When attending on a call, and a patient exclaims immediately they do not want to receive transport to the hospital, what are the directions in terms of treating and providing symptom relief medications. Example, nausea with gravol/ondansetron. Shortness of breath - ventolin, chest pain - nitro. 

Administering a medication to a patient that you know will not be transported to hospital is dispensing medication and not within the scope of a paramedic. The Medical Directives outline treatment options for patients who are expected to be transported to hospital (exception being the approved Treat and Discharge subset). Therefore, the direction for paramedics is not to provide any medications if a patient is not going to be transported to hospital.  

Please see a SWORBHP Tip on this very topic from August 6, 2024. 

Bottom lines: 

1) The Medical Directive treatment is written with the intent that the patient be transported to hospital for further diagnostic and therapeutic treatment. Providing care outside of this model is dangerous and is not following the delegation of the Medical Directive. 2) The patient may feel falsely reassured that they have received all the medical care that they need if care continues by paramedics after the patient decides not to be transported to hospital. It should be made clear to patients after they decide to refuse service that a comprehensive and complete work up has not yet been completed. The only way to complete this work-up is to be transported to hospital. 

You may consider educating your capable patient who is refusing transport that you are unable to give medications due to the incomplete work-up for the cause of their symptoms.  This will assist in making an informed decision in refusing transport. 

Uncategorized

Dispensing medications, Medical Directive, Refusal of Service, Transport

https://www.instagram.com/p/C-VZM09gXTC/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==