The hospital will usually let them leave AMA, but the medical directors just don't want that liability.
So your medical director is directing you to take the person kicking and screaming, and once you get to the ER, they can just AMA out of the ER? sounds like a waste of an ambulance trip.
It's the high risk refusals that usually get people fired/sued.
With all due respect, no it's not. It's the inappropriate high risk refusals that get people fired or sued. Such was when protocols don't get followed, or paramedics fail to do their jobs.
In your case, no one is suggesting you go against your medical director; that is a good way to end up getting fired. But knowing why you are calling your medical director, and realizing that if you do get sued, most of the time the suit will be against the paramedic and the agency. if disciplinary action is taken, it's usually taken against the paramedic, and rarely against online medical control (especially if that person isn't the full time medical director).
So they might tell you something, but there have been cases where medical control tells a paramedic to do something that is questionable, and later found to be wrong. The paramedic usually takes all the heat for it, and the doc on the other end gets at most a slap on the wrist.
BTW, just because someone "accidentally" takes too much narcotic, and needs to be revived with narcan, doesn't mean they lack capacity. Once they are awake, alert, and understand the risk of their actions, they are AOx3. I'm pretty sure I could convince a lawsuit that forcing an AOx3 to go to the hospital against their will is wrongful imprisonment and kidnapping. maybe even battery too, if force was used. Might even be able to file criminal charges against you for your actions. And those would all be directed at your personally; your medical director and agency might be named for the deep pockets in a civil case only.
Reading the OPs description of the patient and the scene I have hard time believing this patient be capable of rational thought. How can the provider complete a thorough assessment to obtain the necessary information needed to inform the patient of the risks WHILE the pt s actively fighting? How can the providers get the necessary vital signs while the patient is "irate, inconsolable, and removing all vitals equipment?" The patient must be able to process all of the information with rational thought in order to make an informed decision. From the description provided I do not think this patient can meet that aspect. Being able to answer questions does not equate to the patient being able to making rational decisions.
So your going to forcibly restrain the patient, prevent them from leaving, the ambulance, and, against their will, reassess their vitals? maybe even chemically sedate/restrain them?
If a patient gets irate and say "get the F off me, get all these things off me" they have made their intentions and desires very clear. I have no problems calling the cops and letting them wrestle with the patient (they are on more solid legal ground than I am), but forcing my treatments on an patient who obviously does not want them is stretching my job description a bit. Esp one whose alert enough to convey the message that they don't want me help.
That being said, have I wrestled with my fair share of drunks, and restrained people in crisis? sure. but a simply overdose patient, especially a violent one who has conveyed that he doesn't want my help? the cynic inside me says he's going to OD again. maybe them time he will only get enough narcan to get him breating, not enough to wake him up.
