Pediatric Pancreatitis Patient Passport

The Pediatric Pancreatitis Passport and Action Plan is a document designed by the Pancreas Committee of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) in collaboration with patient advocacy groups including the National Pancreas Foundation, Rebecca’s Wish, and Mission Cure.

WHY A PANCREATITIS PASSPORT?
Children with recurrent and chronic pancreatitis are often cared for at specialized centers far away from where they live. When these patients need acute care, they often first present to local urgent care and emergency departments, who may not be familiar with the presentation and management of pancreatitis in children. The goal of this document is to improve the care and health of patients with recurrent and chronic pancreatitis by providing a portable resource for patients to share with local urgent care and emergency department providers.

WHAT IS THE PASSPORT?
This passport includes recommendations based on pediatric-specific evidence and pediatric pancreatologists’ expert opinion, as well as personalized background information and treatment suggestions for each patient.

HOW TO USE:
Gastroenterologists can use this passport for patients with acute recurrent and chronic pancreatitis as a resource to help guide acute care management. It is not intended for the work-up or long-term outpatient management of recurrent and chronic pancreatitis patients. It is also not intended to replace the clinical assessment of the local physician. The passport can be filled out by the provider for the specific patient. The document can then be given to the patient to carry as a resource should the patient seek medical care outside the care of their primary gastroenterologist. The passport will provide reference for appropriate testing and treatment for patients with ARP and CP and can also be used as a method to contact the patient’s primary pancreas/gastroenterology provider, if needed. It is intended that the passport should be updated anytime in which the symptoms and/or clinical care of the patient change.
Sample language on how to introduce the passport to urgent care/emergency department providers:
“My doctor is Dr. X. They have asked me to present this medical sheet to acute care facilities that I visit. In this sheet, my doctor has provided a brief history about my condition, management recommendations, medical information links, and their contact information. Their office has offered to be contacted for any questions or communications.”

Print Blank Passport

Electronically Fill Out and Print Passport

Please send any feedback on the Pediatric Pancreatitis Passport to naspghan@naspghan.org

Partners:

The Association of Pediatric Gastroenterology and Nutrition Nurses
Help & Hope for Children with Digestive Disorders
Journal of Pediatric Gastroenterology and Nutrition