# Buzzed 17 year-old refusing treatment



## kaboomgy (Dec 19, 2016)

Scenario: You are working a large 18+ music festival and security brings you an alert and oriented 17 year old male, who has a strong smell of alcohol. He admits to drinking tonight, but states he's fine and doesn't want or need medical attention. He admits to you that his parents think he's at his friend's house and begs of you to not call his mom. How would you handle this situation?

I am wondering about the by-the-book or legal procedure here, particularly in the state of California. My first impression is that the 17 year-old is still considered a minor and cannot legally refuse treatment.


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## Akulahawk (Dec 19, 2016)

By the book, a non-emancipated minor is still a minor and cannot refuse treatment, even if said minor's 18th birthday is tomorrow.


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## TransportJockey (Dec 19, 2016)

Call his parents,  he's a minor and cannot consent or refuse 

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## EpiEMS (Dec 19, 2016)

kaboomgy said:


> Scenario: You are working a large 18+ music festival and security brings you an alert and oriented 17 year old male, who has a strong smell of alcohol. He admits to drinking tonight, but states he's fine and doesn't want or need medical attention. He admits to you that his parents think he's at his friend's house and begs of you to not call his mom. How would you handle this situation?
> 
> I am wondering about the by-the-book or legal procedure here, particularly in the state of California. My first impression is that the 17 year-old is still considered a minor and cannot legally refuse treatment.



Looking at LA County protocols (for example), absent any parental intervention, if he's deemed to be injured or in need of medical attention, you are required to transport. While this individual is not urgently in need of medical attention, I would not release him to his own custody - I would consider (1) calling medical control for their disposition, (2) call his parents, (3) involving LEOs to call the parent so we can release him to the parents, or (4) releasing to LEOs to handle. #2 is preferable, assuming he has no medical complaint or no apparent illness/injury.

Notes:
 - Odor of alcohol on breath/drinking do not alone make somebody "incompetent."
 - California does not have a law prohibiting internal possession.


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## Carlos Danger (Dec 19, 2016)

So what is the medical emergency that's he's not allowed to refuse care for?


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## MonkeyArrow (Dec 19, 2016)

If there is no medical issue, then there is no refusal. What treatment needs to be provided that someone must refuse/accept? If this person were to "consent", what interventions would you provide to him? Consuming alcohol is not a medical issue. This would be different to showing up to a dispatch and not finding anyone.

Turn security to do whatever they please with him. It is not our place to call someone's parents because they snuck out.


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## CALEMT (Dec 19, 2016)

Go available with no medical aid needed. 

But in the sense of your question. Minors can't refuse treatment/ transport. Unless emancipated.


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## DesertMedic66 (Dec 20, 2016)

AOx4, GCS 15 with no complaint = no patient


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## StCEMT (Dec 20, 2016)

There is one little subsection in my protocols that miiiight make me give a call to a supervisor for clarifications, but as far as I see it, there's nothing I need to worry about.  Later tater.


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## akflightmedic (Dec 20, 2016)

Fire Security.

It is 18+ event, they did not do their job.


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## DrParasite (Dec 20, 2016)

Does he have any complaints?  does he want your help?  What care, exactly, are you going to force upon this 17 year old, who admits to indulging in a couple of drinks?

Looks like it's a security problem, because they let the under 18 year old in.  Let them deal with their issue.  

Or even better, they can call his parents to pick him up.


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## Old Tracker (Dec 20, 2016)

Let security call police and have them do a drunk in public, then THEY can call mommy and daddy.


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## Operations Guy (Dec 21, 2016)

This is insane no complaint no patient. Tell security he's not in need of medical care cause drinking is not a medical emergency. Go available let security deal with it.


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## NomadicMedic (Dec 21, 2016)

Did the security staff leave him with you then go back to their post? 

Here's a better question, do you document that you made contact with a minor who appeared to have alcohol on board and that you turned him over to security or do you just "go available"?

How do you document it?

Does it go on an official run report?

How much information do you need to gather if you do document the contact?


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## Operations Guy (Dec 21, 2016)

DEmedic said:


> Did the security staff leave him with you then go back to their post?
> 
> Here's a better question, do you document that you made contact with a minor who appeared to have alcohol on board and that you turned him over to security or do you just "go available"?
> 
> ...



