EMS Refusal of Transport

[WI-AEMT]

Topic has been brought up on other threads but I didn't see anything that wasn't several years old so I would like to see if there is anything more current....

So does anybody have any SOPs or Protocols where you can refuse to transport a patient who does not need emergent 911 response?  I'm not talking anybody who's truly sick.  Nor somebody who is borderline.  I'm talking stable vitals with CC of "I need my meds refilled", or "I don't have a ride", or "I stubbed my toe".  Tons of examples, you've all seen them.

We're a rural fire department with volunteer staff.  2 ambulances in our service.  Taking our first truck out of service to simply transport toe fungus guy puts us at a real risk of not being able to provide timely coverage for a potential second call.  Especially if that second call is "sick". 

We are specifically in Wisconsin but I would be interested to hear anybody that has successfully been able to use protocols like this. 

 

[paramedicmike]

Welcome.

As you noted this topic has come up before.  I don't recall any responses to the various threads producing any guidelines along the lines of what you're looking for. 

If you do hear anything please share here.  There are others out there looking for similar information.

[paramatt_]

Your department is definitely not the first to have issues like this and working in a rural area with volunteers who are giving up their own time makes things even more frustrating.

The service that I work for dose not have any general refusal protocols but like most services we have had problems with frequent non-emergent patients who call wanting transport for a number of reasons, many of which just appear bored or have nothing better to do. In a few cases, there have been specific / targeted procedures put in place in dealing with these people between a supervisor, medical co-ordinatior, and the pt's GP, case worker/social worker, and I think the police in the case of one individual.

If you're having issues with a specific person document document document, and perhaps if you have enough evidence that you're being manipulated or used as a taxi on a regular occurance you might be able to formalise a plan with some external help to deal with the specific person.

Its also important to note many of these people do have legitimate medical problems and you don't want to dissuade them from calling an ambulance when they actually need it.