While I sort of agree that patients, particularly patients feeling the effects of being very sick, can't always make top-notch clinical decisions... it's the squits ffs. You don't need transportation (ambulance, taxi, 4x4, wheelbarrow) for D&V. Unless there are extenuating circumstances, you don't need a doctor either, or a hospital, or any treatment. You need a toilet, a bucket, a blanket, a cup, and a tap that supplies potable water. I cannot get my head round the idea that a person could reach adulthood without realising that the occasional day or two of stomach upset is just one of those things that happen sometimes and having a fair idea of how to deal with it. It's not a clinical judgement, it's common sense, and if a person really is so feverishly semi-conscious that they can't figure that out, they probably need the hospital more on the basis of the altered consciousness, than the squitting. And are likely in no fit state to attempt an argument with the ambo staff.