I wouldn't let security just dump him on me. I would document no patient and concerned bystander reported. Document that individual was not in medical need at time and had no complaint. I would document cause say something medical with individual happens later I have documented proof earlier there was no medical emergency. Also if PD was available I would rather hand a drinking minor over to them instead of a minimum wage rent a goon.


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## Operations Guy (Dec 21, 2016)

Also if your agency uses both ePCR and some type of run reporting system I would just put it into the run reporting system for your documentation with a simple paragraph saying no medical needs handed over to security. No need for a PCR if there is no medical.


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## CWATT (Jan 17, 2017)

*Alberta, Canada:

3.    Mature Minors*
1.1      Considerations for assessing minors as mature minors

a)  Practitioners must consider the following points when deciding if a minor may be deemed a mature minor:


Demonstrates the maturity to make independent decisions (e.g. calling EMS), acts in their own best interests and can clearly make an independent judgment to consent (or not consent) to recommended care and treatment


Demonstrates the intellectual ability to understand both the benefits and risks of proposed care, particularly if their presenting health situation is serious or invasive


Age 14 to 18 years (in rare situations, age may be under 14)


Living apart from parents or representatives (may be married or common law)


Economically independent and successfully managing personal affairs
*

Re: Refusal of Care:*

1.5      Refusal of Care
a)  Practitioners must arrange for mature minors to sign a Refusal of Care and/or Transport record in situations where they refuse care and/or transport.



*However, there's a trump card:*

*2.      Determination of Capacity*

2.1.  An adult patient is presumed to have capacity and is able to make decisions until the contrary is determined. However, the practitioner is required in every case, to satisfy themselves that the patient has the requisite capacity to make treatment decisions and is not unduly influenced by third parties.

2.2.  Patients are considered to lack capacity if their actions indicate that they present a danger to themselves, practitioners or bystanders.

2.3.  The patient’s lack of capacity may be transient or chronic: the lack of capacity may be related to, but not limited to:

A mental disorder
*Intoxication* due to *alcohol* ingestion or drug use
Disability due to acute illness or injury
They present a danger to themselves
They present a danger to others
Inability to answer/complete any of the following suggested questions:
What is your name?
Where are you right now?
What day is it?
What’s your birthday?
Where were you born?


Since the protocols state "intoxication" rather than "alcohol ingestion", it's inevitable left up to practitioner judgment.  

A friend of mine told me of a situation where he was standing outside of a club when an intoxicated girl stumbled out and nose-dived into the sidewalk.  Paramedics were dispatched and on arrival she perked up (lights, sirens, adrenaline, etc.).  He told them what happened and despite the alcohol and a head-injury (abrasion) they allowed her to refuse transport.  I don't agree or disagree with these protocols, and I'm too new to offer any real insight.


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## SpecialK (Jan 17, 2017)

If he has no medical complaint he is not technically a patient.  Regardless, the law in New Zealand allows him to refuse assessment and treatment.  There is no age limit.  As long as he can prove he is competent he can do whatever he likes.

I would still get his name etc. so I could complete a patient report form.  

Honestly? What useless bloody event staff.  They should have told him to PO and called him a cab or uber to take him home, or at worst, the police.


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## hometownmedic5 (Jan 17, 2017)

I'm unable to locate anywhere in the OP a medical complaint. A person without a medical complaint or need for medical aid regardless of their ability or desire to complain is not a patient.

This is a legal matter between the venue, the police, the subject and if available their parents. I would document it as such. This isn't a tough one with a lot of sub textual wrinkles. 

17M presented to EMS by venue security with no complaint and no apparent need for medical aid. Security states subject brought to EMS because he is a minor and is admittedly under the influence of ETOH. Subject presents CAOx4 in no acute distress. Subject states no desire for transport nor desire for further evaluation. PD summoned. Care of child turned over to PD to handle.

Now, clearly there are details lacking. What caused this youth to come to the attention of security? What is their reasoning for believing this person needs medical aid? Is there a higher than average index of suspicion regarding possible unvoiced complaints or is this a straight up dump job as has become all too common with ETOH calls.

With no reason to suspect occult problems, you have a minor child under the influence of ETOH with no complaints. NO medical problems, not a patient. Make the cops do their job and go tot he next call.


