PMID: 9444335Jan 28, 1998Paper

Refusal of out-of-hospital medical care: effect of medical-control physician assertiveness on transport rate

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
J L BursteinJ Alicandro

Abstract

Previous studies have shown that contacting an on-line medical-control physician increases the transport rate of patients who attempt to refuse medical assistance. The authors studied the physician-patient interaction to determine the type of interaction that was more likely to result in patient transport. A prospective, observational study of patient-initiated refusals of medical assistance (RMAs) was performed in a suburban volunteer emergency medical services (EMS) system, with 12 receiving hospitals county-wide. Medical-control contact was required for all patient-initiated RMAs. Consecutive patients who attempted out-of-hospital RMA over a 3-month period were monitored. Structured data instruments were completed by the medical-control operator and medical-control physician for all patients who attempted RMA. Data collected included patient demographics and contact information, scene characteristics, history and physical examination data, length of time of interaction, and the physician's assessment of the need for transport and the patient's capacity to refuse transport. The operator and physician independently graded the physician's assertiveness in talking to the patient on a continuous 10-point scale. There were 130 pat...Continue Reading

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Citations

May 26, 2005·The American Journal of Emergency Medicine·Albert SaeGeoff Stroh
Feb 3, 1999·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·J L Burstein
Jul 4, 2001·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·B T Hoyt, R L Norton
Sep 21, 2006·BMC Emergency Medicine·Deborah ShawA Niroshan Siriwardena
Feb 3, 2016·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Hideo TohiraJudith Finn
Apr 20, 2005·The Journal of Emergency Medicine·Robert P PringleDerrel D Graham
Mar 29, 2012·Emergency Medicine International·Peyton HolderStephen H Thomas
Mar 15, 2006·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Christopher J HainesNorman C Christopher
Apr 19, 2002·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·David C ConeDonald M Yealy
May 19, 2020·The Western Journal of Emergency Medicine·Balaj RaiR Trevor Marshall
Oct 19, 2002·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Gary M VilkeTheodore C Chan
Jul 19, 2017·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Remco H A EbbenSivera A A Berben
Apr 25, 2003·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Mark S PennerDon MacMillan
May 6, 2010·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Christian Martin-GillVincent N Mosesso

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