Tuesday, February 9, 2016

Pt. says "I don't want to go to the hospital!"

Yesterday during my EMT refresher, we talked about advance directives. At times an EMT will arrive at an accident and the patient will not want to go to the hospital. There have been times in my career where I have demanded, stomped my foot, and urged people to go to the hospital.

A competent adult who can prove orientation to "person, place, and time" can deny consent of treatment. The patient must be informed of all potential risks and possibility of death. Even if the scare of death doesn't move them to seek treatment, then try to persuade them.

Make sure the patient is competent and able to make rational informed decisions.

Consult medical direction as needed or follow local protocol.

If the patient still refuses, clearly document what was told to the patient.

Document what the patient response is and have him/her sign a refusal form.

Before you leave the scene, encourage them to seek help if other symptoms occur.

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