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As an EMS worker, you will from time to time come across patients who will refuse transport. A study performed in Utah found that 5.1% of patients refused transport against the direct medical advice of an EMS worker. One of the main reasons many patients refuse transport is the expense. Many people are on a tight budget these days, and they feel they cannot afford the added expense of medical transport. Even those with insurance feel as if the cost will be too much. Another common reason for refusing transport is that the patient may feel their illness or injury is not severe enough to require a medical transport.
When can a patient legally decline medical transport?
The majority of EMS workers will try their best to honor a patient’s power to decide if they want to seek medical attention now or wait and do it privately. However, there is also a factor to the legal and moral duty of an EMS worker when it comes to consenting or not to transport. There are times when an EMS worker may transport a patient without their consent. The two key factors in determining if the patient is able to consent or refuse are:
The competency or capability to consent
The age of the patient
If you have a patient who is unconscious or one who shows an altered state of consciousness or judgment, you can by law transport them without consent. Legally minors cannot refuse medical care; therefore, they must be transported with or without consent. Most of the other patients you may come across will be able to legally refuse transport, and you will be forced to follow their wishes regardless of how you feel.
How to be properly prepared for a patient refusing transport
As an EMS worker, you will want to do everything in your power to help your patient regardless of whether or not they consent to transport. Once a patient refuses transport, you still have to finish your job, and your main duty should be to support and treat your patient to the best of your ability. You will also want to encourage them to seek medical treatment at a hospital or emergency room on their own as soon as possible. The best way to accomplish this is by:
Thoroughly explaining the type of the injury and the extent of the injury to your patient. Ensure that they understand the standard treatment protocol and urge them to seek medical attention as needed as soon as necessary.
Supply them with a list of symptoms that may indicate the necessity of immediate medical intervention. Make sure they are aware that these symptoms will need to be addressed even outside of normal office hours (an emergency room trip will be necessary).
Give the patient any extra medical supplies they may need, such as a blanket to keep them warm, ice packs for bumps and bruises or other aches and pains or extra bandages for wounds. Provide them with as much supportive care as the individual will allow.
Ensure the patient understands any local legal statutes regarding the refusal of transport. You may even want for them to sign a Refusal of Treatment form to ensure that everything is by the book according to your local laws.
It can be frustrating as an EMS worker to have your patients refuse your professional opinion to seek immediate medical attention. However, many patients may not understand the extent of their injury or feel as if they have the money necessary to pay for transport. It can be a tough call to make when trying to decide on someone’s well-being. Unfortunately, in most cases, the patient is free to decide if they want to transport or not. If they happen to decide on not immediately being transported, your main duty will be to urge them to seek medical attention as soon as possible and tend to their needs at their current location as best as you can.