What are the rights of a patient to refuse treatment?
"If you change your mind and want to be transported to the hospital, call 911." ... Which one of the following patients who refuse treatment must be transported to the hospital? 29-year-old female who attempted to cut her wrists earlier but now states it was an accident and she is not suisidal.
When getting a refusal from a patient who does not want EMS?
Which one of the following patients who refuse treatment must be transported to the hospital? A) A homeless man in his 50s who is dirty and disheveled and has a body-wide rash B) Alert and oriented 57-year-old male who is having chest pain and is diaphoretic
When is treatment over a patient’s objection appropriate?
The average time to arrival was 4.2 minutes and average time spent on scene by paramedics was 18.4 minutes. Of the patients, 72% were judged to have minimal need, 25% were felt to have a moderate need, and 3% were felt to definitely need transport to a hospital for further evaluation and/or treatment.
When to refuse medical treatment for financial reasons?
· KP: A simple example of when treatment over a patient’s objection would be appropriate is if a psychotic patient who had a life-threatening, easily treatable infection was refusing antibiotics for irrational reasons. Treatment would save the patient’s life without posing significant risk to the patient.
What should you do if a patient refuses treatment or transport?
What should you do if a patient refuses treatment or transport? As you radio the hospital to give a report on your patient, which of the following should you do? Remain objective and impartial. After you submit the electronic PCR for a call, you realize that you accidentally documented the wrong vital signs.
What is a refusal EMT?
Patient refusals represent situations where EMTs and paramedics have to gather more information than they do from patients who are transported. Gather detailed information about the patient's past medical history; the history of their current illness; signs and symptoms of illness; and vital signs.
What is included in the US Department of Transportation minimum data set?
The Model Minimum Uniform Crash Criteria Guideline (MMUCC) is a minimum, standardized data set for describing motor vehicle crashes and the vehicles, persons and environment involved.
In which one of the following situations would the Good Samaritan law protect the EMT?
In which one of the following situations would the Good Samaritan Law protect the EMT? An off-duty EMT stops at the scene of an auto collision and provides proper care, but the patient dies.
Can a patient refuse treatment at the ER?
A hospital cannot deny you treatment because of your age, sex, religious affiliation, and certain other characteristics. You should always seek medical attention if and when you need it. In some instances, hospitals can be held liable for injuries or deaths that result from refusing to admit or treat a patient.
How do hospitals refuse treatment?
The best way to indicate the right to refuse treatment is to have an advance directive. This document is also known as a living will. Advance directives are kept on file with a hospital.
What is the difference between the patient information section of the minimum data set and the administrative information that is included on the minimum data set?
What is the difference between the patient information section of the PCR and the administrative information that is included on the PCR? The patient information includes specific assessment findings, and the administrative information includes the trip times.
Which of the following is the most important reason for maintaining good documentation standards?
Which of the following is the MOST important reason for maintaining good documentation standards? Good documentation contributes to continuity of care.
Why is it important to not give the name or Social Security number of your patient over the ambulance radio when contacting medical control?
Why is it important to not give the name or Social Security number of your patient over the ambulance radio when contacting medical control? It is illegal. You have received an order from medical direction that you feel would be detrimental to your patient.
How the EMT is required to act or behave is called?
How the EMT is required to act or behave is called: The standard of care. The process by which an individual, an institution, or a program is evaluated and recognized as meeting certain standards is called: Certification.
Which one of the following medical emergencies would most likely result in the use of epinephrine by the EMT?
EMTs may administer Epinephrine for: Anaphylaxis. Anaphylactic shock.
Which one of the following statements shows that the EMT has a good understanding of her role and responsibility related to being an EMT?
Which one of the following statements shows that the EMT has a good understanding of her role and responsibility related to being an EMT? "My safety comes first and then the patient's safety." Once a scene is free of safety hazards, the EMT must recognize and focus on the needs of the: patient.
After a patient, who is short of breath, signs a refusal of service, which one of the following statements would be appropriate prior to leaving the residence? A) "Try taking an aspirin and get a good night's rest; you will probably feel better." B) "If you change your mind and want to be transported to the hospital, call 911." C) "We will leave this oxygen for you; call us when you feel better." D) "Call our dispatch in the morning to let us know how you made out."
B) "If you change your mind and want to be transported to the hospital, call 911.
Which one of the following statements shows an accurate understanding of the legal aspects of the prehospital care report (PCR)? A) "A PCR can be used in a lawsuit only if that lawsuit is filed within six months." B) "A copy of the PCR should be forwarded to the police any time law enforcement is involved in the call." C) "The PCR may be subpoenaed even if the case centers around alleged negligence that occurred in the emergency department." D) "The PCR is considered a legal document only when it describes a crime or act of violence."
C) "The PCR may be subpoenaed even if the case centers around alleged negligence that occurred in the emergency department."
