What gives us the right????

[jaron]

I'm trying to help out a friend do a little research. Any help would be greatly appreciated.

What gives us as EMTs and Paramedics the right to transport someone against there wishes? For example when they are intoxicated or any other AMS. Is it Federal, State, County.... After doing some research on my own I am not able to find any clear documentation other than company policy that allows us to do this.

Thanks again for any help.

 

[MMiz]

I'm trying to help out a friend do a little research. Any help would be greatly appreciated.

What gives us as EMTs and Paramedics the right to transport someone against there wishes? For example when they are intoxicated or any other AMS. Is it Federal, State, County.... After doing some research on my own I am not able to find any clear documentation other than company policy that allows us to do this.

Thanks again for any help.

I don't think you'll find much documentation, only because this is a hotly contested legal issue. The truth is, very little gives us the right to transport someone against their will. When we or online medical control makes the decision to transport someone AMA, it is my understanding that there is a very probable chance that the transport is illegal. Our hope is that a court will recognize the patient's medical necessity to be transported, and that the caregiver was acting in good faith.

It's a very sticky situation to say the least. That's why most folks in EMS like PD or medical control to make the decision. It's all about passing the buck, hopefully to someone with more authority.

 

[DT4EMS]

Actually what you are looking for is "consent".

The "law" regards consent as a person allowing you to treat them. If a person is soooo intoxicated, injured or has an altered mental status you CAN treat and transport under "Implied Consent". Meaning it is "implied" that the person would want treatment to save their life of limb if they "could consent".

That is where you need to look for the research.

 

[jaron]

Thanks for your responses. I understand consent. Maybe I have not explained myself adequately. I'm trying to find out what gives us the legal right to go against someone’s wishes and force them to be transported/treated/evaluated.

Thanks for any help you can give.

 

[Ridryder911]

You can't period.. unless the meet they criteria as mentioned by DT4EMS, otherwise it could be considered kidnapping, assault, etc...

Yes, it can happen..

R/r 911

 

[fm_emt]

They have to say "ok" to it. Sure, you can beg & plead with them, but if they're competent, they can refuse care & transport.

A competent patient can also withdraw their permission for care & transport at any time.

 

[gradygirl]

They have to say "ok" to it. Sure, you can beg & plead with them, but if they're competent, they can refuse care & transport.

A competent patient can also withdraw their permission for care & transport at any time.

Except if they aren't old enough to legally refuse. Good lord, 17 year olds get real angry when you tell them they can't refuse. Never been threatened with a lawsuit that many times in 5 minutes.

 

[Jon]

If they are not competant to refuse, then they usually must be transported. Oftentimes, we call Medical Command and give the doc a chance... I've done it a couple of times when I've explained what was going on and that the patient was appearing resistant so far, but that we were still trying to convince them to go... I was calling for permission to transport against the patient's wishes... I always got the permission, but I've never had to use it... Often, just giving them the "be nice and go" option over the "we'll drag you out" option usually gives them a reason to try it.

underage and/or intoxicated are the most common, but I've had adults who were altered for some other reason.

If they (or their guardians) aren't able to comrehend the risks of refusal, they usually will have to be transported.

 

[ffemt8978]

There is one time a competent adult can not refuse to be transported...

Can anyone tell me what it is?

 

[fm_emt]

Except if they aren't old enough to legally refuse. Good lord, 17 year olds get real angry when you tell them they can't refuse. Never been threatened with a lawsuit that many times in 5 minutes.

Oh yeah, that's right. I think that we were told that if a minor was refusing transport that we oughta get a LEO involved right away. More of a CYA thing. Too many lawyers around here. Although our county says that peds with suspected c-spine injuries get transported regardless.

Kids are a grey area sometimes. :|

 

[Anomalous]

There is one time a competent adult can not refuse to be transported...

Can anyone tell me what it is?

The only time I have had this happen is when they were under arrest.

 

[fm_emt]

There is one time a competent adult can not refuse to be transported...

Can anyone tell me what it is?

When they're ON FIRE?

 

[gradygirl]

There is one time a competent adult can not refuse to be transported...

Can anyone tell me what it is?

When they pose a threat to themselves or others? (Or would that be considered AMS?)

When they're ON FIRE?

Dude, I hope they aren't on fire by the time they're being transported...

 

[davis513]

Well I have only been an EMT-B student for two weeks but I've been a Police Officer (now Sgt, ) in North Carolina for 21 years and can tell you how it's done in NC.

North Carolina General Statute 122C-301 authorizes law enforcement officers to assist an intoxicated person who is found in a public place who is in need of but apparently unable to provide medical care for himself. Further, the statute authorizes the use of reasonable force to protect themselves, the individual or others (Medics). Intoxication can be the result of alcohol or any other substance. There have been many instances when I've handcuffed a patient to a stretcher to be transported by medic to the hospital for treatment.

For mental subjects, NC General Statute 122C-262 provides that a law enforcement officer may transport without a custody order if a patient meets the criteria for involuntary commitment (mentally ill & dangerous to self or others) and requires immediate transportation to prevent harm to self or others.

Also, NC General Statute 122C-262 provides that a law enforcement officer may transport a substance abuser without a custody order if the individual meets the criteria for substance abuse commitment (substance abuser & dangerous to self or others) and is violent and requires restraint and delay would endanger life or property.

Last but not least, if someone is in police custody (arrested) and in need of medical treatment or evaluation they go to the hospital whether they want to or not to get medical clearance before going to jail.

Sorry for the long post but I wanted to give examples of how we do things here in NC. I would be surprised if other states don't have similar statutes.

davis513

 

[HFD EMS]

If they are alert and oriented and you have explained what the possible outcome of not being transported and they still refuse. Let em go. Otherwise the law classifies that as kidnapping and dont try to tell medical control that they arent able to understand when they are because it will definitely come back to haunt you.

 

[ffemt8978]

The only time I have had this happen is when they were under arrest.

We have a winner!!!

 

[fm_emt]

Dude, I hope they aren't on fire by the time they're being transported...

Yeah, one would hope so, but hey, you never know.

Ok, bad joke. I've been doing laundry all evening, so I'm worn out.

 

[Jon]

There is one time a competent adult can not refuse to be transported...

Can anyone tell me what it is?

a "competant" adult is one who is NOT a risk to themselves or others, CAOx4, understands the risks of refusal, etc... Correct?

In that case, the patient would be in custody of an LEO.

 

[eggshen]

Hey FFEMT, 'round these parts that one time would be when your pt is in PD custody. That what yer lookin' for?

Egg

 

[Sera]

sorry if this has already been said.. too lazy to go and read all of the previous posts..
This is on my exam tomorow

Exception to the rule of consent
5 conditions must be present

1. Threat to the life or health of the patient
2. Threat must be immediate
3. Treatment cannot be delayed
4. Patient is unable to consent or refuse
5. Relatives are not available

keep in mind this is from the canadian edition of the pcp textbook...