Refusal

Question 1

Requirements

Answer 1

Individual meets the Definition of a Pt, & the Pt OR Parent/legal guardian wishes to refuse EMS treatment or transport

Question 2

How Many Steps are in this Algorithm

Question 3

Step 1

Answer 3

Complete an initial assessment w/ particular attention to neurologic and mental status

Complete Set of VS

Question 4

Step 2

Answer 4

Determine patient’s ability to make an informed medical decision concerning the extent of his/her illness or injury

Question 5

What must we do to ensure the Pt is able to make an informed decision

Answer 5

• Is alert and oriented
• Has the ability to understand the circumstances surrounding his/her illness or impairment
• Understands possible risks associated with refusing treatment and/or transport
• Demonstrates judgment not significantly impaired by illness, injury, or drug/alcohol intoxication
• Has not attempted suicide or verbalized intent of harm to self or others

Question 6

Step 3

Answer 6

Perform Needed Medical Care w/ Consent of Pt:

Complete the PCR clearly documenting the initial assessment, findings, & discussions w/ all involved individuals regarding the possible consequences of refusing additional prehospital care and/or transportation

Question 7

If we are explaining to the Pt the consequences & risks involved by Refusing, what must we do

Answer 7

• Assess the patient’s understanding of the medical emergency, including possible medical problems, proposed medical care, the benefits of medical care and risks of refusal
• Contact online medical direction if there is a question as to the legality of the refusal or the patient’s ability to make an informed medical decision
• Thoroughly document the patient encounter

Question 8

When MUST online medical control be contacted

Answer 8

• Any Pt < 28 Days regardless of Complaint
• Any febrile infants < 3 months of age w/ a fever reported by parent or measured by EMS
• Potential life-threatening condition or Other Concerns related to Risk of Refusal
• Possible physical/psychological abuse (Contact PD)
• Questionable capacity to Refuse

Question 9

What if the Pt verbalizes intent to Self Harm

Answer 9

Must be evaluated by qualified Mental Health Professional
or
Transported to an appropriate Facility to receive evaluation

*Qualifies for Treat & Refer

Question 10

Who CANNOT Refuse Care/Transport

Answer 10

Altered Pt

Minor/Ped Pt

Petitioned Pt’s CAN refuse care but not Transport (Revoked Court Ordered Pt’s are excluded of both)