The most critical clinical decision a provider can make is not at the devastating car wreck or the witnessed cardiac arrest; it’s during a patient’s refusal of care and transport, the most common incident encountered by most responders. How are you managing refusals on scene? Does your service use provider-initiated refusals or alternative transport destinations? Can your refusal documentation stand up in a court of law? Nick, an EMS Division Chief with over two decades of emergency response and quality assurance experience, and Samantha, an attorney for one of the largest hospital-based EMS systems in the Southeast, examine the clinical, legal, ethical and operational implications of patient refusals. Providers, administrators, and educators will benefit from this practical and interactive street-level approach to managing and documenting patient refusals. Nick and Samantha discuss a consistent method that enhances clinical judgment and acts as a checklist for legally compliant documentation. Using actual incidents and reported legal cases, Nick and Samantha offer tips and tricks for responders to protect themselves and their services from legal liability.
Learning Objectives:

Examine the clinical, legal, ethical and operational issues associated with patient refusals.
Analyze the legal impact of provider-initiated refusals and alternative transport destinations.
Demonstrate the role of documentation in reducing legal liability for patient refusals and use the CURED mnemonic for more effective charting.