Last week, on a computer generated report, you accidentally documented that a patient suffered from hypertension when, in fact, he did not. Unfortunately, the report has been locked by the computer and cannot be changed; however, it can be printed. Your first action would be to: A) retype the entire report and include the change. B) notify the medical director so that she can fix the error. C) print the report and draw a line through the error. D) contact the hospital and have them change it in the patient's medical record.
C) print the report and draw a line through the error.
A pertinent negative would be illustrated by: A) "nausea without vomiting." B) "hypertension and taking medication." C) "dizziness for three days without notifying the doctor." D) "short of breath with history of lung problems."
A) "nausea without vomiting."
Consider the following narrative from a patient care report: "pt. restrained passenger involved in 2 car MVC; c/o left lower leg pain rated 2/10; LOC A/O to person, place, time, and event; BBS clear; abd. Soft with tenderness LLQ; hx of NIDDM with am glucose level of 133 mg/dL." Which of the following is true? A) The patient's abdomen appears uninjured. B) The patient is being tested for diabetes. C) The patient is confused following the accident. D) The patient's lungs sounds are clear and equal.
D) The patient's lungs sounds are clear and equal.
A patient with asthma is using his inhaler tid and prn. You would recognize that: A) the patient is suffering asthmatic attacks three times a week. B) the patient is only prescribed his inhaler three times a day. C) the patient uses his inhaler only when the symptoms are bad. D) the patient uses an inhaler at least three times a day.
D) the patient uses an inhaler at least three times a day.
When writing a prehospital care report, you accidentally document that a laceration was on the left side of a patient's face when it was actually on the right side of the face. How would you correct this mistake? A) Carefully use White-Out to cover the term "left" but nothing else in the narrative. B) Color over the term "left" with black ink and write the word "right" next to it. C) Draw a single line through the term "left" and write the word "right" next to it. D) Start the entire prehospital care report over from the beginning.
C) Draw a single line through the term "left" and write the word "right" next to it.
Your partner states that he is the "world's worst speller" and has great difficulty using medical terms. Which one of the following statements is appropriate? A) "Do not document information that requires medical terms you are unsure of." B) "Consider abbreviating medical terms that you are unsure how to spell." C) "Ask the emergency physician or nurse how to spell the words of which you are unsure." D) "Use plain English if you are unsure of how to apply or spell a medical term."
D) "Use plain English if you are unsure of how to apply or spell a medical term."
A nauseated patient with fever and abdominal pain states that he has not vomited. Which one of the following describes how that fact should be documented? A) As a subjective finding B) This fact would not be documented. C) As a pertinent negative D) As a treatment finding
C) As a pertinent negative
What to call if you change your mind and want to be transported to the hospital?
B) "If you change your mind and want to be transported to the hospital, call 911 ."
What does "d" mean in a patient's lungs?
D) The patient's lungs sounds are clear and equal.
How long can PCR be used in a lawsuit?
A) "A PCR can be used in a lawsuit only if that lawsuit is filed within six months."
When is PCR considered a legal document?
D) "The PCR is considered a legal document only when it describes a crime or act of violence."
How many times a day should a patient use an inhaler?
D) the patient uses an inhaler at least three times a day.
What to call if you change your mind and want to be transported to the hospital?
c. "If you change your mind and want to be transported to the hospital, call 911 ."
What does it mean when you encounter a 41 year old male with slurred speech?
You have been called to the house of a patient with altered mental status. You encounter a 41-year-old male who exhibits slurred speech, an unsteady gait, and has an odor of alcohol on his breath. His wife states that he is an alcoholic and needs help to get better.
When treatment over a patient's objection would be appropriate?
KP: A simple example of when treatment over a patient’s objection would be appropriate is if a psychotic patient who had a life-threatening, easily treatable infection was refusing antibiotics for irrational reasons. Treatment would save the patient’s life without posing significant risk to the patient.
What are the first few questions in a treatment plan?
The first few questions consider the imminence and severity of the harm expected to occur by doing nothing as well as the risks, benefits, and likelihood of a successful outcome with the proposed intervention. Other questions consider the psychosocial aspects of this decision—how will the patient feel about being coerced into treatment? What is the patient’s reason for refusing treatment? The last question concerns the logistics of treating over objection: Will the patient be able to comply with treatment, such as taking multiple medications on a daily basis or undergoing frequent kidney dialysis?
Is there anything out there to help health care professionals approach the problem of delivering medical treatment against the wishes of patients
And there are fairly clear policies and laws concerning the ethics and legality of delivering psychiatric care to patients who refuse it. But there is nothing out there to help health care professionals approach the problem of delivering medical treatment against the wishes of patients who lack decisional capacity.
Can you force dialysis on a patient who resists?
As Dr. Rubin stated, one cannot force three times weekly dialysis sessions on a resistant patient even if it means that the patient will die without the treatment.
What is the justice of healthcare?
Justice: Demands healthcare professionals try to be as fair as possible when offering treatments to patients and allocating scarce medical resources. Professionals should be able to justify their actions in every situation.
What is the meaning of autonomy in medical terms?
