Emergency Care Ch. 3
An 8-year-old boy was struck by a car, is unconscious, and is bleeding from the mouth. A police officer tells you that he is unable to contact the child's parents. You should: a. continue to treat the child and transport as soon as possible b. cease all treatment until the child's parents can be contacted. c. continue with treatment only if authorized by medical control. d. provide airway management only until the parents are contacted.
A. The child in this scenario is critically injured and requires immediate treatment and transport; waiting until his parents are contacted wastes time and increases his chance of a negative outcome. If you are unable to contact a minor's parents or legal guardian, you should proceed with care based on the law of implied consent
You are treating a patient with an apparent emotional crisis. After the patient refuses treatment, you tell him that you will call the police and have him restrained if he does not give you consent. Your actions in this case are an example of: a. assault. b. battery. c. negligence. d. abandonment.
A. Unlawfully placing a person in fear of immediate bodily harm (ie, having him restrained) without his consent constitutes assault.
The EMT has a legal duty to act if he or she is: a. off duty and witnesses a major car accident. b. a volunteer, is on duty, and is dispatched on a call. c. paid for his or her services, but is not on duty. d. out of his or her jurisdiction and sees a man choking.
B. The EMT—paid or volunteer—has a legal duty to act if he or she is on duty and is dispatched on a call, regardless of the nature of the call. If the EMT is off duty and/or out of his or her jurisdiction, he or she has a moral obligation to act, but not necessarily a legal one.
An advance directive is: a. a set of specific guidelines that clearly defines the different types of consent. b. a formal list that defines by state law whether a patient has decision-making capacity. c. a written document that specifies the care you should provide if the patient is unable to make decisions. d. a verbal order given to you by a dying patient's family regarding whether treatment should be provided.
C
You arrive at the scene of an older woman complaining of chest pain. In assessing her, she holds her arm out for you to take her blood pressure. This is an example of: a. implied consent. b. informed consent. c. expressed consent. d. emergency consent
C Expressed consent (also called actual consent) is when the patient authorizes you to provide treatment and transport, either verbally or nonverbally. For example, a patient who holds out his or her arm to allow you take a blood pressure is nonverbally giving you expressed consent.
The unauthorized confinement of a person is called: a. assault. b. battery. c. false imprisonment. d. slander.
C. False imprisonment is defined as the confinement of a person without legal authority or the person's consent.
Which of the following patients is competent and can legally refuse EMS care? a. A confused young female who states that she is the president b. A man who is staggering and states that he drank only three beers c. A conscious and alert woman who is in severe pain from a broken leg d. A diabetic patient who has slurred speech and is not aware of the date
C. A patient who is of legal age (18 in most states), is conscious, and is alert to person, place, time, and event, likely has decision-making capacity and can legally refuse EMS care. However, patients who are confused, possibly intoxicated, or delusional are not capable of making rational decisions; therefore, you should provide care based on the law of implied consent.
Failure of the EMT to provide the same care as another EMT with the same training is called: a. libel. b. slander. c. negligence. d. abandonment.
C. An EMT could be held liable for negligence if he or she fails to provide the same care as another EMT with the same training would provide in the same situation. For example, if an EMT fails to give oxygen to a patient with shortness of breath (an intervention that is clearly indicated), he or she may be held liable for negligence.
Which of the following statements about records and reports is FALSE? a. Legally, if it was not documented, it was not performed. b. A complete, accurate report is an important safeguard against legal problems. c. An incomplete or untidy patient care report is evidence of incomplete or inexpert emergency medical care. d. Your patient care report does not become a part of the patient's hospital record because your treatment was provided outside the hospital.
D.
Which of the following is an example of abandonment? a. An EMT leaves the scene after a competent adult has refused care. b. An EMT transfers care of a patient to an emergency department nurse. c. An AEMT transfers care of a patient to a paramedic. d. An AEMT transfers care of a patient to an EMR.
D. Abandonment occurs when patient care is terminated without the patient's consent or when care is transferred to a provider of lesser training and level of certification.
