On scene we provide some basic cleaning and bandaging, usually using only a commonly available individually packaged self adhesive bandage.
Then out comes the refusal form, required by law and policy requires we document a full set of vital signs.
Why?
If the condition does not warrant monitoring of vital signs, can we agree the form is not necessary? Can we start addressing the huge amount of patients who don't need a full assessment documented?
Imagine the time we can save, the amount of documenting time we can save, the amount of QI time wasted on these charts.
I'm not saying don't treat them, I'm saying it doesn't need to include a full set of vital signs, offering of an ambulance and a signed refusal of said ambulance.
I know we still have knuckleheads who can't figure out how to properly document calls they do need to pay attention to, but maybe easing the number of ridiculous charts required they can focus on the ones that matter.
Recently I had to have a talk with a medic who has the phrase "risks of refusal up to and including death explained" on their refusals...for patients like the one I described. When I asked if they really told the finger laceration patient they could die from the injury they replied "I just include it on all of them for liability." That's an entirely different issue, but imagine if they only had to write that on the ones that could die from refusing.
Will my Medical Directors go for it? Most likely no since they changed the definition of "patient" to include anyone and everyone, and every "patient" requires a signed refusal.
Sigh...
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