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## DrParasite (Jan 18, 2017)

Just to play devil's advocate, I'm assuming this is how you are going to document the event exactly as stated, correct?


hometownmedic5 said:


> 17M presented to EMS by venue security with no complaint and no apparent need for medical aid. Security states subject brought to EMS because he is a minor and is admittedly under the influence of ETOH. Subject presents CAOx4 in no acute distress. Subject states no desire for transport nor desire for further evaluation. PD summoned. Care of child turned over to PD to handle.


Let's pretend I'm your supervisor and reviewing this chart as part of a random QA.  Please answer these questions:
1) you were brought a patient who was a potentially intentional overdose victim.  and you didn't transport why?
2) did you assess the patient?  if not, how do you know he wasn't in any distress?  after all, drugs can do weird things on a patient's body
3) of course you assessed the patient, you documented that he is CAOx4 in no acute distress.  if you did assess the patient, did you offer transport?  oh, he's a minor... so he can't legally refuse to be transported.  so you abandoned him?  after all, there is no documentation for what happened, and you did initiate care by the assessment
4) Why did you turn over a patient who consumed a drug, and was very likely under the influence of said drug,  to a non-medical person?   I believe that is the definition of abandonment.
5)  This patient was found by the police the next day at home, with the suspected cause of death being an overdose.  your documentation says he was given to you and you didn't transport him.  there is no documentation that he refused transport, nor that you explained the risks.  now the family is suing us and you personally for being the cause of death of their son.  We have notified to department of health, who are conducting their own investigation, we are conducting an internal investigation regarding this incident, and you are on unpaid leave pending the outcome of this lawsuit.

Doesn't sound good does it?


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## hometownmedic5 (Jan 18, 2017)

Your whole argument is predicated on this being a patient. He isn't. Once again, he has no medical complaint or desire for services. That makes him not a patient. 

Did I work him up? No. Why not? Not a patient.  Why did I turn him over to the police? Because a minor under the influence of ETOH with no other issues isn't a medical problem, it's a legal problem. He doesn't need medical care. He didn't request medical care. He doesn't want medical care. My version is as close to abandonment as yours is too kidnapping. 

Now, if this kid was stuperous, fall down drunk we might be having a different conversation; but merely ingesting alcohol doesn't require medical attention regardless of age. This would be a cake walk to defend in CQI. Maybe not for you at your service, but I don't live in a world where every person I contact goes to the hospital whether they want to or not.


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## bakertaylor28 (Jan 23, 2017)

Except for the fact that your overlooking the fact that in most states minors (i.e. under 18) lack capacity to enter into informed consent in the first place, unless they are emancipated. Rather, a parent or legal guardian is the party that must legally consent to treatment. So unless, the parent /.legal guardian is around, and given the fact that we don't know if it's a potential life threatening situation or not, getting some rudimentary information, such as vital signs, etc. is within reason - as the presumption is that it is a potentially life-threatening situation until concrete information and evidence proves otherwise.
You have to keep in view that:

1. We CANNOT assume that alcohol is the only substance involved. Teenagers LIE all the time, TO EVERYONE.
2. The scenario of an 18+ party suggests the strong possibility of the presence of illegal drugs in context of the situation.
3. We cannot affirmatively rule out the presence of other drugs in the situation without resorting to techniques we don't have at our disposal in the field.
4. What do the vital signs suggest? This will give more information as to the situation. (i.e. if I see something like a brady or tachy pulse rate its a red flag - Alcohol on its own doesn't do that sort of thing unless BAC is relatively high.)  A Drug overdose victim can look relatively fine on arrival
    but within a mater of moments deteriorate rapidly to a life-threatening level. Early intervention is often key to successful treatment of the overdose
    situation. (example: I once saw a amitriptyline overdose that hit the proverbial fan before I had the time to persuade the victim to get in my rig and
     at least let me get a set of vitals - think less then five minutes! )

These facts demonstrate the potential for a life threatening situation UNTIL and only UNTIL you affirmatively prove them INCORRECT To the situation at hand. IF you presume and your WRONG, you stand a chance of a DOA happening. No lawyer is going to sue you over a case like this, because of the fact that a court of law would most likely view this type of situation as frivolous on its face. (not that malpractice law, etc. involves what a REASONABLE person would believe about the situation, and my outline above is perfectly reasonable. ).


