tag:blogger.com,1999:blog-4505990433916682663.post7710243411052198723..comments2024-03-13T02:04:31.476-04:00Comments on Paramedicine 101: California Man Dies after Declining EMSAdam Thompson, EMT-Phttp://www.blogger.com/profile/18107359165856983910noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4505990433916682663.post-91690527455643835292010-01-17T22:22:47.520-05:002010-01-17T22:22:47.520-05:00I could not agree more. Our refusal form has yes/n...I could not agree more. Our refusal form has yes/no check-off boxes, and if there is a "yes" checked for any of them, such as the points you mentioned, you must call an MD. Sometimes it is a pain, but in the long run, it is better for the patient and protects your hide.Shaggyhttps://www.blogger.com/profile/10687847155700323439noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-53919750470162740452010-01-15T11:26:35.063-05:002010-01-15T11:26:35.063-05:00This is one of those topics that makes us all feel...This is one of those topics that makes us all feel an unease. I think we have all had to get a signature on a refusal that we didn't want to do. It is so important to do and document that full assessment. Some of the key points our agency concentrates on are as follows.<br /><i><br />1. Is the patient an adult or emancipated minor?<br />2. Is the patient mentally capable of making their own healthcare decisions? <br />3. Has the patient been made aware of possible consequences of transport refusal? <br />4. Is the patient aware they may use our service after this refusal?<br />5. Who is the patient being left with?<br />6. Is the patient hemodynamically stable and without obvious significant injury?<br />7. What is the patient's plan for treatment if any?<br />8. Document how many times transport was offered.<br />9. Document full assessment with vital signs<br />10. Have witness sign refusal<br /></i><br />One of the things I like to do when I feel completely uncomfortable with a refusal is call the doc. I have yet to have a physician give me orders to take a patient against their will, but it shows that I have exhausted all options. <br /><br />In this field we become somewhat of salesmen. I think many of us know how to get a patient to go, or even refuse transport based on the way we phrase our questions. <br /><br /><b>Get that refusal phrases:</b><br /><br />"You want to go by ambulance or have one of your friends here take you?"<br /><br />"Well, we have to tell everyone that they should go."<br /><br />"So do you want to go to the hospital by ambulance for this?"<br /><br />"Well if you are going to go with us, we are going to have to put you on that big board and strap you down."<br /><br />"It is not quicker to go by ambulance, that is a common misconception."<br /><br /><br /><b>Urge transport phrases:</b><br /><br />"Okay so lets go to the hospital and get you checked out."<br /><br />"We don't have all the equipment they do at the hospital..."<br /><br />"I want you to realize that you could possibly die from this."<br /><br />"Have a seat on the stretcher"<br /><br />That last one is huge. Once you get the patient on the stretcher, they are much more inclined to go with you. <br /><br /><b>Other things to remember:</b> <br /><br />-If the patient wants to refuse transport because of treatment, they can just refuse that treatment. ie. IV, backboard, C-collar, etc..<br /><br />-Utilize those worried family members to help you convince the patient.Adam Thompson, EMT-Phttps://www.blogger.com/profile/18107359165856983910noreply@blogger.com