Most of the time I secretly enjoy when a patient signs out AMA, as they are usually the less pleasant patients who didn’t really need to be here in the first place, but every once in a while, patients decide to leave when they really shouldn’t. Today I’ve had a couple people who have decided against medical care which was obviously needed and potentially very bad things could happen to them.
Alert, oriented, sober, you can leave when you want … but really, you should think about it a little bit if your nurse tells you there is a good chance you are going to die if you leave.
We had a guy who really needed to be intubated. High-flow cannula wasn’t enough, and he refused a BiPAP. By morning, he wanted to go AMA. Seen by psych, who said he may be stupid, but he’s not nuts. So he goes home. Later that day, he’s found down. EMS brings him back to us, brain dead.
Oh, well. Whatcha gonna do?