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## hometownmedic5 (Jan 23, 2017)

I saw nothing in the op regarding wonky vitals, or any other measure of instability. What I did see was a situation where the police wanted EMS to take a pile of paperwork off their hands, a daily occurrence where I work. This isn't a medical emergency. This is a dump job, plain and simple. If you work in a system where you have no options in this type of situation except to say thank you as you wipe your chin and walk away, then so be it. That isn't the case for me.

If you think this kid is in a "life threatening situation" I can only assume you've never consumed alcohol. A person who has consumed a life threatening amount of alcohol doesn't present stable one minute and then box out of nowhere unless they just funneled a bottle of everclear or similar.

Either way, this kid needs to go to the hospital about as much as I need two left shoes..


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## bakertaylor28 (Jan 23, 2017)

Here's the thing the OP only gives the scenario background and gives no further information, from my reading of it. Hence, getting a set of vitals is in order, minimally (IF you had carefully read my post, you'd have realized what I was getting across.) The thing is that some of us are making the assumption that it is what it appears to be, which is not always the case. When we combine that with the fact that the law in most states does not allow a minor to authorize a legal document (meaning that a 17 year old effectively CANNOT refuse treatment in the majority of states ) we may only defer to the parent on that issue (whom isn't present based on the OP) Consent to treatment is really immaterial at the scene. (Until at such point the parent arrives on scene - and I'm going to assume that law enforcement has already made the necessary notification- as such would be their SOP .) Further, regardless of medical, law enforcement COULD potentially treat and process this as a mental health commitment case (under laws such as Florida's Marchman act.) Where the real liability is involved here is if EMS does nothing and then later something happens.

hometownmedic5, you also didn't carefully read the part  of my post about the distinct and overwhelming possibility that drugs OTHER than alcohol may be present. C;mon what do kids these days do at an 18+  party? smoke pot which could be laced with God knows what, and/or engage in drug use. Its not the environment you expect within the typical adult (21+) bar scene anymore. We're seeing increased use of hard drugs and we're seeing things like synthetic pot these days.- and the effects of some of these substances can be unpredictable in their own right. Alcohol when combined with certain other drugs (particularly with the case of stimulants) will have an erratic and unstable onset of symptoms. Chances are that a 17 year old ISN"T going to tell the truth with that regard, likely because they want to avoid getting arrested for constructive possession OR because they want to avoid the distinct possibility of someone else ending up being arrested for a drug offense as a result of the situation. Therefore, it would be wise to assume, if anything, that about everything that comes out of this kid's mouth is probably a LIE.

Therefore, as an insurance policy, personally, I'm going to assume a drug / alcohol interaction or drug overdose has taken place UNTIL I have at least two sets of relatively stable vital signs OR enough verifiable information to lead me to safely believe that it's nothing more than an alcohol case.


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## Carlos Danger (Jan 23, 2017)

Following the reasoning presented in the last few posts, we are pretty much responsible for anyone under the age of 18 who we come into contact with. 

17 year old at the fast food place: "Here's your order, sir".

EMT to 17 year old: "Thank you. Hey, you look a little fatigued. Are you feeling OK?"

17 year old: "Yea, I'm fine. Just a little wiped out from a long busy day. School, practice, and now work."

EMT: "Are you sure you are just tired? How do we know you don't have a medical problem going on?"

17 year old: "I don't know....I'm perfectly healthy........and I feel fine, other than just being tired".

EMT: "Well, you could have something going on not know it. Maybe you are on drugs and just aren't admitting it to me - lots of kids your age use drugs. You could possibly even wake up dead tomorrow, and I'd be responsible. I know you say you are fine, but I can't legally take your word for that since you are under 18. I'll need to take you to the hospital if I can't get ahold of your parents".

17 year old: Wut is happening?


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## NomadicMedic (Jan 23, 2017)

Remi said:


> Following the reasoning presented in the last few posts, we are pretty much responsible for anyone under the age of 18 who we come into contact with.
> 
> 17 year old at the fast food place: "Here's your order, sir".
> 
> ...


