Signed refusal, or no EMS?

[sevenball]

Here's a situation for everyone to ponder. You are called to the scene of a MVC. Upon your arrival you find multiple patients all ambulatory and in no apparent distress. Upon your assessment, each individual states that they are unijured and wish no treatment or transport. If you continue to question them as to the nature of injury, for example, you state "You're uninjured, no pain, cuts, scrapes, bumps, bruises, nicks or stiffness?" If they state no to all questions, should you obtain a refusal of care and transport, or should you not classify them as a patient, and document as "no ems needed"?

[afib]

you made pt contact you have to document as such that they didnt want any treatment and or transport. i dont talk to anyone I.E. police cancel me no paperwork.

[sevenball]

I'm not so much talking about documenting pt. contact. I'm saying should you get a signed refusal? If your pt. doesn't have a complaint of injury, are they considered a patient at all?

[Just Plain Ruff]

yes you made contact with them they said they weren't hurt you get a refusal. But you really need to talk to your powers that be rather than here because you will get answers across the board, some right some wrong but only your ems agency you work for can answer this question.

[sevenball]

yes, I understand that each service is different, and each service will have their own set of rules, policies and guidlines. I already know what my service has to say on the matter. I was just asking the question for a general opinion on the matter, not as a rule that would dictate my own actions in the field. I am simply curious to see who's opinions match my own.

Definition of Patient

Patient: A person under health care. The person may be waiting for this care or may be receiving it or may have already received it. There is considerable lack of agreement about the precise meaning of the term "patient."

It is diversely defined as, for examples:

A person who requires medical care.

A person receiving medical or dental care or treatment.

A person under a physician's care for a particular disease or condition.

A person who is waiting for or undergoing medical treatment and care

An individual who is receiving needed professional services that are directed by a licensed practitioner of the healing arts toward maintenance, improvement or protection of health or lessening of illness, disability or pain. (US Centers for Medicare & Medicaid Services)

A sick, injured or wounded soldier who receives medical care or treatment from medically trained personnel. (US Army Medical Command)

The word "patient" is of interesting origin. It comes from the Latin verb "patior" meaning "to suffer" both in the sense of feeling pain and in the sense of forbearance. Thus, the two uses of the word "patient" -- as a noun denoting "someone who suffers" and as an adjective meaning "to bear with forbearance" -- stem from the same origin. (A patient may be patient or impatient.)

[firespec35]

Wow that was deep. If I make scene and talk to someone, I sign them off if not transporting. They dont want to sign thats ok no reason to get mad just fill out the refusal to sign part

[mobey]

I may be corrected here but I believe in Canada once you start assessing a possible patient you have "Made a relationship" with them. At that time they are considered a patient and you are required to properly assess and write a care report even if they refuse.

I sometimeswrite a "Generic" PCR and have multiple patients sign it.

Something like "The following patients were involved in a 2 vehicle T-Bone at approx 30km/hr, bla bla bla....... All patients presented with no pain, no visible trauma, bla bla bla,.... then get all who want to refuse care to sign the bottom.

[Just Plain Ruff]

No need to get your knickers in a bunch, you made no reference to already knowing your services answer.

So many people come here and post what should they do when they haven't even gone to their management to find out what they require you to do.

so that is why I pointed out that you needed to get your information from your service and not from us.

now that we know that you know what your service requires, then in my opinion, if you make it to the scene, you make contact with the injured or uninjured then they are your patient.

When in doubt, get a refusal, you gotta write a refusal and report. It takes you minimal time to write it up.

[mshow00]

If for nothing else getting a refusal is a great SOYA. Anytime I talk to a PT that has no complaint then I get a refusal from them. It only takes a couple of minutes. The only time I do not is when PD &/ or FF discontinue me, and even then I write a very very simple report that says disregarded by PD( or FD). Again just a SOYA.

[sevenball]

bus filled with people on their way back from some sight seeing trip. That do gooder bystander sees them involved in a minor... very minor MVC, calls because it's "the right thing to do". Should you get refusals from all of them if there isn't a single injury?