title: Patients with head injuries refusing emergency medical services transport.
abstract: OBJECTIVE
  To characterize patients with head injury who refuse emergency medical services (EMS) transport to an emergency department (ED). To identify predictors of patients with head injury who refuse EMS transport.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Patients with a head injury cared for by EMS during 2001 were identified. Medical records were abstracted for demographic and clinical information and reasons for refusing transport. Patients accepting transport were compared to those refusing. Reasons for refusing transport were described.
  
  
  RESULTS
  Three hundred and thirty-three patients with head injuries were identified. Sixteen per cent refused EMS transport. Patients refusing transport were more likely to be male, younger and victims of assault and less likely to have lost consciousness. Patients refusing transport often felt they did not need care or could obtain care later.
  
  
  CONCLUSIONS
  Patients with head injuries frequently refuse EMS transportation. Individuals accepting care differ significantly from those refusing care. Sufficient awareness of the risk of head injury seems to be lacking among patients.
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. manish_shah@urmc.rochester.edu
authors.forename: Manish N
authors.initials: MN
authors.lastname: Shah
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Bazarian
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Mattingly
authors.forename: Eric A
authors.initials: EA
authors.lastname: Davis
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Schneider
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D006259:Craniocerebral Trauma / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D012189:Retrospective Studies; D012737:Sex Factors; D014187:Transportation of Patients / Q000706:statistics & numerical data*; D016312:Treatment Refusal / Q000706:statistics & numerical data*