Let Vero draft the letter.
Vero drafts the emergency care letter from your review visit, in your template, with the baseline and plan you discussed. Check every dose and number, then export it to PDF or Word for the patient to carry.
Emergency Care Letter Template
An emergency care letter tells an emergency team, on one page, what to do first for a patient with a complex or rare condition. Copy the template, see a sickle cell and an adrenal insufficiency example, and check what the guidelines say about first doses and timing.
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- Word and text downloads
- Two filled examples
Blank emergency care letter template
FreeEMERGENCY CARE LETTER For the emergency team: please read this before treating. [Practice or clinic name] [Address] [Phone] Written: [Date] Review by: [Date, no more than 12 months from now] Patient: [Full name] Date of birth: [Date] Weight: [Weight, if doses depend on it, and the date measured] CONDITION [Diagnosis and type, named with the patient's agreement] Other conditions that change emergency care: [None, or each one] USUAL BASELINE Vital signs: [Usual blood pressure, heart rate, and oxygen saturation on room air] Blood tests: [Usual values that matter in an emergency, with the date of each] Function: [What the patient usually manages, and how they communicate] WHAT USUALLY BRINGS THEM IN [The emergencies this patient has had, and what tends to trigger them] Warning signs: [Signs that point to a more serious complication, and what to do] WHAT TO DO FIRST [First treatment: drug, dose, route, and how soon] Then: [What to reassess or repeat, how often, and what to check alongside treatment] PLEASE AVOID [Drugs, procedures, or delays that are unsafe for this patient, and why] MEDICINES AND ALLERGIES Current medicines: [Each drug, dose, and frequency] Allergies: [Drug, and the reaction, or none known] DEVICES AND IMPLANTS [Each device, where it is, and any limits on access or imaging, or none] WHO TO CALL Specialist team: [Service, and daytime phone] After hours: [24-hour route, such as the specialist on call through the hospital switchboard] Family physician: [Name and phone] Emergency contact: [Name and phone, if the patient wants one listed] This letter shares what we know about [patient name] to help you act quickly. It doesn't replace your own assessment. The patient carries a copy and keeps one on their phone. [Your name, credentials, specialty] [License or registration number] [Signature]
Use it for
- Sickle cell disease
- Adrenal insufficiency
- Rare metabolic diseases
- Implanted devices
- Travel away from home
Two filled examples. Every part, filled in.
Each one follows the template. Use them to judge how much detail every part needs.
Emergency care letter: adult with sickle cell disease
Hematology clinic, written at the yearly review; the patient carries it
Patient and dates
26-year-old woman, weight 60 kg. Written on Wednesday, October 14, 2026, at her yearly review. Review by October 2027, or sooner if her treatment changes.
Condition
Sickle cell disease, HbSS. Named with her agreement, so triage staff know at once. No other long-term conditions.
Usual baseline
Hemoglobin 82 g/L (8.2 g/dL), reticulocytes 8%, creatinine 48 µmol/L (0.54 mg/dL), all on October 14, 2026. Oxygen saturation 96% on room air, blood pressure 104/62, heart rate 84. Fully independent; works full time and drives.
What usually brings her in
Pain crises in her lower back, hips, and thighs, about 3 times a year, often after a cold or a day without enough to drink. One episode of acute chest syndrome, in 2023.
What to do first
Treat her pain as an emergency: start analgesia within 30 minutes of triage, or 60 minutes of arrival. For severe pain, give an IV or subcutaneous opioid, with the dose based on the short-acting opioid she has taken at home in the last 24 hours; she logs it on her phone. Hydromorphone has worked best for her. Reassess every 15 to 30 minutes and re-dose until her pain is controlled, considering a 25% increase in the dose if it isn’t. Add an oral NSAID if there is no contraindication.
Warning signs
Fever of 38.5°C (101.3°F) or more: examine her, and send a CBC with differential, reticulocyte count, and blood culture straight away. Cough, shortness of breath, fast breathing, or wheeze, with or without fever: check for acute chest syndrome with a chest X-ray and pulse oximetry. Give oxygen if her saturation is below 95% on room air. Hemoglobin 20 g/L (2 g/dL) or more below her baseline, so 62 g/L or lower, is acute anemia: call hematology. Severe headache, weakness, trouble speaking, or a seizure: urgent head CT and neurology.
