Palm Beach County Fire Rescue SOG 520-03 Patient Refusal (PDF)

Palm Beach County Fire Rescue Standard Operating Guideline SOG 520-03 Patient Refusal Issue Date: 12/21/2020...

Palm Beach County Fire Rescue Standard Operating Guideline SOG 520-03 Patient Refusal Issue Date: 12/21/2020 Effective Date: 01/18/2021 PURPOSE: The purpose of this Standard Operating Guideline (SOG) is to provide a process to determine who can legally sign a PBCFR Patient Refusal Form, and to establish a procedure for properly documenting refusals. AUTHORITY:  Fire Rescue Administrator  Medical Director, Palm Beach County Fire Rescue  Florida State Statutes 401.445 and 766.103 SCOPE: This standing operating guideline shall apply to all Fire Rescue personnel. PROCEDURE: 1. General a. Palm Beach County Fire Rescue strives to deliver quality healthcare to every patient we encounter, and to that end, the Patient Refusal should be the last course of action crews utilize. Our goal is to ensure patients are treated and transported to the most appropriate hospital. b. All patients with life-threatening or potentially life-threatening emergency medical conditions should be transported to the closest appropriate Emergency Department. Every attempt shall be made by Fire Rescue personnel to convince the patient not to refuse treatment and/or transport. Personnel may enlist help from the patient’s family members, friends, physician, the EMS Captain, or Medical Director as needed. c. When a patient refuses transport, Fire Rescue personnel shall: i. Exhaust all reasonable efforts to have a competent adult stay with the patient. ii. Inform the patient that if at any time they change their mind or their condition deteriorates/changes, they should call 9-1-1. d. Patients with suspected emergency medical conditions who are deemed likely to be incapacitated either by intoxication, the effects of their emergency medical condition, or otherwise as described in Florida Statute 401.445 may be examined, treated, and taken to an Emergency Department without their consent, but unreasonable force shall not be used. SOG 520-03 Patient Refusal Page 1 of 4  2. Who Can Refuse Treatment or Transport a. Adults ≥ 18 years old i. Mentally competent patients have the right to refuse all or any portion of treatment or transport if they meet all of the following criteria: 1. AAOx4 2. Clinically sober (clear speech, no difficulty with balance or coordination) 3. Without life-threatening or potentially life-threatening emergency medical conditions that could impair their judgment, such as, but not limited to: a. Hypoxia (