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## CALEMT (Jan 23, 2017)

People on this thread be turning a whole lot of nothing into a full blown "give me every fire rider and go code 3 to the hospital now" type of call. This is a classic security "I don't want to deal with this so I'll pawn it off to someone else" kinda call. There's no medical aid needed, therefor there is no patient. How this call should go: 
EMS: "kid, you okay?"
Kid: "yeah, just drunk"
EMS: "cool beans, sercurity, you can handle this"
Security: "crap"


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## NomadicMedic (Jan 23, 2017)

CALEMT said:


> People on this thread be turning a whole lot of nothing into a full blown "give me every fire rider and go code 3 to the hospital now" type of call. This is a classic security "I don't want to deal with this so I'll pawn it off to someone else" kinda call. There's no medical aid needed, therefor there is no patient. How this call should go:
> EMS: "kid, you okay?"
> Kid: "yeah, just drunk"
> EMS: "cool beans, sercurity, you can handle this"
> Security: "crap"




Right, but it's not really a no patient. Its a request for service that turned out to be a no patient. You need to document that you saw the kid, there was no medical need and the subject remained with the security officer. I'd say a set of vitals wouldn't be to far out of line. At least you can say that there was no immediate medical need if you wind up sitting at a conference room table giving a deposition.


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## hometownmedic5 (Jan 23, 2017)

I read, and understood, every word. We just have contrary opinions on how best to handle this call.

This thread keeps circling back to refusing medical treatment and the authority to contract, neither of which are necessary if the PERSON is not a PATIENT. You don't become my patient till you state a specific complaint or request services without the presence of a complaint; or a third party request services on your behalf and upon presentation to me you are unable to be medically cleared in the prehospital context. If they aren't a patient, I don't need a refusal and if I don't need a refusal, i couldn't care less how old the person not refusing my care is. 

I get asked at least once a shift to evaluate a person for the police. The majority don't get in my ambulance. Whether they end up sent not heir way or hooked and booked I don't know, but I don't live in a world where every person I contact gets a ride in my truck and a two thousand dollar bill.


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## bakertaylor28 (Jan 24, 2017)

Remi said:


> Following the reasoning presented in the last few posts, we are pretty much responsible for anyone under the age of 18 who we come into contact with.
> 
> 17 year old at the fast food place: "Here's your order, sir".
> 
> ...



As for this- NO, it doesn't quite work this way. There's a distinct difference between sitting in line at mcdonalds (where dispatch doesn't have you marked a being an in-service unit) and being called out on an emergency run where at least one objective adult feels that there is at least potential. Plus the SOPs have that little thing in there about someone signing the treatment refusal form, but Oh snap, the law doesn't allow a 17 year old to sign legal documents. (So go complain to your congressman if you have a problem with that!)  So at minimum, this means your unit is tied up until you can get someone with capacity to sign the damn form.  Unless you want to take the chance of something happening and take the Chance at being sued without having much of a valid legal defense. (Because, after all,  we're supposed to be considering the remote but theoretically possible contingencies of outcome) Now, had the OP listed a little more objective information to suggest that our scenario isn't something that's more than what meets the eye. I might take a different position on the matter. The argument here tends to forget that a lot of things can present in very atypical manners.

So the critical question is:

What objective and reliable facts do we have that prove that we don't have something suitcased along with ETOH, that perhaps might still be on the up-side in terms of bioavailability?

The answer, is that other than LOC, absolutely NONE, given only the information presented in the OP.

If we read carefully , the  OP doesn't give us any information other than LOC. While LOC is a good measure of indicator, its NOT EVERYTHING, and taken on its own can sometimes be deceiving. (one only need to see the effects of psychedelic mushrooms to know what I mean.)  Therefore, given what we've been told in the OP, a set or two of vital  is the next appropriate step, playing by the book. Bottom line, this is not the sort of thing we can afford to be playing law of averages with - because it only takes that ONE TIME to turn out to be DEAD WRONG - and end up being in the pickle of having some 'splaining to do.


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## hometownmedic5 (Jan 24, 2017)

And we again return to the unnecessary signing of the unnecessary form....

I quit. Go ahead and transport him.....


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## VFlutter (Jan 24, 2017)

bakertaylor28 said:


> Bottom line, this is not the sort of thing we can afford to be playing law of averages with - because it only takes that ONE TIME to turn out to be DEAD WRONG - and end up being in the pickle of having some 'splaining to do.



