No, I don’t mean that cup of frozen water you’re using to take the arterial blood sample to the lab. A recent Immigration and Customs Enforcement (ICE) policy change means that ICE agents may come to hospitals and emergency departments. EMRA and ACEP both have issued guidance for emergency department staff. Key points: patient information including immigration status is protected by HIPAA, do not include immigration status information in the medical record, ICE officers may enter public areas but entrance to private patient care areas requires a judicial (signed by a judge) warrant, patients have the right to decline speaking with an ICE agent. “Red cards” outlining people’s rights can be printed here. Patients should hand the red card to the ICE agent without saying anything.