Patient Refusal/AMA & Active Duty Considerations

Question 1

What kind of patient care do patients get and who do you consult if needed?

Answer 1

General patient care and OLMD

Question 2

What kind of interventions do patients get?

Answer 2

Life-saving interventions

Question 3

How do adults & emancipated minors demonstrate capacity for a refusal?

Answer 3

The ability to understand the benefits and frisks of obtaining treatment for a particular condition, to verbalize the consequences of failing to obtain treatment, to include the possibility of death, and to be able to verbalize reasons for electing to refuse treatment/transport

Question 4

How can children (<18 who are not emancipated) refuse treatment?

Answer 4

Must obtain parental/guardian consent

Question 5

What do you do if a patient has a life-threatening injury/illness and is refusing treatment?

Answer 5

Contact OLMD immediately

Question 6

Patients who present a threat to themelves or others, what do they require?

Answer 6

They require medical evaluation for organic etiologies of behavioral disorders.

Question 7

What happens if active duty service members who refuse care/transport and negatively impact their fitness for duty?

Answer 7

They can face administrative actions such as an MEB or potential administrative discharge.

Question 8

What are the requirements for diabetic patients refusal?

Answer 8

HX of insulin-dependent DM, have not taken an oral hypoglycemic or long-acting insulin in the last 24 hours, presenting with AMS, return to baseline mental status within 10 mins of Dextrose administration, pre-treatment BG of <80 mg/dL, post-treatment BG of >100 mg/dL, ability to tolerate food by mouth, has follow-up with a primary care physician, normal VS post-treatment, and has family present to monitor him/her.