Treat and Release

[pond life]

Hi all.

Does your system allow you to employ a treat and release or refer system on your payient contacts?

Mike

[Chief1C]

If the patient wants treated, to an extent, and doesn't want transported; that's covered in our protocols.. We've also had patients who wanted transport, but no treatment. I'd have them sign a refusal of treatment and amend it to note that transport was made.

We can suggest that they seek treatment on their own, if they refuse treat/transport. However we can't suggest that they don't need EMS, or treat them and tell them to get further treatment on their own. Also, If I don't believe refusal is appropriate, even though a conscious/competent patient has the right to refuse. I'd suggest that they speak with our medical command physician.

[spenac]

At my current part time (former full time) we would treat and release all the time. We would administer meds wait a while re-check and leave. We also had the right to deny treatment and transport to those that did not need it.

At my current full time job we pretty much have to drag patients on board and take them to hospital. It is a pain. They want all but immediate life saving treatment saved for in the ambulance enroute to hospital. If we suggest to the patient they do not need the ambulance it is grounds for dismissal. If patient insists on not going we are to repeatedly emphasis that we are not doctors and they could die if not riding in the ambulance. This part of bigger town EMS disagrees with me. I enjoy the wider variety of patients but sure miss the ability to use my brain.

[itku2er]

Where I am from we transport everything. No such thing here, but I do live in the sticks so that might have something to do with it. The only way we dont transport is if its a patient refusal.

terr

[Dustdevil]

I am allowed to treat and release, or even initiate a refusal to transport.

I suppose it helps that, if I were to transport them, I would be the one I was transporting them to anyhow.

[Harold1]

In Aruba we have two options when we get a case that does not need ambulance care.

Either we treat and release, or we contact a physician of the ER in the area for consultation.

Sometimes we assess, treat, document the care and then arrange for transportation to the ER by personal vehicles.

We only have three or two ambulances on each shift, so we have to make sure that units are not kept busy with BS.

[firedoc5]

In Aruba we have two options when we get a case that does not need ambulance care.

Either we treat and release, or we contact a physician of the ER in the area for consultation.

Sometimes we assess, treat, document the care and then arrange for transportation to the ER by personal vehicles.

We only have three or two ambulances on each shift, so we have to make sure that units are not kept busy with BS.

Anytime we treated someone at the scene but they wanted to go by private vehicle, we always followed them, especially if it was a peds patient. Wanted to make sure they did go to the ER like the family said they would.

[JPINFV]

What exactly would you do if they didn't go to that ER and either decided to go to a different one, or go home?

[firedoc5]

What exactly would you do if they didn't go to that ER and either decided to go to a different one, or go home?

In some cases DCFS (Dept. of Children & Family Services) are contacted. When you have a kid that you know needs immediate treatment and the family does not take them, that falls under neglect.

In adult cases, 9 times out of 10 you get called to the home and wind up transporting them anyway. Not much you can do for that legally, unless you feel that the patient is not capable of making that judgement. If not, a family member needs to be sure that he does get seen in a timely manor. They too can be reported if the patient is elderly and/ or not physically/ mentally capable of making decisions.

[iMac]

The second 911 is dialed and an ambulance responds, the patient is charged a standard fee. (I think the 911 fee is $189.00)It goes up from there.

If the patient decides they no longer want aride to the hospital then we would just explain to them the pros and cons and tell them to call back should they change their mind(cover our rears), then we document, document, document.