Every time that I have bought a wallet, or received one as a gift, it included a small card for listing contacts to be used in case of emergency.  It was a simple thing to do-that should you ever be ill or injured and unable to provide appropriate information-caregivers or police could look in your wallet to find a contact person to advise of the situation and solicit necessary information.

Contrast that with the recent hubbub over the modern day version of that card, use of three little letters--ICE--in your cellular telephone address book to identify your next of kin or other emergency contact. 

ICE, standing for “In Case of Emergency” was an idea that originated in the United Kingdom as a mechanism to identify who to contact in case of emergency.  This recommendation has spawned significant discussion in the media and on emergency services e-mail lists.

The idea was originally developed by a paramedic at the East Anglian Ambulance National Health Service (http://www.eastanglianambulance.com/) in the United Kingdom as a means by which people with cellular telephones could identify their emergency contact or next of kin to emergency workers in the event that they were unable to provide that information.  The program recommends placing ICE in front of the name of your emergency contact in your cellular telephone address book.  Multiple contacts can be identified by using ICE1, ICE2, etc.  There have been additional modifications that recommend that a punctuation mark (!) be placed in front of the ICE entry to ensure that it will appear as the first entry in the address book. 

The idea took off and gained national attention in the United States after the London transportation system bombings.  National media outlets picked up on the idea and touted it on the six o’clock news or in front page newspaper articles.  On-line EMS discussion groups were soon inundated with messages regarding the pros and cons of using ICE. 

Some thought it was a great idea and were quick to recommend it to anyone that they could. 

However, there were a multitude of ideas offered as reasons not to use ICE, ranging from interference with patient care to the possibility of triggering explosive devices. 

Some EMS practitioners believed that simply putting the concept of ICE out to the public created a potentially false expectation that EMS practitioners would immediately dial an emergency contact.  Others stated emphatically that they believed that checking for an ICE entry in a cell phone would distract personnel from providing care.  Others reversed that thought, stating that their primary concern would be patient care and that they would not bother to check for a cell phone entry.  Some stated that it was not an EMS role to notify the emergency contact, that it was something that should be left to hospital or law enforcement personnel.  Still others argued that there could potentially be HIPPA issues related to using an ICE entry to speak with an emergency contact.  (See www.pwwemslaw.com)

Another idea that made the rounds was that a terrorist could enter a number into their cell phone as an ICE contact that would trigger an explosive device geared to create the greatest possible impact on emergency responders.  Cell phones have been used as triggering devices in the past.  The belief was that rescuers dialing a terrorist created ICE entry could trigger an explosive device aimed to injure or kill the greatest possible numbers of emergency responders.

All of these arguments have valid points, but they overcomplicate a simple idea.

For years, many people have carried emergency contact information in their wallet or purse.  Occasionally these have been used to identify and contact the next of kin in a case of serious illness or injury, when the patient was unable to provide that information, and a caregiver thought to look for the contact information. 

Completing one of those cards was a simple step that provided piece of mind.  There was no expectation of an immediate call to the emergency contact.  There was no concern about the impact to patient care.  HIPPA was never a concern.  Who made the call was of far less concern that ensuring that someone knew where the card-carrier was and what had happened. 

As for the triggering of an explosive device, there are far more efficient, effective  and reliable mechanisms to do the greatest possible amount of damage than relying on someone to locate a cell phone on a victim and dial a specific number to trigger the device.  

ICE, at its most basic, provides the same simple piece of mind that used to be provided by a small piece of cardboard.  It’s the modern equivalent.  It’s just carried electronically in a cell phone rather than tucked in a wallet or purse. 

It provides a mechanism for the general public to carry their emergency contact information.  It gets them thinking about emergency preparedness.  It’s a small degree of piece of mind in uncertain times.

Everyone is entitled to an opinion, but often we make things more complicated than necessary.  We end up--as in the old analogy--“Too busy looking for alligators to think about how to cross the river”.   

ICE is a simple idea.  It’s a simple step that someone can take to ensure that their loved ones are notified if the unthinkable happens. 

It’s nothing more grandiose than that. 

Personally, the first entry in my cell phone address book begins with !ICE followed by contact information for my wife.  Hopefully it will never be used, but it’s there if it’s needed.