The Pathway for "Found Down" or Unidentified Patients: From Field to Identification and Social Reintegration
Abstract
Background: Patients who are found unconscious or unresponsive, often referred to as "found down" or unidentified individuals, present significant challenges across emergency medicine, forensic science, public health, and social services. Typically, from marginalized groups such as the homeless or those with severe mental illness or substance use disorders, their lack of identity complicates clinical decision-making and undermines person-centered care. This often leads to fragmented treatment, ethical issues, and discharges to unsafe conditions, continuing a cycle of vulnerability. Aim: This narrative review synthesizes evidence from 2010-2024 to map and evaluate integrated, ethically grounded protocols for managing unidentified patients from pre-hospital discovery through to identification, clinical stabilization, and safe social reintegration. Methods: A comprehensive search of PubMed, Scopus, CINAHL, forensic science, and public health databases was conducted. Results: Effective management in healthcare relies on a coordinated multi-agency approach. Key roles include paramedics offering essential scene insights, nursing staff providing trauma-informed care, medical secretaries managing information, laboratories conducting critical analyses, epidemiologists tracking public health trends, and health planners connecting to social services. Successful integration of these roles leads to better patient outcomes, increased identification rates, and lower recidivism by prioritizing identification as a fundamental clinical and ethical task. Conclusion: The "found down" pathway is a litmus test for healthcare system equity and resilience. It demands protocols that harmonize acute medical stabilization, forensic investigation, and compassionate social care, ensuring that society's most invisible individuals receive dignified, continuous, and effective support.
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References
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Authors
Copyright (c) 2024 Reham Mohammed Ali Shaykhayn, Bashair Hassan Eshwi, Shahad Jaber Al Jaberi, Yasmeen Mohd Hassan Mahboob, Waleed Salem Said, Mohammed Ali Qahmash, Basma Abdall Ali Afif, Fatmah Naser Mohsin Mashary, Ibrahim Ahmed Sehaqi, Bader Hassan Mofarh Almalkiy, Yousef Yaqoub Ayoub Alsaleem, Mudaysh Yahya Ahmad Bajawi
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