There may be rare situations in which a patient expresses a desire to refuse care or transport.

If a refusal is voiced:

• Immediately notify the AOC (Administrator On Call) for guidance before proceeding.

• Do not attempt to dissuade or argue with the patient. Maintain a calm and professional demeanor.

• Do not continue with transport until directed to do so by the AOC or flight team, unless there is a threat to patient or crew safety.

• Document the event thoroughly in the ePCR, including the time, what was said, who was present, and any actions taken.

• If directed, obtain a refusal signature using the refusal form or via documentation in the ePCR, acknowledging that the patient declined care and/or transport.

• If the flight team takes the lead on handling the refusal, iCare personnel shall document their involvement and defer to the flight team’s medical authority while still notifying the AOC.

Reminder: While refusals are rare in the iCare setting, any indication that a patient does not consent to treatment or transport must be taken seriously and escalated to leadership without delay.