You are more than welcome to practice ultra-conservative, always cover your ***, everything black and white however not everyone sees things that way. Feel free to take every intoxicated underage kid at a concert to the ER if that is what you think is best. I just do not think you are going to convince many people. 

If you have a medical director that thinks that way and never allows any deviation from protocol or will never give you orders out of fear of litigation does that make them "safer"? Maybe. Does it make them a better provider? Not in my opinion. I like that quote that every doctor, or medical provider for that matter, owns a piece of the graveyard but that doesn't mean you should practice out of fear for that one time.


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## bakertaylor28 (Jan 24, 2017)

hometownmedic5 said:


> And we again return to the unnecessary signing of the unnecessary form....
> 
> I quit. Go ahead and transport him.....



I don't know how your procedures read, but around here, you pretty much have a "patient" from Time of Arrival on scene, regardless of the scenario that presents itself, unless the call is determined to be dispatched based on false information.


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## TransportJockey (Jan 24, 2017)

bakertaylor28 said:


> I don't know how your procedures read, but around here, you pretty much have a "patient" from Time of Arrival on scene, regardless of the scenario that presents itself, unless the call is determined to be dispatched based on false information.


Or if the person on scene does not desire you there, did not call you, and does not want assessment or treatment. 

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## VFlutter (Jan 24, 2017)

So this 17 year old is adamant he does not want medical treatment or transport are you going to forcibly provide treatment? Get law enforcement involved to detain him and transport? Chemically restrain him because you never know what he may have took, he may be a threat to himself or others in a few minutes.


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## TransportJockey (Jan 24, 2017)

Chase said:


> So this 17 year old is adamant he does not want medical treatment or transport are you going to forcibly provide treatment? Get law enforcement involved to detain him and transport? Chemically restrain him because you never know what he may have took, he may be a threat to himself or others in a few minutes.


If you're gonna go overboard, you might as well go full retard 

Sent from my SM-N920P using Tapatalk


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## VentMonkey (Jan 24, 2017)




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## bakertaylor28 (Jan 24, 2017)

Chase said:


> You are more than welcome to practice ultra-conservative, always cover your ***, everything black and white however not everyone sees things that way. Feel free to take every intoxicated underage kid at a concert to the ER if that is what you think is best. I just do not think you are going to convince many people.
> 
> If you have a medical director that thinks that way and never allows any deviation from protocol or will never give you orders out of fear of litigation does that make them "safer"? Maybe. Does it make them a better provider? Not in my opinion. I like that quote that every doctor, or medical provider for that matter, owns a piece of the graveyard but that doesn't mean you should practice out of fear for that one time.



Its called being in business to make money, and try to avoid loosing it at reasonable costs. Not something I agree with in this profession, but I will be sure to put in a ***** about it to medical direction on your behalf, Chase - and I'll let you know what they have to say about it. Plus, in that rare event that it goes south, what really are you going to say when confronted by the family? Its a smaller world than you think, and frankly I don't want to be in the position to try to justify something like that. I try to live with the ethical standpoint of keeping as much blood off my hands as humanly possible.


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## NomadicMedic (Jan 24, 2017)

I think you guys may have fallen into the spiral death trap.

Should he be transported? No.

Is he truly a patient? No. He's is only a patient in the sense that a third party (security guard) brought you into his encounter. If you're not needed, politely extricate yourself. 

Should you document that security brought him by and he had no medical complaints and he left with security? You betcha. 

Do you need to do any more than that? Probably not. Every event I've ever worked only requires a PCR for a patient I've actually treated. Otherwise, a running timeline would suffice.

2010. Handed bandaid to woman with blister on foot. No medical attention requested.

2030. Security stopped at first aid station with a minor (Smith, John 01/01/2000) who admitted to alcohol ingestion. He was in no apparent distress and when asked if he needed or wanted any medical attention, replied "no". He left with security at 2031.

That's probably all you need. No signature.


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## hometownmedic5 (Jan 24, 2017)

bakertaylor28 said:


> I don't know how your procedures read, but around here, you pretty much have a "patient" from Time of Arrival on scene, regardless of the scenario that presents itself, unless the call is determined to be dispatched based on false information.