Please avoid
Meperidine. Holding pain relief until tests are back: investigate other causes while you treat. A blood transfusion for an uncomplicated pain crisis; call hematology if you think she needs one. IV fluids above the maintenance rate if she isn’t dehydrated but can’t drink.
Medicines, allergies, and devices
Hydroxyurea 1,500 mg daily. At home for pain: hydromorphone tablets and ibuprofen as needed. Allergy: morphine, widespread hives. Implanted port in the right upper chest, placed in 2024 because her veins are hard to access; it should be accessed only by staff trained to do so, with sterile technique. If IV access is delayed, give the opioid subcutaneously rather than wait.
Who to call
Hematology clinic, weekdays 8 am to 4 pm: 555-0142. Day or night: the hematologist on call, through the hospital switchboard at 555-0100. Family physician: 555-0187.
Signed and shared
Her hematologist, with credentials, registration number, and signature. She keeps the letter in her bag and a PDF on her phone, and a copy is on file at the hospital she usually attends.
Emergency care letter: adult with adrenal insufficiency
Endocrinology clinic, reissued after a dose change; the patient carries it
Patient and dates
44-year-old man, weight 82 kg. Reissued on Tuesday, October 20, 2026, the day his fludrocortisone dose went up. Review by October 2027.
Condition
Primary adrenal insufficiency, or Addison’s disease, diagnosed in 2019. His body can’t make cortisol, so illness, injury, or vomiting can bring on an adrenal crisis. Named with his agreement.
Usual baseline
Blood pressure 118/74, heart rate 70. Sodium 138 mmol/L and potassium 4.4 mmol/L on October 6, 2026. Fully independent; works and drives.
What usually brings him in
Vomiting or diarrhea that stops him keeping his tablets down; his last admission was for gastroenteritis in March 2025. Signs of a crisis include vomiting, dizziness, low blood pressure, low back pain, confusion, and low blood sugar.
What to do first
If you suspect an adrenal crisis, give hydrocortisone 100 mg IV at once, or IM if there is no IV access, before any results are back. Then 1,000 mL of 0.9% saline over the first hour, and more IV saline as he needs it. Continue hydrocortisone 200 mg over 24 hours, as a continuous IV infusion or 50 mg IV or IM every 6 hours, reduced to 100 mg over the following day. Call us to plan the switch back to tablets.
Before he arrives
He carries a hydrocortisone 100 mg injection kit, and he or his partner may have used it on the way. Ask when; he still needs assessment, the IV fluids, and the 24-hour hydrocortisone.
Please avoid
Waiting for a cortisol level or other results before the first dose. Stopping his steroids while he is nil by mouth; give hydrocortisone by injection instead. Major surgery under general anesthesia without steroid cover: give hydrocortisone 100 mg IV first, then 200 mg over 24 hours. If hydrocortisone runs out, use prednisolone; dexamethasone only if no other glucocorticoid is available.
Medicines, allergies, and devices
Hydrocortisone 10 mg on waking and 5 mg at 2 pm. Fludrocortisone 0.1 mg each morning, up from 0.05 mg on October 20, 2026. No other regular medicines. No known allergies. No devices or implants. He wears a medical alert bracelet.
Who to call
Endocrinology clinic, weekdays 8:30 am to 4:30 pm: 555-0163. Day or night: the endocrinologist on call, through the hospital switchboard at 555-0100. Family physician: 555-0119.
Signed and shared
His endocrinologist, with credentials, registration number, and signature. He keeps a folded copy in his wallet and a photo on his phone, and his partner has a copy.
What the guidelines say about emergency plans. Checked October 2026.
For the two conditions in the examples, these guidelines set how fast treatment should start, the first doses, and what patients should carry. They are clinical guidelines, not laws; check your local protocols and the patient’s own specialist plan too.
