ER pain treatment after accident without ID on the person?

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A nurse practitioner told me that if someone was to be in a bad car accident and is rushed to the ER in critical condition and doesn't have their photo ID on them, that the patient will be denied pain medicine as it's a "federally controlled substance" and they have no photo ID on their person.

This is a hypothetical question, but doesn't sound correct.

Surely if a patient is a serious accident, say, as a passenger, and is rushed in the ambulance with serious enough injuries to place them in the ER to begin with and simply lacks their govt photo ID, that they will not receive pain medicine/pain relief while in the ER. Surely sometimes accidents happen that justify pain medicine or pain IVs while someone is n an ER-- camping trips come to mind where someone might be lacking their wallet/photo ID. They are a USA legal citizen with an SSN, employed, and health insurance, just don't have their photo ID on their person.

Is that true? No pain relief in an ER with a serious injury if you don't have your photo on you? What if the patient doesn't have local family unable to go find the photo ID or the photo ID is unrecoverable after a bad car crash-- they have to suffer in pain in serious condition or critical condition all because pain relief is a federally controlled substance, even in an ER, just because they don't have a photo ID on them?

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Specializes in Pediatrics, Mother-Baby and SCN.

This sounds ridiculous, and I sincerely hope this is not the practice, but I don't work in the US, nor in the ER so I don't know the answer is for you.

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Specializes in OR, Nursing Professional Development.

Any patient who comes in as a trauma or as an ER patient is given identification- a medical record number. Once the patient's name, birth date, and other relevant information is obtained and verified, the patient is no longer known as only a medical record number/John or Jane Doe. Sounds like either that NP doesn't know what they're talking about or is intentionally spreading false information. Not to mention the fact that those who are too young to drive and don't have a passport require emergency medical treatment all the time and do not even have government issued photo ID.

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I have taken my husband to the hospital due to pain. They never asked for a photo id and they never hesitated to give him narcotics for the pain.

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Specializes in Oncology.

Yeah, even if they're intubated and paralyzed- no fentanyl drip for them. They're just going to have to enjoy being paralyzed and feel the foley placement, central line placement, art line placement, and NG placement without analgesia. Just propofol, if they're lucky. That's not controlled.

That NP is nuts and FOS. That's not true.

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Specializes in LTC and Pediatrics.

I have never had to show my photo ID in an ER/ED. Maybe if one is unconscious they will look for it. It has always been my understanding that if you are brought to the ER, you get treated and stabilized first.

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Specializes in Reproductive & Public Health.

Maybe she meant getting a script to go home with? But yeah i cant imagine any scenario where lack of ID would be a barrier to acute pain management in the ED.

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Specializes in AGNP.

I think she was referring to a discharge script for controlled substances. I have heard that being practice to not give scripts for controlled substances without identification

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Specializes in ALF, Medical, ER.

We never check ID before giving scripts for controlled substances. They will need their ID when they get to the pharmacy to pick up the meds. If the name on the script doesn't match the name on the ID they present, then no meds will be dispensed

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Specializes in ER, Med-surg.

That NP was either confused or pulling your leg.

We give controlled substances to John Doe trauma patients as well as people who can tell us their name but have no identification (whether due to age, legal status, having been robbed or lost it in an accident just pta, whatever) all the time. Pain treatment is determined by medical need, not ID status.

I don't think I've ever seen a take-home script denied to a person because of their ID status, either, although if they have no ID they're gonna have a challenging time getting it filled. Generally the take-home scripts written for narcotics in the ED aren't any great shakes- a couple of pills to tide the patient over till they can get to their referral.

The idea of denying pain meds to someone because they don't have their ID is... I'm as opposed to Rx abuse as anyone, but I'd much rather see some seekers get away with scamming the ER out of Norco scripts five tabs at a time than see someone forced to suffer in a misguided attempt to prevent minor diversion.

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Specializes in ER, Med-surg.

Also, "They are a USA legal citizen with an SSN, employed, and health insurance, just don't have their photo ID on their person" is totally irrelevant to receiving emergency care in the US. You can be undocumented, unemployed, and have no health insurance and we're still going to stabilize and treat your emergency condition, ID or no, or face a massive EMTALA violation.

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As others have said, none of the info in your post will keep someone from being medicated in the Ed. It's a medical decision, not anything else.

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