For first responders & ER staff

If a patient presents with a wallet card or QR code

1. This is an Advance Medical Directive — it specifies which blood products the patient accepts and refuses
2. The patient wants treatment — this is NOT a DNR
3. Scan the QR code for full details including per-product decisions and special instructions
4. Call the Healthcare Agent listed on the card — they're authorized to make decisions for "Personal Decision" items
5. Note the REFUSES line — these are absolute, legally binding refusals

Key terminology on the card

• "Refuses all allogeneic blood" = no donor blood products
• "Accepts autologous procedures" = patient's own blood can be collected and returned (cell salvage, etc.)
• "Personal Decision" = defer to the Healthcare Agent for this item

What you can do

• Administer volume expanders (saline, Ringer's lactate) to maintain blood volume
• Use tranexamic acid if available and the patient accepts pharmaceuticals
• Apply pressure and standard hemostasis techniques
• Transport to a facility with bloodless surgery capability if possible
• Document the Directive in your handoff report

More detail

• Reading the wallet card — field-by-field breakdown
• Provider guide — for the receiving hospital team