# duty to act?



## Emtsgv (Nov 24, 2013)

Ok guys so i was talking to one of my good friends, who runs IFT's and im currently running 911's.


So we were talking and he mentioned a call to me that he had yesterday, he came across a TC , car VS tree, 1 person in car no injuries and PT refused any transport or treatment and did not sign AMA. fire not on scene nor PD.


So i was like , bro....you didn't call PD or fire? 

"she refused so we left".

and then we got into a big argument so im looking for some advice isn't this abandonment? or am i wrong or right


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## Mariemt (Nov 24, 2013)

All patients in their right level of consciousness have a right to refuse.
Not having her sign a release was pretty stupid. 
Let's remember they came across this, they were not dispatched. She refused all care, how is that abandonment?


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## DesertMedic66 (Nov 24, 2013)

Is patient refuses care and is mentally competent to do so, then no issue. I will be having the patient sign an AMA unless it's a straight up "no don't touch me at all". Then I will try to get the patient to sign a refusal paper.


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## epipusher (Nov 24, 2013)

The patient, being fully competent, can refuse absolutely everything including signing any forms. I would document everything and include a witness if possible.


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## chaz90 (Nov 24, 2013)

Maybe I'm alone in this opinion, but I don't even see the point of trying to get her to sign any kind of "release" in this case. She wasn't a patient at any time, didn't contact 911, has no complaint, and this crew just happened to drive by. I mean, we see PD only MVAs all the time. I think rolling a window down at a minor MVA, asking if they're all OK and need anything then clearing is perfectly appropriate.


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## Tigger (Nov 24, 2013)

I'm with you Chaz, I wouldn't be getting a refusal. Did not call for EMS and is not injured?

Med 13 clear, no patient found. 

Also for the record your patients are not required to sign a refusal. Document as such and try an get a witness, but they are not obligated to sign it.


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## NomadicMedic (Nov 24, 2013)

Even if there's no refusal, because the driver doesn't meet the requirement of being a patient, at least notifying dispatch of your location and the disposition via radio can keep you out of trouble. I wouldn't do any documentation, as I'm not doing any assessments or patient care.


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## epipusher (Nov 24, 2013)

My documentation would only stem from any direct contact with any possible patient. Personal choice if I was in this sort of situation.


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## Medic Tim (Nov 24, 2013)

The person did not call 911 or request any help. You or the primary 911 agency was not requested. Asking if someone is ok or do they need an ambulance does not start a pt provider relationship. I would contact dispatch that we came across a mvc and that there were no injuries and give the vehicle / location description to save the local 911 from having to run out to it from a passer by calling 911.


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## Ewok Jerky (Nov 24, 2013)

"Dispatch we just on-viewed a 1 vehicle MVC at [address] , out investigating"

followed by


"Dispatch we are Code 4 no patient found"

or

"Dispatch we are clear no injury"

-ever been called for "man down" only to find an urban outdoorsman asleep on the park bench? No injury + no complaint + no transport = no patient contact = no paperwork...err minimal paperwork if there was a 911 call generated.


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## mycrofft (Nov 25, 2013)

Car accident is police reportable if it causes any great deal of damage to car, tree, or driver. Call 911 and sit and do paperwork until units arrive.

No duty to act if the pt refuses and the vehicle is not an emergency vehicle, just an IFT in my opinion, but we're getting into legalities now.


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