Pt refusal, extreme edition...

[Kiwiology]

But their surviving family members don't.

Touche, Emergentologist.

I should sue my Psychiatrist, whatever she is doing, it aint workin' ....

[jsd67]

do Psychiatrists really work ?

[Arctickat]

do Psychiatrists really work ?

I used to think so, but then you showed up. Your treatment was obviously ineffective.

[Kiwiology]

I used to think so, but then you showed up. Your treatment was obviously ineffective.

That was pretty damn good, even I wouldn't have probably gone that far, nice work Trev, have a Tim's!

[scubanurse]

do Psychiatrists really work ?

What in the world does this have to do with patient refusals?!?

[Mario1105]

contact med control see if they want to take responsibility to take him in then document and write it down. otherwise not much you can do.

other then get PD involved. but best shot would be to make a case to med control.

Edited February 5, 2013 by Mario1105

[Just Plain Ruff]

Hey Dwayne, what level of Medical control do you actually have in your neck of the woods?

Can you do what most have asked and fallen back on the US basis and call medical control and possibly force this guy to go or are you sort of on your own?

What will your medical control actually take responsiblity for when you are on a call? Will they tell you to force the patient to go to the hospital? Can you contact them to get orders for advanced procedures or are you on your own?

What level of medical scene control do they actually do?

I envision you being out on your own and not having much oversight from Med control whatsoever. Do I have a good picture?

Edited February 5, 2013 by Captain ToHellWithItAll

[ERDoc]

Speaking as the guy on the medical control end of the phone, I would speak with the guy and get the same story, there is no way I can make this guy go. I don't some magical legal powers any more than you do in the field. Does this guy need to go, absolutely. Can we force him to, nope.

[Mario1105]

i was looking back at his main concern being his employeer? well maybe having a talk with the employeer seeing if he couldnt sway things. but other then that i guess its really just making sure you cover your butt.

[DwayneEMTP]

Hey all, sorry so long to respond.

Medical control wouldn't be a realistic option in this environment. I do have medical control that I can call but they're either in Singapore or Sydney. They don't have much idea what goes on in environments that we work, they are primarily for medical advice, maint of company policy compliance, and helping to arrange medivacs. They would have been happy to speak to him, but the likely outcome would have been that he'd've refused to follow their instructions also, and they may have demanded that I take him against his will, something that I would have refused to do, the refusal of which would have possibly been terminal to my continued employment with this company. So I didn't see any up side to involving them.

I did consider talking to his employer, but he's also, like me, employed by a company that's outside of the country and subcontracted to a trucking company in country. They might have helped, if getting past the language barrier was likely, which it wasn't, but more than likely once notified they forgot about him and were on the phone demanding to know when replacement truck driver would arrive.

I didn't follow up with him, but my guess is that they amputated the leg and he went on his vacation as planned. He would have needed to be medivac'd to Brisbane or Cains for any chance for reattachment efforts, and he would almost certainly not have made it to either place for 24-48hrs.