Monday, April 18, 2016

Is the directive at hand? Can the document be found?

What happens if an EMT, Paramedic, or Firefighter comes to a scene and the claim is that there is a directive that needs to be followed? Given the scenario that a patient has an advance directive and it can not be found or the patient refuses care. What appropriate actions are to be taken?


  • Consider initiating treatment immediately
  • Contact your medical directive for instructions on how to proceed
  • Continue treatment until the problem has be resolved


A competent adult who can prove orientation to "Person, Place, and Time" can deny treatment. Be sure to inform patient of all potential risks and the possibility of death.

What if the patient still refuses?


  • Try to persuade the patient to accept treatment or transport to the hospital
  • Clearly document what was told to the patient, their response, and have them sign a refusal form.
  • Before you leave the scene, encourage patient to seek help if symptoms occur.
  • If unsure about patient the contact your medical directive.

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