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Patient Refusal

When a patient who is need of medical care or that a license healthcare provide makes contact (visual or physical) with refuses care, then every effort should be made to get the patient to consent to treatment and transport to a medical facility. All communication with that person needs to be documented in depth with a patient care report.

After a patient repeatedly refuses treatment and transport, then under Florida law, EMS personnel cannot forcibly restrain a patient and force transport against their wishes. If problems arise, contact the shift supervisor.

All patient contact should have appropriate refusal form completed and full documentation completed on PCR. Refusal/disposition form should be read and explained to the patient, including possible consequences of refusing services. All attempts should be made to make a thorough assessment of patient, including vital signs, mental status and compentency check and other diagnostic test. All of the previous should be documented.

If a patient receives ALS treatment on scene and then refuses, (IV, Meds.) then an EMS supervisor must be contacted prior to obtaining refusal. In cases of patients under 18 years of age refusing transportation, only a parent or legal guardian can override the minor's decision. All efforts should be made to contact a guardian.

Medical Control and the EMS Supervisor may also be contacted for assistance. In cases of life threatening symptoms, the crew chief can determine that the minor is unable to care for him/herself and may act in their best interest under the doctrine of implied consent.
---Emancipated minors may offer consent and refusal.
---When confronted with a patient refusing against medical advice, the EMTP should contact a supervisor.
---If needed notify patient of medical control's advice and document same. A full/complete narrative must be completed in the patient care report for all patients refusing care. It should include description of incident/injuries, assessment, steps taken to gain transport permission, and number of times patient was offered care and subsequently refused.

See Florida State Statute 401.445

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