As I said, if that's the world you live in then do what you have to do. I don't live in that world, nor do most of the providers on this thread. 

If I treated every person I contact in a month as a patient, I'd spend most of my time writing refusals. I probably do ten third party activations a month where I arrive and find a person who was napping on a bench, or in their car, or who was confused because the store they were looking for closed last month and they were wandering up and down the street looking lost and confused and because they happen to be 80, some cell phone wielding hero called 911. 

Not everybody I talk to after being dispatched to their location is a patient and non patients don't require refusals. As presented, this is a police matter, not an EMS call. I would write it up exactly as I posted here and not give it a second thought. If you live in a different world then so be it, but no matter how many times it's repeated that a 17 year old lack legal capacity to refuse care, you're not going to change my mind that this person is not a patient and has business only with the police and his parents.


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## VentMonkey (Jan 24, 2017)

@hometownmedic5 I appreciate your insight and forethought, however, somethings are just lost on others.


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## hometownmedic5 (Jan 24, 2017)

Yup. Some people you just can't reach. :smh:


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## bakertaylor28 (Jan 28, 2017)

hometownmedic5 said:


> As I said, if that's the world you live in then do what you have to do. I don't live in that world, nor do most of the providers on this thread.
> 
> If I treated every person I contact in a month as a patient, I'd spend most of my time writing refusals. I probably do ten third party activations a month where I arrive and find a person who was napping on a bench, or in their car, or who was confused because the store they were looking for closed last month and they were wandering up and down the street looking lost and confused and because they happen to be 80, some cell phone wielding hero called 911.
> 
> Not everybody I talk to after being dispatched to their location is a patient and non patients don't require refusals. As presented, this is a police matter, not an EMS call. I would write it up exactly as I posted here and not give it a second thought. If you live in a different world then so be it, but no matter how many times it's repeated that a 17 year old lack legal capacity to refuse care, you're not going to change my mind that this person is not a patient and has business only with the police and his parents.



Even If it is a police matter, they know their not going to get a detention facility to accept someone in this sort of state anyways without an MD clearance, so either way, the net effect is the same. Its really more of a question of who's vehicle is doing the transport.


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## Handsome Robb (Jan 28, 2017)

bakertaylor28 said:


> Even If it is a police matter, they know their not going to get a detention facility to accept someone in this sort of state anyways without an MD clearance, so either way, the net effect is the same. Its really more of a question of who's vehicle is doing the transport.



Plenty of juvenile detention centers will accept a minor who's intoxicated...not if they fall down, passed out drunk but adult facilities won't accept a person like that either. 


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## bakertaylor28 (Jan 28, 2017)

Handsome Robb said:


> Plenty of juvenile detention centers will accept a minor who's intoxicated...not if they fall down, passed out drunk but adult facilities won't accept a person like that either.
> 
> 
> Sent from my iPhone using Tapatalk



Gee, then it appears that our local SOPs are much stricter than average. Our local county-run facilities will not accept an individual that shows any signs of CNS impairment whatsoever without clearance from an MD not directly in the employ of the county. Of course they changed their SOP after they booked someone they thought was drunk, it turned out to be a stroke, and a DOA.


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## Handsome Robb (Jan 28, 2017)

bakertaylor28 said:


> Gee, then it appears that our local SOPs are much stricter than average. Our local county-run facilities will not accept an individual that shows any signs of CNS impairment whatsoever without clearance from an MD not directly in the employ of the county. Of course they changed their SOP after they booked someone they thought was drunk, it turned out to be a stroke, and a DOA.



That's definitely not the norm. 


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## bakertaylor28 (Jan 30, 2017)

Handsome Robb said:


> That's definitely not the norm.
> 
> 
> Sent from my iPhone using Tapatalk



Well, what can I say- the notion that any idiot doesn't know that when someone looks like their face is starting to melt off their head has at least *some sort* of serious medical issue going on isn't normal either. So I guess I'm dealing with an abnormal local administration. Of course then again,  I'm from a state where exists the only EMS system on the face of the planet that faces a lawsuit because the administrators actually ***Thought*** they would allegedly screw the government out of a bunch of money using a rather ornate set of kickbacks. (And then after getting caught, try to say they didn't). Gee, Imagine That.


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