Re: Re: Informed refusal of ambulance transfer

[Guest guest]

Maybe when Gene Gandy checks his email, he'll be kind enough to repost his

suggestions on what's needed for refusal of care.

I believe that he's got something that might cover this already in the can.

ck

In a message dated 05/17/11 11:08:44 Central Daylight Time,

phillipsdo@... writes:

Good questions. A one sized fits all just isn't right. I have patients

who refuse a test or treatment, but not everything. In those cases, it is

best to do what you can and have them understand that the test or treatment

is really important by having a special informed refusal for that.

In my 20+ years, I have also found that often we treat AMAs as a do what I

say or get the hell out situation. Oh yes, and don't come back or call

back. That is WRONG! we must take the time to explain why everything is

important (if it is) and document they do understand that, have mental capacity

to understand and make the decision, and give them MANY chances to change

their minds.

I do understand not wanting another form, in hospital or pre-hospital, but

have you looked at yours and your partners' documentation of these? I have

looked at lots, and we don't do them well, at all!

>

> > We have had a few instances lately where our ED physicians have

recommended

> > transfer by ambulance and the patient/parent has refused and will go

by POV

> > instead. We have a refusal form for tests/treatment (this is not a

leaving AMA

> > form but just refusing specific care items) but our CNO wants

something specific

> > for these instances. Do you know of any hospitals with such a

form/policy?

> >

> > I would imagine something such as:

> > I refuse transfer to ________ hospital by ___ground ambulance _____Air

> > ambulance. I will instead go by privately owned conveyance (my own

car).

> >

> > I understand that my provider has prescribed EMS transfer for the

following

> > reasons: speed, patient monitoring, medications, oxygen, safety,

bypassing the

> > triage process at the receiving hospital, ___________.

> > I understand and accept all potential risks and/or complications,

including, but

> > not limited to: death, disability, pain, worsening of condition,

shortness of

> > breath, ________________.

> > I understand and acknowledge that if I go by my own transport that I

am

> > accepting responsibility to carry and deliver the required paperwork

to complete

> > the transfer. I understand that at the receiving facility I may be

delayed in

> > accomplishing triage and ultimate definitive care and this may be

detrimental to

> > mine, or my loved one's care, comfort and final outcome.

> >

> > I understand and acknowledge that the staff of XYZ hospital have

explained this

> > to me, feel that I have understood all items and have the mental

capabilities to

> > understand all risks and complications, and have offered to answer any

and all

> > questions.

> >

> > I understand and acknowledge that if I change my mind I may tell staff

right

> > now! I also understand and acknowledge that if circumstances arise

while

> > driving to the receiving facility that I should immediately stop and

call 911.

> > If I do call 911, I may not be taken to the designated receiving

hospital if in

> > the judgement of the responding agency it would be detrimental to the

health of

> > me or my loved one to continue that transport.

> >

> > Thoughts? If anyone has such a form, I'd love to see it.

> >

> > Don

> >

> >

> > [Non-text portions of this message have been removed]

> >

> >

> >

> > ------------------------------------

> >

> >