Emergency Care (Chapter 3) Medical/legal And Ethical Issues

Front 1

Scope of Practice

Back 1

A set of regulations and ethical considerations that define the scope, or extent and limits, of the EMT's job.

Front 2

Quality Improvement

Back 2

After a call, constructively critique both yourself and the crew. Accept suggestions from others to improve your skills, communication, and patient outcome.

Front 3

Consent

Back 3

Permission from the patient for care or other action by the EMT.

CONSENT IS REQUIRED FOR ANY TREATMENT.

Expressed Concent must be obtained from every conscious, mentally competent adult before providing care and treatment.

Front 4

What are the three types of Concent?

Back 4

1. Expressed.
2. Implied.
3. Concent.

Front 5

Espressed Concent

Back 5

- Concent given by adults who are of legal age and mentally competent to make a rational decision in regards to their medical well-being.
- Must be INFORMED concent, that is, the patient must understand the risks associated with the care they will recieve.
- Legal requirement (and sound emotional) to explain all procedures to the patient.

Front 6

Implied Concent

Back 6

The concent it is presumed a patient or patient's parent or guardian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed.

Front 7

Concent for Children and Mentally Incompetent Adults

Back 7

- They are not legally allowed to provide concent or refuse medical care and treatment.
- The parents and guardians of these patients HAVE to give consent before treatments, unless, it is a life-threatening illness or injury where the parent or guadian is not present.

Front 8

What are the reasons a patient may refuse care?

Back 8

- Denial.
- Fear.
- Failing to understand the seriousness of the situation.
- Intoxication.
Etc.

Front 9

What are the conditions that MUST be met for a patient to refuse care?

Back 9

1. Patient must be legally able to consent.
2. Patient must be mentally competent and orientated.
3. Patient must be fully informed.
4. Patient must sign a "release" form.

Front 10

Liability

Back 10

Being held legally responsible.

Front 11

If in doubt, what may you do to help persuade the patient to accept your care?

Back 11

1. Spend time speaking with the patient.
2. Inform the patient of the consequences of not going to the hospital.
3. Consult medical direction.
4. Contact family members to hlep convince the patient.
5. Call law enforcement personnel if necessary.
6. Try to determine why the patient is refusing care.

If patient still refuses it becomes vital to document the attempts you made (in order to prevent liability).

Front 12

Do Not Resuscitate Order
(DNR)

Back 12

A legal document, usually signed by the patient and his physician, which states that the patient has a terminal illness and does not wish to prolong life through resuscitative efforts.

Front 13

Advance Directive

Back 13

A DNR order; instructions written in advance of an event.

Front 14

Proxy

Back 14

A person whom the signer of the document names to make health care decisions in case he is unable to make such decisions for himself.

Front 15

What three things HAVE to be proved to prove negligence?

Back 15

1. The EMT had a duty to the patient.
2. The EMT did not provide the standard of care.
3. By not providing the standard of care, the EMT caused harn to the patient.

Front 16

Negligence

Back 16

A finding of failure to act properly in a situation in which there was a duty to act, that needed care as would reasonably be expected of EMT was not provided, and that harm was caused to the patient as a result.

The negligent EMT may be required to pay for medical expenses, loss wages, pain and suffering, and various other factors as determined by the court. (Will not have to pay any insurance expenses).

Front 17

Duty to Act

Back 17

An obligation to provide care to a patient.

Front 18

Abandonment

Back 18

Leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training.

If you are off duty, begin care, and then leave before other trained personnel arrive, you may still be considered to have abandoned the patient.

Front 19

Good Samaritan Laws

Back 19

A series of laws, varying in each state, designed to provide limited legal protection for citizens and some health care personnel when they are administering emergency care.

Front 20

Confidentiality

Back 20

The obligation not to reveal information obtained about a patient except to other health care professionals involved in the patient's care, or under subpoena, or in a court of law, or when the patient has signed a release of confidentiality.

Front 21

Health Insurance Portability and Accountability Act
(HIPAA)

Back 21

A federal law protecting the privacy of patient-specific health care information and providing the patient with control over how this information is used and distributed.

Front 22

Organ Donor

Back 22

A person who has completed a legal document that allows for donation or organs and tissues in the event of death.

Front 23

Crime Scene

Back 23

The location where a crime scene has been committed or any place that evidence relating to a crime may be found.

Front 24

Evidence at a Crime Scene

Back 24

- Condition of the Scene
- The patient
- Fingerprints and footprints
- Microscopic evidence

Front 25

What should you remember at a crime scene that may be helpful to law enforcement?

Back 25

- Remember what you touch
- Minimize your impact on the scene (ex: avoid using the phone or bathroom)
- Work with the police