You Make the Call – Handcuffed

Man it sure has been awhile since we fired up the ol’ You Make the Call Machine here at HMHQ, but I thought it’s finally time to get back on the posting circuit.


For you new people, I post a situation, you answer it based on your local policies.


Dispatched in the first response vehicle of choice for your agency, the local PD has detained a man who assaulted another person.  The other person is receiving care from your partner and is stable, bleeding controlled and has agreed to transport.  PD presents you to the window of the patrol car where you can see a superficial laceration to the forearm just distal to the left elbow.  There was a small drip of blood that appears to be dry, no other injuries are obvious through the window.

After repeated pleas the officer agrees to open the door and remove the patient but warns that he became violent when they took him into custody.  He stands and allows a brief primary and secondary exam and you note no other deformity or injury.  He is refusing vital signs, treatment and transport in colorful language, but denies alcohol or drug use.  When asked if he understands the risks of refusing assessment and treatment he replies in the affirmative and states his reason for assaulting the man and the police is his business, not yours.


Is he able to refuse service?  If so, who signs the form when PD tells you there’s no chance of him removing the cuffs to allow for a signature?


You Make the Call.

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7 thoughts on “You Make the Call – Handcuffed”

  1. Easy over here in UK land. Patient has superficial laceration that is not deep enough to require closure, and no other injuries. Police advised patient does not need hospital care. Plaster / dressing offered. Only person who signs my paperwork is me, as he hasn’t refused anything!

  2. Fax over the paperwork to the police station and have him sign it there when he’s behind bars. Or follow him to booking and let them keep him in custody and add it to one more paper for him to sign.

  3. Suspect/patient doesn’t want to go? Cop signs.

    Suspect/patient wants to go, but cop says no? Cop signs.

    Cop won’t allow more assessment? Cop signs.

    It is a custody thing where I am.

    1. Here our policy is if patient refuses treatment and cannot/won’t sign we just tick the box and move on.
      That said our org are volunteers.

  4. in our area PD probably wouldn’t have even asked us over. In our county all police officers are EMTs. it’ standard for pd to ask a perp at the time of processing if they have any injuries and want to go to the hospital. if someone was that dangerous PD would probably transport with a minor injury. We have signatures to worry about just check the box and have pd sign as a witness if he could even be deemed a patient with a superficial injury.

  5. Easy… and I agree with SAP. In our system I would just document that the patient has been assessed as competent, is refusing to have his vital signs assessed, describe his minor injury, offer him a dressing and leave it at that. He is not refusing anything, as I am not recommending that he needs further treatment or transport.

  6. In this neck of the woods by and large the prisoner doesn’t get to make the decision. He’s in the custody of the police and they get to make the decision. The cops are generally more risk averse in medical situations than the scarediest risk manager, so unlike days of yore, they generally want the prisoner to go to this hospital. In the old days, the city didn’t want to spend the money to guard prisoners, so they tried to get us to talk the patient into staying in jail. Then they could say “Well, EMS said he didn’t have to go.” if the fit hit the shan.

    That worked out about as well as you’d think, so now it’s 180 degrees opposite. They generally can’t wait to get anyone with claimed illness or injury out of a jail cell and into a hospital bed.

    And to answer the inevitable question, I’m far more concerned about getting sued (as much as I concerned about getting sued) for not taking someone to the hospital than I am for taking them to the hospital. Rogue Medic notwithstanding.

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