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Do patients refusing transport remember descriptions of risks after initial advanced life support assessment?
T A Schmidt1, N C Mann, C S Federiuk
1Department of Emergency Medicine, Oregon Health Sciences University, School of Medicine, Portland 97201, USA. schmidtt@ohsu.edu
Summary
Many patients refusing ambulance transport do not recall instructions or risk explanations. A significant number would reconsider their decision if faced with the same situation again.
Area of Science:
- Emergency medicine
- Patient decision-making
- Health services research
Background:
- Patients refusing emergency medical services transport after paramedic assessment present a challenge for ensuring informed consent.
- Understanding patient recall of instructions and perceived understanding is crucial for improving pre-hospital care communication.
Purpose of the Study:
- To evaluate patient recall and comprehension of instructions provided after refusal of emergency medical services (EMS) transport.
- To assess subsequent healthcare utilization and patient decision-making regarding transport.
Main Methods:
- A phone interview was conducted with patients who refused transport after advanced life support (ALS) assessment.
- Participants were queried on recall of risk/benefit explanations, understanding of their condition, and subsequent medical care seeking.
Main Results:
- Of 256 respondents, 55% recalled written instructions and 22% recalled risk explanations.
- 35% still experienced symptoms; 6% were hospitalized, and 59% sought other medical care.
- 18% would now accept ambulance transport if the same situation recurred.
Conclusions:
- A significant portion of patients refusing transport have poor recall of instructions and risk information, questioning informed decision-making capacity.
- Most patients seek subsequent medical care, highlighting the importance of clear communication and follow-up after refusal of transport.
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