United States, NHLBI
For a sickle cell pain crisis, start analgesia within 30 minutes of triage or 60 minutes of registration. Use an individualized prescribing and monitoring protocol written by the patient’s sickle cell provider, or a sickle cell–specific protocol, whenever possible. For severe pain, give parenteral opioids, and reassess and re-dose every 15–30 minutes until the pain is controlled.
Ontario, Ontario Health
People with sickle cell disease who come to an emergency department with a pain episode should get a Canadian Triage and Acuity Scale score of at least 2, “emergent,” and their treatment should begin within 30 minutes of triage or 60 minutes of presentation. Before discharge, they help write a plan for managing the episode at home.
United States, Endocrine Society
In a suspected adrenal crisis, give an immediate parenteral injection of hydrocortisone 100 mg, or 50 mg/m² for children, followed by fluid resuscitation and 200 mg over 24 hours, or 50–100 mg/m² for children, by continuous IV infusion or injection every 6 hours. With severe symptoms or a crisis, treat before diagnostic test results are available.
Canada, Canadian Paediatric Society
For a child with adrenal suppression from glucocorticoids who has an adrenal crisis, severe illness, or severe injury: hydrocortisone 100 mg/m², up to 100 mg, IV or IM at once, then 100 mg/m² over 24 hours, up to 200 mg, divided every 6 hours or by continuous infusion. Families without rapid access to an emergency department, or planning remote travel, should be taught to give IM hydrocortisone.
Ontario, Ontario Health, care plans
People with sickle cell disease should have a comprehensive health assessment at least once a year at a dedicated sickle cell disease centre, leading to an individualized care plan shared with their circle of care. The patient guide asks people to take their care plans to the emergency department, and to know their baseline hemoglobin.
United States, Endocrine Society, emergency cards
Every patient with primary adrenal insufficiency should have a steroid emergency card and medical alert identification, saying they need more glucocorticoid and immediate parenteral steroid in an emergency, and a glucocorticoid injection kit they know how to use. Adults and children should see an endocrinologist, or a clinician with endocrine expertise, at least once a year.
What goes in each part.
Header and dates
Who wrote the letter, when, and when it is due for review, so the team can judge whether it is current.
- Your practice’s name, address, and phone
- The date you wrote it
- A review date, no more than 12 months away
- The patient’s name, date of birth, and weight, if any dose depends on it
Avoid: A letter with no date. The team can’t tell this year’s plan from one written 5 years ago.
Condition and baseline
The condition, named, and what normal looks like for this patient, so the team can see what has changed.
- The diagnosis and its type, named with the patient’s agreement
- Other conditions that change emergency care
- Usual blood pressure, heart rate, and oxygen saturation on room air
- Usual blood test values that matter in an emergency, with dates
- What the patient usually manages, and how they communicate
Avoid: Population reference ranges. The team needs this patient’s own numbers.
What usually brings them in
The emergencies this patient has had, and the signs that point to something more serious.
- Their usual presentations, and what tends to trigger them
- Serious complications they have had, with the year
- Warning signs that need a different approach, and what to do
Avoid: Every complication the condition can cause. Keep to what applies to this patient, and the few signs no one should miss.
What to do first
The first treatment and how soon, written so a clinician who has never met the patient can start it.
- The drug, dose, route, and time target
- How to work out the dose, if it depends on what the patient took at home
- When to reassess and repeat
- What to check alongside treatment, without delaying it
Avoid: “Treat as per protocol.” Name the drug, the dose, and how fast it should be given.
What to avoid
The drugs, procedures, and delays that are unsafe for this patient or wrong for the condition.
- Drugs to avoid, and why
- Delays to avoid, such as waiting for results before the first dose
- Treatments to discuss with the specialist team first
Avoid: Leaving a serious past reaction only in the allergy list. If it matters in the first hour, repeat it here.
Medicines, allergies, and devices
What the patient takes and carries, so the team can continue it, adjust it, or work around it.
