XXL_Medic

Once the hospital was presented w/ the refusal what could they say. I've been doing this job for now on 13 years.

My protocol states "all patients being of sound mind and being over the age of 19 after being informed have the right to refuse treatment and transport."

It doesn't matter, we can debate this to the end of time, its not changing anything. As a paramedic I will not transport any patient using false pretenses. The patient was competent enough to live by himself, he was informed that due to his advanced age that his condition could worsen and that being evaluated by a physician would be in his best interest.

Even after putting it like that he still refused. Contacting medical control wouldn't have changed anything, because I asked our medical director if he would have given me transport orders and his reply was, "No, if he's alert and understands what is going on, he has the right to refuse care."

As for the accumulation of blood, that took place over several days, it wasn't immediate, it was more like 72 hours after the fact.

My documentation supports everything I have said. The nurse got her "ass chewed" and is simply trying to pass the Buck.

Secondly if the nurse knew of his condition she didn't relay it to me. When I asked for his MHx she replied HTN, Heart Disease.

Speaking w/ my MCP he is backing me. If the nurse was that concerned she should have spoke up!

Thanks guys! I had a meeting w/ management and that is what I told them. Hopefully the issue is settled.

WWW.parameducators.com

Hey guys this happened to me the other day and I wanted to get some opinions regarding it.

Responded to a medical call / fall at a private residence. Arrived on scene, and was met by a private duty nurse. She advised my partner and I that the patient had fallen earlier and had a cut under his eye.

Made contact w/ the patient, the patient was A&Ox4. Noted a small skin tear under his left eye, bleeding stopped. Pt denied loss of consciousness, had no other complaints. Pt assessed and vitals noted as normotensive.

Pt asked by both myself and my partner if he wanted to be transported to the ER. Pt stated unless I need stitches, I don't wanna go. As my partner was filling out the run sheet, I was explaining to both the pt and nurse about the refusal.

I explained as I always do, we recommend you always get checked out, after any injury or illness. Whether you go by car or ambulance is the pt choice. I also advised the patient that due to him falling if he suffered any headache, nausea, vomiting, dizziness, blurred vision, to seek immediate medical treatment.

The pt indicated that he understood and signed the refusal of treatment / transport. The nurse signed witnessing the pt refusing.

Two days later I get a phone call from management because this pt is now at the hospital. Turns out the patient had thrombocytopenia and due to the fall, blood collected into the surrounding tissue.

The ER wanted to know why wasn't transported the day it happened. When.they were told that he signed a refusal of treatment / transport which was witnessed by the nurse.

They said that the patient and nurse said that my unit refused to transport the pt, which is an outright lie. When we presented the refusal form to the ER, they continued w/ "you still should have transported him!"

As per our protocol if a patient is alert and oriented x 4 and understands the risks of refusing medical treatment / transport, that pt is allowed to sign said refusal and we are released from all liability.

Would anyone have handled this situation any different if you were faced with it?

We carry Zofran but I have found Benadryl to be effective as an anti-emetic. Personally I prefer Phenegran as well.