Autonomy: An informed competent adult patient can refuse or accept treatment drugs or surgeries according to their wishes. Decisions must be respected.
What is the best way for a patient to indicate the right to refuse treatment?
Advance Directives. The best way for a patient to indicate the right to refuse treatment is to have an advance directive, also known as a living will. Most patients who have had any treatments at a hospital have an advance directive or living will.
What are the rights of a patient who refuses treatment?
In addition, there are some patients who do not have the legal ability to say no to treatment. Most of these patients cannot refuse medical treatment, even if it is a non-life-threatening illness or injury: 1 Altered mental status: Patients may not have the right to refuse treatment if they have an altered mental status due to alcohol and drugs, brain injury, or psychiatric illness. 6 2 Children: A parent or guardian cannot refuse life-sustaining treatment or deny medical care from a child. This includes those with religious beliefs that discourage certain medical treatments. Parents cannot invoke their right to religious freedom to refuse treatment for a child. 7 3 A threat to the community: A patient's refusal of medical treatment cannot pose a threat to the community. Communicable diseases, for instance, would require treatment or isolation to prevent the spread to the general public. A mentally ill patient who poses a physical threat to himself or others is another example.
How to refuse treatment?
The best way for a patient to indicate the right to refuse treatment is to have an advance directive, also known as a living will. Most patients who have had any treatments at a hospital have an advance directive or living will.
What is the end of life refusal?
End-of-Life-Care Refusal. Choosing to refuse treatment at the end of life addresses life-extending or life-saving treatment. The 1991 passage of the federal Patient Self-Determination Act (PSDA) guaranteed that Americans could choose to refuse life-sustaining treatment at the end of life. 9 .
What must a physician do before a course of treatment?
Before a physician can begin any course of treatment, the physician must make the patient aware of what he plans to do . For any course of treatment that is above routine medical procedures, the physician must disclose as much information as possible so you may make an informed decision about your care.
When a patient has been sufficiently informed about the treatment options offered by a healthcare provider, the patient has the right
When a patient has been sufficiently informed about the treatment options offered by a healthcare provider, the patient has the right to accept or refuse treatment, which includes what a healthcare provider will and won't do.
What are the four goals of medical treatment?
There are four goals of medical treatment —preventive, curative, management, and palliative. 2 When you are asked to decide whether to be treated or to choose from among several treatment options, you are choosing what you consider to be the best outcome from among those choices. Unfortunately, sometimes the choices you have won't yield ...
What is the right to refuse medical care?
The patient’s rights movement of the 1980s and ’90s ushered in the concept of a patient’s right to refuse medical care of any kind. The Supreme Court finalized this issue in 1990 in”ž Cruzan v. Director, Missouri Department of Health. In it they stated that the “United States Constitution would grant a competent person a constitutionally protected right to refuse life-saving medical treatment.””ž Whether for financial, spiritual or religious reasons, a patient has the ultimate say over what is done to his or her body. This concept was best stated by Justice Cardozo of New York in 1914 when he wrote, “Every human being of adult years and sound mind has a right to determine what shall be done with his own body.”
What to do if a patient refuses care?
If, however, the patient still refuses care or transport, make them aware of all of the risks and rewards of treatment and non-treatment as necessary in implied consent, complete a patient refusal form (usually located on the back of a standard PCR), and obtain the patient’s signature. Document your medical opinions and the patient’s reasoning and steps taken to convince the patient to accept treatment and transport.
Why is emancipation a problem for EMS?
The major problem for EMS providers is that emancipatory status is dictated by the states rather than on a national level. Thus, prehospital providers must know their state’s laws in order to provide the most informed care.
How to avoid refusals?
Tips to avoid refusals: First, always attempt to establish a good rapport with your patient. We must remember that we can often be battling unseen forces, such as negative feelings toward hospitals, the medical profession or insurance companies. Showing a friendly and helpful face to the patient could make the difference when you must try to convince them to go to the hospital for their own good. Try to find a balance between what’s best for them physically and what they’re willing to agree to mentally.
Can an incapacitated person be treated by EMS?
The major exception to this rule, as judged by the courts and our social ethics, is that in an emergency situation, an incapacitated person may be treated by EMS with lifesaving care under the assumption that a normal person would consent to prehospital care. This concept has come to be known as the”ž doctrine of implied consent. But let’s first discuss the history behind informed consent before we get into the exceptions.
Can an EMS transport a patient?
In these specific situations, EMS is allowed to suspend the concept of informed consent and transport the patient, even against their wishes. In this case, as with many others, however, field providers must contact medical control for approval because only a trained physician can declare capacity.
Which states allow transport against the patient's wishes?
Arkansas, Mississippi and Nebraska allow for transport against the patient’s wishes, but only when the patient shows signs of material and morbid change. Other states, such as Iowa, Indiana and New Jersey, although not deliberately stating the doctrine of implied consent, remove civil liability from any health-care provider who does not obtain consent if the provider has acted in good faith in an emergency situation.