Podcast
Questions and Answers
What is the primary condition in which a patient may be considered incompetent to refuse medical care?
What is the primary condition in which a patient may be considered incompetent to refuse medical care?
- Refusal of treatment by family members
- Age under 21 years
- Having an advocate present
- Altered mental status (GCS < 15) (correct)
Which of the following groups is explicitly stated as being able to refuse medical care?
Which of the following groups is explicitly stated as being able to refuse medical care?
- Individuals with a legal guardian present
- Married minors
- Mentally competent adults (correct)
- All individuals over 25 years of age
Under what condition might Implied Consent be invoked?
Under what condition might Implied Consent be invoked?
- When the medical personnel are unfamiliar with the patient
- When no adult consent can be obtained for a minor (correct)
- When the patient is conscious and coherent
- When the total refusal of care is voiced by family members
What is one reason a patient under 18 may be treated without consent?
What is one reason a patient under 18 may be treated without consent?
Which circumstance does NOT qualify a patient for treatment under Implied Consent?
Which circumstance does NOT qualify a patient for treatment under Implied Consent?
What documentation is essential in supporting the decision to treat a patient under certain circumstances?
What documentation is essential in supporting the decision to treat a patient under certain circumstances?
Which of the following does NOT represent a reason a patient might be deemed incompetent to refuse care?
Which of the following does NOT represent a reason a patient might be deemed incompetent to refuse care?
When is it appropriate to restrain a patient during treatment?
When is it appropriate to restrain a patient during treatment?
Under which circumstances may Fire Rescue personnel take action without informed consent?
Under which circumstances may Fire Rescue personnel take action without informed consent?
What documented score is required for a patient to refuse treatment or transport?
What documented score is required for a patient to refuse treatment or transport?
Who is authorized to impose the Baker Act?
Who is authorized to impose the Baker Act?
In the context of patient refusal, what is a necessary action if a patient cannot sign their release?
In the context of patient refusal, what is a necessary action if a patient cannot sign their release?
Which of the following resources can Fire Rescue personnel consult when facing difficult patient refusal situations?
Which of the following resources can Fire Rescue personnel consult when facing difficult patient refusal situations?
What information must be documented on the ePCR after utilizing the Baker Act?
What information must be documented on the ePCR after utilizing the Baker Act?
If a patient who has consumed alcohol refuses treatment, what must Fire Rescue personnel assess?
If a patient who has consumed alcohol refuses treatment, what must Fire Rescue personnel assess?
In cases of multiple patients refusing care due to an accident, what is the exception regarding ePCR documentation?
In cases of multiple patients refusing care due to an accident, what is the exception regarding ePCR documentation?
What must Fire Rescue personnel do if an ALS patient refuses to be transported to the closest facility?
What must Fire Rescue personnel do if an ALS patient refuses to be transported to the closest facility?
What condition must be met in order to consider that the patient meets the criteria for the Baker Act?
What condition must be met in order to consider that the patient meets the criteria for the Baker Act?
What is essential for Fire Rescue personnel to communicate to a patient refusing care?
What is essential for Fire Rescue personnel to communicate to a patient refusing care?
What must be included when documenting a patient's refusal in the narrative section of the ePCR?
What must be included when documenting a patient's refusal in the narrative section of the ePCR?
Which command prioritizes the stabilization of a patient's condition?
Which command prioritizes the stabilization of a patient's condition?
What is the appropriate course of action for a family member wishing to refuse treatment for an adult patient?
What is the appropriate course of action for a family member wishing to refuse treatment for an adult patient?
Study Notes
Patient Rights and Consent
- Competent adults can refuse medical care, treatment, and transportation; consent is essential.
- Consent may be implied through 911 requests, but verbal consent should always be verified if uncertain.
- Conditions for refusal include being mentally competent and an adult (18+), with exceptions for certain minor statuses (emancipated, self-sufficient, married, military).
Incompetence to Refuse Care
- Incompetence to refuse care may arise from severe conditions, including:
- Altered mental status (e.g., GCS < 15).
- Suicide threats or attempts.
- Severely abnormal vital signs.
- Mental impairments.
- Underage status (unless qualifying under exceptions).
Implied Consent
- Patients found unconscious presumed to consent to care; reasonable person standard applies.
- Inability to obtain adult consent for minors allows for implied consent.
- Reasonable measures, including restraint, may be employed if necessary.
Incapacitated Persons Law
- Allowed to treat without informed consent if:
- Patient is incapacitated (intoxicated, drug-influenced).
- Experiencing an emergency medical situation.
- Treatment would be reasonable if the patient could consent.
- Documentation of rationale is necessary.
Baker Act Criteria
- Imposed if:
- A person is believed to be mentally ill and cannot determine necessary care.
- Likely to suffer neglect or harm, or may harm self/others.
- Only authorized by a judge, sworn law enforcement officer, physician, psychologist, or psychiatric nurse.
Patient Refusal Protocol
- Inform patients of potential consequences when refusing treatment.
- Document that refusing individuals have a GCS of 15.
- Assess decision-making capabilities if under the influence of substances.
- Encourage family involvement to persuade patients to accept care.
- E-PCR documentation is crucial; if a patient refuses to sign, a witness signature is required.
- For multiple refusals in accidents, each patient requires a separate ePCR unless specific conditions apply.
ALS Patient Transport Protocols
- Patients refusing transport to the nearest facility must be assessed under the Incapacitated Person Law.
- If compliant, explain seriousness and transport them to the nearest facility; if not compliant, respect their choice and ensure a signature on the refusal.
- Family members cannot refuse treatment for adult patients, except in specific circumstances (e.g., valid DNR orders).
Medical Support Resources
- Difficulty in managing refusal cases may warrant consultation with:
- On-duty EMS Field Supervisor.
- Medical Control Physician (MCP) of the closest facility.
- Medical Director or Assistant Medical Director via FAO for guidance.
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Description
This quiz covers the essential principles of medical consent and the rights of mentally competent adults regarding medical care. It outlines the importance of obtaining consent before treatment and the implications of requesting emergency services. Understanding these concepts is vital for healthcare professionals.
