REFUSAL OF TREATMENT / TRANSPORT (ADULT)
ALL LEVELS
DESIGNATION OF CONDITION
A competent adult (18 years or older) may refuse any or all treatment or transport at any time. If patient is not capable or lacks the capacity to make rational decisions, follow Involuntary Restraint and Transport Guidelines. All refusal patients must be evaluated, vital signs obtained (if possible), and informed of the situation and the potential life threat or disability.
EMPHASIS ON PATIENT CARE
Provider safety, transport decisions
1. Primary Management - Assess airway, breathing and circulation and manage as indicated.
2. Perform Secondary Management including (if patient allows):
a. Inform patient of her/his medical condition, potential injury or illness and the potential ramifications if treatment and transport are refused.
b. Assure the patient fully understands what you are saying.
c. Attempts to inform should be done in the presence of a witness, i.e. family members,
bystander, or Police Officer (preferably not a member of the EMS service).
d. Obtain the patient’s signature on refusal and patient information for report.
e. Have a witness sign below in appropriate place.
f Even though you have obtained a signature, take reasonable steps to protect patient by calling a friend or family member to attend to patient.
3. EMS refusal of care represents one of the highest liability exposures that an
EMS Provider will ever face. All refusals should be carefully documented.
Consider having medical control speak directly with patient by cell phone or radio.
ALL LEVELS
DESIGNATION OF CONDITION
A competent adult (18 years or older) may refuse any or all treatment or transport at any time. If patient is not capable or lacks the capacity to make rational decisions, follow Involuntary Restraint and Transport Guidelines. All refusal patients must be evaluated, vital signs obtained (if possible), and informed of the situation and the potential life threat or disability.
EMPHASIS ON PATIENT CARE
Provider safety, transport decisions
1. Primary Management - Assess airway, breathing and circulation and manage as indicated.
2. Perform Secondary Management including (if patient allows):
a. Inform patient of her/his medical condition, potential injury or illness and the potential ramifications if treatment and transport are refused.
b. Assure the patient fully understands what you are saying.
c. Attempts to inform should be done in the presence of a witness, i.e. family members,
bystander, or Police Officer (preferably not a member of the EMS service).
d. Obtain the patient’s signature on refusal and patient information for report.
e. Have a witness sign below in appropriate place.
f Even though you have obtained a signature, take reasonable steps to protect patient by calling a friend or family member to attend to patient.
3. EMS refusal of care represents one of the highest liability exposures that an
EMS Provider will ever face. All refusals should be carefully documented.
Consider having medical control speak directly with patient by cell phone or radio.