Statutory provisions enacted by many states to protect citizens from liability for errors and omissions in giving good faith emergency medical care, unless there is wanton, gross, or willful negligence
Good Samaritan laws
A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf in the event that the person making the appointment loses decision-making capacity
Health care proxy
False and damaging information about a person that is communicated in writing
Libel
False and damaging information about a person that is communicated by the spoken word
Slander
Unilateral termination of care by the EMT without the patient's consent and without making provisions for transferring care to another medical professional with the skills and training necessary to meet the needs of the patient
abandonment
Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decision; also called a living will or health care directive.
advance directive
The manner in which principles of ethics are incorporated into professional conduct
applied ethics
Unlawfully placing a patient in fear of bodily harm
assault
Unlawfully touching a patient or providing emergency care without consent.
battery
The study of ethics related to issues that arise in health care
bioethics
Disclosure of information without proper authorization
breach of confidentiality
Damages awarded in a civil lawsuit that are intended to restore the plaintiff to the same condition that he or she was in prior to the incident.
compensatory damages
Able to make rational decisions about personal well-being
competent
In the context of EMS, permission to render care.
consent
A legal defense that may be raised when the defendant feels that the conduct of the plaintiff somehow contributed to any injuries or damages that were sustained by the plaintiff.
contributory negligence
An established process to determine the qualifications necessary to be allowed to practice a particular profession, or to function as an organization.
credentialing
Ability to understand and process information and make a choice regarding appropriate medical care
decision-making capacity
The communication of false information about a person that is damaging to that person's reputation or standing in the community.
defamation
Blood settling to the lowest point of the body, causing discoloration of the skin; a definitive sign of death
dependent lividity
Oral questions asked of parties and witnessed under oath.
depositions
The phase of a civil lawsuit where the plaintiff and defense obtain information from each other that will enable the attorneys to have a better understanding of the case, which will assist in negotiating a possible settlement or in preparing for trial. This phase includes depositions, interrogatories, and demands for production of records.
discovery
Written documentation by a physician giving permission to medical personnel not to attempt resuscitation in the event of cardiac arrest.
do not resuscitate order (DNR)
A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf in the event that the person making the appointment loses decision-making capacity
durable power of attorney for health care
A medicolegal term relating to certain personnel who either by statute or by function have a responsibility to provide care
duty of care
A person who is under the legal age in a given state but, because of other circumstances, is legally considered an adult.
emancipated minor
A serious situation, such as injury or illness that threatens the life or welfare of a person or group of people and requires immediate intervention.
emergency
The principle of law that permits a health care provider to treat a patient in an emergency situation when the patient is incapable of granting consent because of an altered level of consciousness, disability, the effects of drugs or alcohol, or the patient's age.
emergency doctrine
Immediate care or treatment
emergency medical care
The philosophy of right and wrong, of moral duties, and of ideal professional behavior
ethics
A type of consent in which a patient give verbal or nonverbal authorization for provision of care or transport
expressed consent
The confinement of a person without legal authority or the person's consent.
false imprisonment
The act of physically preventing an individual from initiating any physical action.
forcible restraint
Legal doctrine that can protect an EMS provider from being sued or that may limit the amount of monetary judgment that the plaintiff may recover; generally applies only to EMS systems that are operated by municipalities or other governmental entities
governmental immunity
Conduct that constitutes a willful or reckless disregard for a duty or standard of care.
gross negligence
A written document that specifies medical treatment for a competent patient, should he or she become unable to make decisions. AKA as an advance directive or a living will.
health care directive
Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment
implied consent
Refers to the legal responsibility of a person or organization to take on some of the functions and responsibilities of a parent
in loco parentis
Permission for treatment given by a competent patient after the potential risks, benefits, and alternatives to treatment have been explained.
informed consent
Written questions that the defense and plaintiff send to one another
interrogatories
The seizing, confining, abducting, or carrying away of a person by force, including transporting a competent adult for medical treatment without his or her consent
kidnapping
Relating to medical jurisprudence (law) or forensic medicine
medicolegal
A code of conduct that can be defined by society, religion, or a person, affecting character, conduct, and conscience
morality
Failure to provide the same care that a person with similar training would provide
negligence
A theory that may be used when the conduct of the person being sued is alleged to have occurred in clear violation of a statute
negligence per se
The right of a patient to make informed choices regarding his or her health care
patient autonomy
Any information about health status, provision of health care, or payment for health care that can be linked to an individual. This is interpreted rather broadly and includes any part of a patient's medical record or payment history.
protected health information (PHI)
When a person who has a duty abuses it, and causes harm to another individual; the EMT, the agency, and/or the medical director may be sued for negligence
proximate causation
Damages that are sometimes awarded in a civil lawsuit when the conduct of the defendant was intentional or constituted a reckless disregard for the safety of the public
punitive damages
Decomposition of body tissues; a definitive sign of death
putrefaction
When the EMT or an EMS system is held liable even when the plaintiff is unable to clearly demonstrate how an injury occurred.
res ipsa loquitor
Stiffening of the body muscles; a definitive sign of death
rigor mortis
Most commonly defined by state law; outlines the care that the EMT is able to provide for the patient
scope of practice
Written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organizations so that the patients are not exposed to unreasonable risk or harm.
standard of care
The time within which a case must be commenced
statute of limitations
A wrongful act that gives rise to a civil lawsuit
tort