- Each medicine, with dose and frequency
- Allergies, with the reaction
- Devices and implants, where they are, and any limits on access or imaging
- Emergency kits the patient carries, and whether they may have used one
Avoid: A medicines list that is out of date. Reissue the letter when a dose changes.
Who to call
Someone who knows the condition and can be reached at 3 am, not only in clinic hours.
- The specialist team and their daytime number
- A 24-hour route, such as the specialist on call
- The family physician
- An emergency contact, if the patient wants one listed
Avoid: A clinic number that no one answers after 5 pm.
Signature and copies
Whose plan it is, and where the copies are, so the letter is with the patient when they need it.
- Your name, credentials, specialty, and registration number
- A line saying the emergency team still makes its own assessment
- Copies for the patient’s bag or wallet and phone, and for family if the patient agrees
- A copy for the hospital the patient usually goes to, where it can be added to their record
Avoid: One paper copy in a drawer at home.
Common mistakes, and how to avoid them.
Old doses and numbers
A letter written 3 years ago can send the team the wrong dose or the wrong baseline. Set a review date no more than a year away, and reissue the letter after any change.
Too long to use at triage
The team reads it in the first minutes. Keep it to one page, with what to do first near the top; the full history belongs in your clinic letters.
First steps with no dose or time
“Give analgesia promptly” or “consider steroids” leaves the team to guess. Name the drug, the dose, the route, and how soon.
No one to call at night
Emergencies often happen out of hours. Give a 24-hour route to someone who knows the condition, not only the clinic’s daytime line.
Written as orders
The emergency team still makes its own assessment. Write the plan as advice from the clinicians who know the patient, and say which signs point to a different problem.
Personal detail no one needs
The letter travels with the patient, and strangers may read it. Leave out history and personal details that don’t change emergency care.
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Frequently asked questions.
What should an emergency care letter include?
The condition, named with the patient’s agreement; their usual vital signs, blood tests, and function; what usually brings them in; what to do first, with doses and how soon; what to avoid; current medicines, allergies, and devices; and who to call, day and night. Add the date you wrote it and a review date.
Who should write an emergency care letter?
The clinician who knows the condition best, usually the treating specialist, or the family physician with the specialist’s input. Sign it with your name, specialty, and registration number, so the team knows whose plan it is and how to reach you.
How often should an emergency care letter be updated?
At least once a year, and whenever a dose, a baseline value, or a contact number changes. Put the review date on the letter and reissue it after each change, so the copy the patient carries is the current one.
Does the emergency team have to follow the letter?
No. It’s advice from the clinicians who know the patient, and the emergency team still makes its own assessment. A clear letter helps them start the usual first steps quickly, and says which signs mean something else is going on.
Should an emergency care letter name the diagnosis?
Yes, with the patient’s agreement: the team can’t use the plan without it. Leave out history that doesn’t change emergency care.
What should a sickle cell emergency letter include?
The patient’s baseline hemoglobin and oxygen saturation, their pain plan and what has worked before, and the signs of complications such as acute chest syndrome. Guidelines say pain relief should start within 30 minutes of triage or 60 minutes of arrival, so put that near the top.
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What should an adrenal insufficiency emergency letter say?
That in a suspected adrenal crisis the patient needs hydrocortisone 100 mg IV or IM at once, before test results, then IV fluids and 200 mg over 24 hours. A child’s dose depends on body surface area, so write in the child’s own dose. Add their usual replacement doses, and whether they carry an injection kit.
How should the patient carry the letter?
A paper copy in a wallet or bag, and a photo or PDF on their phone, so it’s with them even if they can’t speak for themselves. A medical alert bracelet or card can point the team to it. With the patient’s agreement, give copies to family and to the hospital they usually attend.
Is this emergency care letter template free?
Yes. Copy it, or download it as a Word or text file. No account needed.
Can Vero write an emergency care letter from my visit?
Yes. Paste this template into Vero, and it drafts the letter from your review visit, with the baseline values and plan you discussed. Check every dose and number, then export it to PDF or Word for the patient to carry.
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Your template. Filled in from the visit.
Vero writes your notes and letters in the templates you choose, so you review instead of type.
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