According to the BLS-PCS Patient Refusal of Treatment Standard, when a patient or substitute decision maker (SDM) refuses treatment and/or transport, the paramedic shall:

a) Make reasonable efforts to inform the patient or SDM that treatment and/or transport are recommended and explain the possible consequences of such refusal;

b) Confirm that the patient or SDM has capacity utilizing the Aid to Capacity Assessment as per the Ambulance Call Report Completion Manual;

c) Advise the patient or SDM to call 911 again if further concerns arise; and

d) Obtain signatures and complete additional documentation requirements as per the Ontario Documentation Standards and the Ambulance Call Report completion Manual

AND remember to DOCUMENT all of these actions in your ACR under a code 370, otherwise it is not communicated that these requirements were met (and you will be contacted via audit)!

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