Question: Are we required to complete a patient refusal and obtain a signature for any patient who for example refuses gravol administration, or does not want a medication given by IV, but accepts the medication administered IM, or refuses oxygen. Or any similar instance where there is a refusal, but the patient is still being transported to hospital.
Thanks for your question. The patient refusal form is specific to refusal of transport to the Emergency Department. It sounds like you are asking about consent for delivery of a therapy or a certain mode of therapy delivery (ie IM vs IV) for a patient that is being or will be transported to the ED. In most pre-hospital circumstances consent is implied and not a formal process. In circumstances where a patient refuses an available treatment paramedics should ensure and document that the patient understands the risks and benefits of receiving the therapy being offered, the risks and benefits of not receiving the therapy being offered and the available alternative therapies in the current setting. If a patient does not consent to an available therapy we would suggest that the consent discussion is documented on the ambulance call record and include that the patient understood the items above.