What's the most out-of-the-ordinary refusal you've ever gotten?

[MrBrown]

Sweet!

Yeah, but Brown making $1000 a procedure as an anaesthetist in private practice is way sweeter ... last time Brown checked their was little private work for Consultants in emergency medicine

Brown wonders what sort of private jet Brown should get ... hmm

 

[JPINFV]

last time Brown checked their was little private work for Consultants in emergency medicine

Job satisfaction >> Reimbursement alone.

 

[NomadicMedic]

For something like that Brown wouldn't feel too bad about leaving her at home, it's clearly something she has a history with and its not like the hospital are going to do a great deal (if anything) for her.

Agreed. But the ER doc was aghast when I called him about the refusal. He said to me, "is she aware you just stopped her heart?" I said, "yep and now she feels better, so I guess she's gonna stay home..."

It was actually funny to me. We do the same thing with d50 all the time.

 

[rmabrey]

Nothing really out of the ordinary, just the same people with diabetic emergencies weekly, give em some D50 and they sign a refusal.

I think this has something to do with us switching to D10

 

[JPINFV]

Nothing really out of the ordinary, just the same people with diabetic emergencies weekly, give em some D50 and they sign a refusal.

I think this has something to do with us switching to D10

Actually, D10 should only help patients sign AMA since it results in much less drastic swings in the patient's blood glucose level following administration.

 

[rmabrey]

Actually, D10 should only help patients sign AMA since it results in much less drastic swings in the patient's blood glucose level following administration.

hmm is it cheaper then?


I know they are getting charged the same whether we transport them or not so I just assumed it was for better transport percentages

 

[abckidsmom]

Agreed. But the ER doc was aghast when I called him about the refusal. He said to me, "is she aware you just stopped her heart?" I said, "yep and now she feels better, so I guess she's gonna stay home..."

It was actually funny to me. We do the same thing with d50 all the time.

I think as long as you can point to a simple insulin error or taking meds without eating, hypoglycemics don't need to go. But if the low doesn't make sense to the well-educated patient, I always feel like they should go, to see what the problem is.

 

[abckidsmom]

Agreed. But the ER doc was aghast when I called him about the refusal. He said to me, "is she aware you just stopped her heart?" I said, "yep and now she feels better, so I guess she's gonna stay home..."

It was actually funny to me. We do the same thing with d50 all the time.

It's July, you know, so the med control physician I talked to about the orders for the treat and release solumedrol and fluid bolus was a newly-minted 2nd year resident. He was extremely uncomfortable with the situation and said something similar, "Is he aware that he could die from this? He's not drunk or anything is he?"

Poor dear, he didn't want to share the responsibility, but we have a policy that ALS treatment on the scene means we have to talk to med control before we clear up.

 

[MrBrown]

One of the criteria for us to consider leaving a post hypo at home is no overdose including accidental of insulin or oral antihypoglycaemics

Oh and we've been using D10 for donkey's years, its great stuff

 

[RocketMedic]

thats going to open up alot of jobs then. There are alot of medics and EMTs that do it here.

It doesn't limit it to only an ambulance transport. The police can also transport them depending on how stable they are.

IMO people should be able to choose what they want done up to a point. There is a point where honestly some peoples choices are well stupid.

Complete and total disagreement. Personal choice from competent adult patients regarding their health care is a fundamental freedom. By your logic, we would ban fast food and everything even remotely hazardous due to potential risk.

 

[abckidsmom]

thats going to open up alot of jobs then. There are alot of medics and EMTs that do it here.

It doesn't limit it to only an ambulance transport. The police can also transport them depending on how stable they are.

IMO people should be able to choose what they want done up to a point. There is a point where honestly some peoples choices are well stupid.

Stupid is totally allowed. There's no law against it.

 

[dstevens58]

Had one girl, each time I took her blood pressure, it kept going lower and lower. Last BP was something like 60/palp and she was still refusing. We spent over an hour on the scene attempting to convince her to go into the hospital. We resigned ourselves to standing by until she passed out. Luckily, between her boss, her husband, the paramedic and a couple of EMT's, we finally got her to agree to be checked out.

Later talked to her manager and she stated she spent a couple of days in ICU, but I never received an official follow-up from the hospital.