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How to refuse Ambulance trips to ER?
Fri, 11/16/2012 - 16:05I've had several seizures over the past few years where I regain consciousness soon enough that a paramedic hasn't yet arrived but before I am not fully coherent until after I reach the hospital. My insurance has a high deductable for going to the emergency room, so I really don't want to go.
Each time that I've had a seizure, I have tried to refuse to let the paramedics take me to the hospital. After having a seizure, I just want to stay where I am and rest until I can get up and go on with lift. But they insist on doing it as a precaution. The paramedics standard procedure is to ask me a battery of questions over and over again. At first, I can hear them and understand them and can picture who the president is but I can't speak. Eventually I get to a point where I can barely speak but can remember his name (so the best that I can answer is something like "big ears, black") and can't remember whether they've asked me this question already. Eventually I am coherent enough (by the time that we reach the hospital) that I can say "I don't want to go, I don't need to go" but they take me in anyway
How do I stop them? At what point are they no longer allowed to insist on taking me?
Comments
Re: How to refuse Ambulance trips to ER?
Submitted by tonialpha on Mon, 2012-11-19 - 18:50
When I am post-ictal and have trouble answering questions the paramedics are checking vital signs and in my area they will repeat things 3 times. I have signed the paper work several times declining to go.
I had 2 seizures together . It was a benefit for me. I have medication to stop seizures and my family gives it to me and the EMTs will let them give it to me and that has stopped me from going to the ER's.
One time I had a questionable medication reaction/TIA? The next thing I woke up in the ER. I was going into Status.
I have been pulled out of pools, out of streets and dangerous locations and went on there wishes. I was groggy and could not speak, but the hospital staff knew me and for my safety checked me and called my husband to say I was all right and that I could be picked up. After they did labs and a CT.
It seems like a hassle, but at times when you cannot quiet get out of it. It is better to be safe then sorry. I have had status epilepticus attacks and didn't know it.
Each individual is different my medic alert bracelet is a life saver for me.
When I am post-ictal and have trouble answering questions the paramedics are checking vital signs and in my area they will repeat things 3 times. I have signed the paper work several times declining to go.
I had 2 seizures together . It was a benefit for me. I have medication to stop seizures and my family gives it to me and the EMTs will let them give it to me and that has stopped me from going to the ER's.
One time I had a questionable medication reaction/TIA? The next thing I woke up in the ER. I was going into Status.
I have been pulled out of pools, out of streets and dangerous locations and went on there wishes. I was groggy and could not speak, but the hospital staff knew me and for my safety checked me and called my husband to say I was all right and that I could be picked up. After they did labs and a CT.
It seems like a hassle, but at times when you cannot quiet get out of it. It is better to be safe then sorry. I have had status epilepticus attacks and didn't know it.
Each individual is different my medic alert bracelet is a life saver for me.
Re: How to refuse Ambulance trips to ER?
Submitted by kj1989 on Sat, 2012-11-17 - 09:04
I cannot include URL's here but I found this paper on pateint refusals. It can be found at: www(dot)emsmdc(dot)com(slash)pdf(slash)patient(underscore)refusals(underscore)cumulative1(dot)pdf
What it boils down to is that a competent adult with the capacity to understandcan legally refuse. Competency is decided by the court and an incompetent person is usually assigned a guardian. Capacity refers to: "At the outset, a patient must be eighteen years of age or older, and be alert, oriented to person, place and
time, and have a glascow coma scale score of fifteen in order to refuse care. The mere fact that a patient
appears intoxicated, has received a head injury, or suffers from a mentally debilitating disease such as
dementia or Alzheimer's does not mean that a patient who is A& Ox3 and has a GCS of 15 lacks the
capacity to refuse care."
The tricky thing is that paramedics risk lawsuits if someone refuses and later changes their mind.
You may want to consider some sort of legal pre-reufsal. By that I mean get documentation from a Dr. about your E and how you respond to seizures (like just needing to rest, that whereas you may not recall the president at the moment it is just an effect of coming out) if your Dr is on board. Also perhaps speak to an attourney if you can (the Dr's note would help) to draft some kind of release "I am aware that I have E, I understand the risks of not being transported to an ER after a seizure, I may not be able to answer your questions, however as a competent adult I am refusing medical advocacy for now and in the future when I have had a seizure with no injury." You colud also try to write this document yourself but it will not hold as much water.
I don't know the legalities of all of this it may not even be an option, but perhaps something to look into.
When the paramedics come and you cannot answer their questions about the president, it may lead them to think you are incompetent at the moment to refuse care. Maybe documentation would help clarify that. I don't really know for sure.
I cannot include URL's here but I found this paper on pateint refusals. It can be found at: www(dot)emsmdc(dot)com(slash)pdf(slash)patient(underscore)refusals(underscore)cumulative1(dot)pdf
What it boils down to is that a competent adult with the capacity to understandcan legally refuse. Competency is decided by the court and an incompetent person is usually assigned a guardian. Capacity refers to: "At the outset, a patient must be eighteen years of age or older, and be alert, oriented to person, place and
time, and have a glascow coma scale score of fifteen in order to refuse care. The mere fact that a patient
appears intoxicated, has received a head injury, or suffers from a mentally debilitating disease such as
dementia or Alzheimer's does not mean that a patient who is A& Ox3 and has a GCS of 15 lacks the
capacity to refuse care."
The tricky thing is that paramedics risk lawsuits if someone refuses and later changes their mind.
You may want to consider some sort of legal pre-reufsal. By that I mean get documentation from a Dr. about your E and how you respond to seizures (like just needing to rest, that whereas you may not recall the president at the moment it is just an effect of coming out) if your Dr is on board. Also perhaps speak to an attourney if you can (the Dr's note would help) to draft some kind of release "I am aware that I have E, I understand the risks of not being transported to an ER after a seizure, I may not be able to answer your questions, however as a competent adult I am refusing medical advocacy for now and in the future when I have had a seizure with no injury." You colud also try to write this document yourself but it will not hold as much water.
I don't know the legalities of all of this it may not even be an option, but perhaps something to look into.
When the paramedics come and you cannot answer their questions about the president, it may lead them to think you are incompetent at the moment to refuse care. Maybe documentation would help clarify that. I don't really know for sure.