REFUSAL OF TREATMENT / TRANSPORT (PED)
ALL LEVELS
DESIGNATION OF CONDITION
Children are unable to refuse treatment and transport on their own behalf. A parent, or guardian, may refuse any part of or all treatment and/or transport on behalf of the patient. Remember this guideline is used only if no life threats exist. If a life threat is present, follow Involuntary Restraint and Transport Guideline.
EMPHASIS ON PATIENT CARE
Provider safety, transport decisions
1. Assess ABC’s and ensure no immediate life threats.
2. Secondary Management - History, physical exam, vital signs (if patient allows):
a. Inform parent or legal guardian of patient’s medical condition, potential injury or illness, potential ramifications if treatment and transport are refused.
b. Assure the parent or legal guardian fully understands what you are saying.
c. Attempts to inform must 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 parent’s or legal guardian’s signature on refusal and information for report.
e. Have a witness sign the refusal.
f. Document all attempts to gain consent for treatment, advisement of potential injury or illnesses, and potential ramifications if treatment is not rendered.
3. If parents are not available, make all reasonable efforts to locate parents or legal guardians and have them come to the scene, otherwise transport the patient to the nearest appropriate facility.
4. 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 the patient by cell phone or radio.
ALL LEVELS
DESIGNATION OF CONDITION
Children are unable to refuse treatment and transport on their own behalf. A parent, or guardian, may refuse any part of or all treatment and/or transport on behalf of the patient. Remember this guideline is used only if no life threats exist. If a life threat is present, follow Involuntary Restraint and Transport Guideline.
EMPHASIS ON PATIENT CARE
Provider safety, transport decisions
1. Assess ABC’s and ensure no immediate life threats.
2. Secondary Management - History, physical exam, vital signs (if patient allows):
a. Inform parent or legal guardian of patient’s medical condition, potential injury or illness, potential ramifications if treatment and transport are refused.
b. Assure the parent or legal guardian fully understands what you are saying.
c. Attempts to inform must 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 parent’s or legal guardian’s signature on refusal and information for report.
e. Have a witness sign the refusal.
f. Document all attempts to gain consent for treatment, advisement of potential injury or illnesses, and potential ramifications if treatment is not rendered.
3. If parents are not available, make all reasonable efforts to locate parents or legal guardians and have them come to the scene, otherwise transport the patient to the nearest appropriate facility.
4. 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 the patient by cell phone or radio.