'd, and he's fine.  So just be aware that with open wounds there's a chance of getting pushed to get that shot.  Also a good idea to know how prolific tetanus is in your area (I live in AZ where there have been a handfull of cases over the last decade, and all of those people had had contact with cow manure).

post #29 of 41
Quote:
Originally Posted by Chloebelle View Post

Regarding electronic records, is it not a privacy issue? Do hospitals have to right to look up your vax (or any other medical) history without your or your doctor's consent? Perhaps I can see the necessity in the case of certain illnesses, but in an unrelated visit such as what I had, if electronic records were available, would they have the right to look up vax history "just because"?



I always thought health records would be private. I found out when I had an ectopic pregnancy in the hospital and was referred to a cardiologist because of some issues afterward that they were able to access my records electronically. I questioned them about how they were able to do that without my consent. I guess they don't have to ask your consent.

post #30 of 41

Digital files make it very easy to access EVERYTHING esp when your ped or dr is associated with the hospital.
 

Quote:
Originally Posted by TonyaW View Post





I always thought health records would be private. I found out when I had an ectopic pregnancy in the hospital and was referred to a cardiologist because of some issues afterward that they were able to access my records electronically. I questioned them about how they were able to do that without my consent. I guess they don't have to ask your consent.



 

post #31 of 41

Great advice! I have always worried about the ER room. I had just planned on saying, "No, I don't shoot neurotoxins into my child...thanks for asking."   orngtongue.gif

post #32 of 41
Quote:
Originally Posted by Magali View Post
But I did cut my finger a while back and of course they brought up tetanus and if I was up to date.  I was 100% unconcerned that I was at risk for tetanus and I haven't had a shot in over 10 years so I asked the Dr.  "are you concerned that this cut is at risk for tetanus?" and he said no.  So I said that there was no reason to even talk about tetanus and that was that.


I like this approach more than anything I've seen thus far. I've wondered/worried about this question, and admitting to not being "up to date" on vaccines worries me just as much as lying about it does. Honestly, if DD were totally on schedule, I would hate this question anyway. Unless the question was "did your child receive a vaccine within the last 72 hours" or something (if a reaction is a possibility), it simply should not be part of the diagnostic process. Meningitis should not be ruled out if my child has been vaccinated, nor should it jump to the list of "most likely" if she hasn't. It should be all about the symptoms.

 

But asking a question in response seems like a potentially reasonable strategy.

 

I take DD in for stitches... they ask if she's up to date... my answer: "Are you concerned about tetanus?"

I take DD in for high fever and listlessness.... they ask if she's up to date... my answer: "Are you concerned about meningitis?"

etc

Now this won't likely allow me to duck the question, and I'm ok answering honestly. But I like the idea of asking because it opens the lines of communication. If I just say "no she's not" then they'll just decide whatever the hell they want to decide - order lumbar punctures or whatever. But if I say "are you concerned about meningitis" then it's a discussion. They could make a case for why they are concerned, and maybe I'll see their point. Or maybe it will just be BS and I have a better chance of dealing with it then. It's not perfect, but nothing is, and I just like the idea of making it a discussion rather than just an "opportunity" for the doctors.

post #33 of 41


clap.gif

Quote:
Originally Posted by seashells View Post





I like this approach more than anything I've seen thus far. I've wondered/worried about this question, and admitting to not being "up to date" on vaccines worries me just as much as lying about it does. Honestly, if DD were totally on schedule, I would hate this question anyway. Unless the question was "did your child receive a vaccine within the last 72 hours" or something (if a reaction is a possibility), it simply should not be part of the diagnostic process. Meningitis should not be ruled out if my child has been vaccinated, nor should it jump to the list of "most likely" if she hasn't. It should be all about the symptoms.

 

But asking a question in response seems like a potentially reasonable strategy.

 

I take DD in for stitches... they ask if she's up to date... my answer: "Are you concerned about tetanus?"

