What is the protocol for a patient who has resolved insulin-induced hypoglycemia but refuses transport?

• A. Release the patient without any documentation
• B. Document the patient's condition and ensure they understand the risks of refusal
• C. Transport the patient to hospital anyway
• D. Administer additional glucose and re-evaluate

Answer: (B)

When someone has resolved insulin-induced hypoglycemia and is alert and capable of making their own decisions, the priority is to address informed refusal for transport. The correct approach is to ensure the patient understands the risks of declining transport (the possibility of recurrent hypoglycemia, delayed care if symptoms return, and potential deterioration) and to document this understanding clearly. This protects both the patient and the provider by confirming the patient has the capacity to refuse and that they were fully informed of the consequences. Accompany that with practical safety steps, such as confirming they have access to glucose or other sources of rapid energy and guidance on warning signs, and arranging follow-up or return if symptoms recur. Releasing with no documentation, transporting against a patient’s wishes, or simply administering more glucose without addressing the patient’s refusal do not align with proper practice in this scenario.