RMA or No Patient Found
80 year old male accidentally activated the medical alert. No complaints or injuries noted. A/Ox4.
No patient found
55 year old male with chest pain and shortness of breath
High risk due to a serious chief complaint
30 year old male found on side of the road with a obvious head injury and a bottle of vodka and refusing care aggressively
Does not have capacity to refuse care due to head injury and EtOH use. Consider using law enforcement for assistance.
Under what tab can you find the two refusal forms?
The signature tab
True or false
A person evaluated beyond a visual observation (assessment, vital signs) without any complaints or injury could be considered as "no patient found"
False. Once you go beyond the visual assessment, the person becomes a patient and would need the appropriate documentation.
Bystander called 911 for an unconscious person inside of a vehicle on the side of the road. First responders arrive in the area and is unable to find any car on the side of the road.
No patient found (after properly checking the reported location)
5 week old female with a temperature of 101oF
High risk due to age and fever
22 year female stating she took 50 Tylenol to try to kill herself but does not want to go to the hospital.
She does not have capacity to refuse due to suicidal ideation.
How many signatures from the patient are required for a RMA?
Two!
Who can be a witness for a RMA?
Preferably a neutral third party such as a police officer.
You are on scene during a working structure fire and one of the firefighters discovers he was stung by multiple bees while the packing hose. The bites are painful and itchy with no history of bee allergy. Does not want to go the hospital.
RMA
60 year old female restrained driver in a minor MVA with no apparent injury/complaint with the following vitals
Pulse: 112 bpm
Blood pressure: 124/86
Respirations: 18 bpm
Not high risk due to lack of complaint/injury and vital signs within the accepted ranges.
42 year female tripped over her dog and fell injuring her elbow. No head injury or loss of consciousness. Vitals are within normal limits. A/Ox4
She has the capacity to refuse!
What do you do if the patient refuses to sign the RMA form?
Document and have a witness
How would you explain to someone the risks of refusing transport?
By refusing care/transport, the possibility of serious illness, permanent disability, and death may increase.
30 year old male was involved in a MVA with reported overturn. No head injury or LOC. Complains of a headache. Does not want to go to the hospital.
RMA needed based on mechanism of crash and complaint.
88 year old male with a now resolved episode of confusion
High risk due to serious chief complaint.
16 year old male fell during a baseball game and has a laceration on left knee with minimal bleeding. Refusing transport but accepts care on scene.
The minor cannot refuse without a parent present
How many sets of vitals are required for a valid RMA?
Two sets of vitals are required!
Can someone who earlier today had a RMA call 911 again for the same problem?
YES!
92 year old female fell out of bed. A/Ox4. No complaints or injury. Not on blood thinners. Needs help getting up and does not want to go to hospital.
No patient found. No complaint or injury and has the capacity to refuse.
45 year old male was reported unconscious on toilet. Found by family, panicked and called 911. Upon arrival, patient was conscious and has no complaints or obvious injury. No head injury, A/Ox4, and vitals within normal limits. Patient is refusing transport.
Patient is high risk, due to episode of unwitnessed syncope. Call medical control.
6 month old male with prior recent episode of choking. Parent on scene was able to do the back blows and now the infant is responding appropriately and parent is refusing transport.
Parent is unable to refuse transport for the infant due to being under one year of age.
If a patient is involved in a MVA and qualifies for a RMA what are two additional requirements in the ePCR?
The motor vehicle crash form and the trauma criteria form in the forms tab.
The daughter called 911 for her mother who has a UTI. She is 82, does not want to go to the hospital and clears the capacity assessments. RMA or no patient found?
No patient found due to the third party caller.