I take DD in for high fever and listlessness.... they ask if she's up to date... my answer: "Are you concerned about meningitis?"

etc

Now this won't likely allow me to duck the question, and I'm ok answering honestly. But I like the idea of asking because it opens the lines of communication. If I just say "no she's not" then they'll just decide whatever the hell they want to decide - order lumbar punctures or whatever. But if I say "are you concerned about meningitis" then it's a discussion. They could make a case for why they are concerned, and maybe I'll see their point. Or maybe it will just be BS and I have a better chance of dealing with it then. It's not perfect, but nothing is, and I just like the idea of making it a discussion rather than just an "opportunity" for the doctors.


 

 

post #34 of 41

Accessing the EMR of a patient under my care requires no consent from anyone. The EMR is there so that he medical professional admitting you or caring for you has the "global picture" of your health history. We have to take many things into consideration when providing care for patients and having acess to their entire medical record is of great importance if we want to treat them appropriately.


Edited by PediNP - 3/18/11 at 11:51am
post #35 of 41
Quote:
Originally Posted by PediNP View Post

Accessing the EMR of a patient under my care requires no consent from anyone. The EMR is there so that he medical professional admitting you or caring for you has the "global picture" of your health history. We have to take many things into consideration when providing care for patients and having acess to their entire medical record is of great importance if we want to treat them appropriately.



Do you tell the patients what records you're accessing in order to make decisions, so that the patient can correct any errors, or do you just assume the records are correct?

post #36 of 41

Hubby answered sincerely once when we were at the ER. Said we didn't vax and the doc gave the run around. He practically interviewed us over why we would possibly think vaccines could be harmful. And told us that we were wrong. So, honestly, at the ER, where you don't know how they will react - if they ask if we are up to date, I prefer to just say, "Yep." Because we are up to date on all the vaccines I ever intend to give my children. (AKA none) LOL

My family practice doc knows we don't do vaccines and is totally cool with it. I'm so happy to have him around. 

post #37 of 41

.  


Edited by member234098 - 6/10/12 at 4:25pm
post #38 of 41



Edited by member234098 - 6/8/12 at 8:55am
post #39 of 41
Quote:
Originally Posted by miriam View Post





What were you in the ER for in the first place?  Was the question even pertinent?  I have been asked that when I took my boys in for a broken bone; unless the bone is protruding from the skin, vaccine status is virtually irrelevant.  The doctor was wasting your time in an emergency situation.  I am sure the doctor had other patients waiting for care.  I would have reminded the doctor of this fact and the fact that this was not the place to change my mind or his regarding vaccinations. 



I was in the ER because my youngest was puking and had diarrhea off and on for a few weeks and I wanted to figure out what was up. So, I don't feel the question with the vaccines was very relevant in that situation - like with the situation you described. If I don't feel the info is relevant next time, I will just say yep, when asked if my kids are up to date as it really isn't their business unless it's relevant. 

post #40 of 41

I have always been honest about my kids' vaccine status. Our oldest only had two rounds of DTaP starting at 18 months and then I just never went back for more. We had a lot of trouble with our family doctor and I finally went somewhere else.  When they asked about vaccines I simply said "it's against our beliefs" and they left me alone. They ask every time I go in and I just say the same thing. No hassle. And they've been very nice. I've had the same experience in the ER. My middle child tipped over the kitchen stove on himself (yikes!!) and I thought he was in serious trouble. When the doctor asked about shots I said no, we don't vaccinate and started to explain and she stopped me. She didn't ask any more questions, for which I was very grateful. Last summer my middle child (seems like he's always the one getting hurt) was running around barefoot in the yard and cut the bottom of his foot open. It was a pretty decent cut and bled like crazy. I cleaned it and covered it and showed the doctor when I took my son in. He saw that it was clean and didn't say a word about a tetanus vaccine (my heart was pounding because I am still a little scared of tetanus and I thought they would talk me into giving him a shot). Now I am worried about school as my oldest will be starting next year. But as for the ER, we have had no problems and I prefer to be truthful for the same reasons as others have posted when it comes to diagnosing what is wrong.

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