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- Feb 16, 2014
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I had an interesting scenario last night and wanted to get y'alls thoughts on how you would have approached:
Clearly intoxicated (ie smelling of EtOH and slurring words) HOWEVER oriented x3 and ambulating with a mostly-steady gait, presents after swerving off the road and hitting a light pole. He has some abrasions on his face and thinks he blacked out, but adamantly refuses to get any imaging. He understands the risks of having a head bleed but says 'just let me go to jail'. He is accompanied by a police officer, who brought him in for 'medical clearance'.
What do you do:
A - let him go without imaging
B - give him some meds and get the images anyway (ativan or what not)
C - make him stay until he is more clearly sober then allow him to refuse
There's problems with all of these choices.
Normally 'obs to sober' for me anyway, means a/ox3 and ambulating with a steady gait. He can smell of EtOH as much as he wants. So you could argue this guy has capacity and can refuse. As long as you document it well, you should be legally protected.
In reality what happened was the officer told him he had to, and he then consented. But, what if the officer didn't say that. What if there was no officer. Do you let him walk?
Clearly intoxicated (ie smelling of EtOH and slurring words) HOWEVER oriented x3 and ambulating with a mostly-steady gait, presents after swerving off the road and hitting a light pole. He has some abrasions on his face and thinks he blacked out, but adamantly refuses to get any imaging. He understands the risks of having a head bleed but says 'just let me go to jail'. He is accompanied by a police officer, who brought him in for 'medical clearance'.
What do you do:
A - let him go without imaging
B - give him some meds and get the images anyway (ativan or what not)
C - make him stay until he is more clearly sober then allow him to refuse
There's problems with all of these choices.
Normally 'obs to sober' for me anyway, means a/ox3 and ambulating with a steady gait. He can smell of EtOH as much as he wants. So you could argue this guy has capacity and can refuse. As long as you document it well, you should be legally protected.
In reality what happened was the officer told him he had to, and he then consented. But, what if the officer didn't say that. What if there was no officer. Do you let him walk?