For a patient who had insulin-induced hypoglycemia resolved, what is required for refusal of transport?

• A. The patient must sign a written consent form.
• B. The patient must be transported immediately to the hospital.
• C. The patient must show rapid improvement and have normal vital signs.
• D. The patient must have a caregiver present.

Answer: (D)

The main idea here is informed refusal and decision-making capacity after a hypoglycemic event. If insulin-induced hypoglycemia has resolved, a patient may refuse transport only if they are capable of making an informed decision and there is a responsible witness present.

A caregiver must be present because they can witness that the patient understands the risks, isn’t coerced, and has support and supervision after discharge. Hypoglycemia can leave a person with impaired judgment, so having a caregiver nearby helps ensure safety and provides accountability for the refusal. If there’s any doubt about the patient’s capacity, transport or medical control should be involved.

Written consent isn’t the standard requirement, transport isn’t something the patient “refuses” when they’re still at risk, and simply showing improvement or normal vitals doesn’t by itself prove decision-making capacity. The caregiver presence directly supports a safe and valid refusal.