Legal

HIPPA

Health Insurance Portability and Accountability Act

Minor Consent/ In Loco Parentis

If under 18, must get parental consent or consent is implied. Exceptions- Emancipated children, married children, or children in the armed forces. Pregnant children can consent for their baby (ie. birth)

MCIs

Multiple Casualty Incidents. care & documentation may be limited

Informed consent/ refusal

Nature of Illness, Treatments Recommendations, Risks of treatment, Risks of refusal, Alternatives, leave patient is good hands when possible.

Refusal documentation should include

Pt name, address, DOB, age, sex, Chief complaint & pertinent history. level consciousness & 1 complete set vital signs. subjective/objective assessment findings treatment given & response. parent/guardian name if applicable. identification physician/law enforcement if applicable. risks explained & understood

Plaintiff

a person who brings a case against another in a court of law.

MOLST

medical orders for life sustaining treatment

Protocols

orders written by doctors for treating patients

Medical restraint can be used when...

patient is: suicidal, harming you or others. Soft restraints only. CONSTANTLY MONITOR THEM. If situation escalates, call for police backup.

Assault

physically or psychologically intimidating person creating fear of injury

Battery

physically touching a person without consent

Scope of Practice

procedures enabled by legislation

Good Samaritan Act

protects the actions performed by health care facility, as long as they act within the scope of their training and in good faith.

Medical ID

provides clues when patient can't communicate-should be documented-may also indicate organ donation wishes (may alter transport decisions)

Reporting timeline

report within 24 hrs, fill out follow up paperwork within 48

Administrative law

rules from executive branch of government

Legislative law

rules made by legislative branch of government

Criminal law

rules made to safeguard society

Res ipsa loquitor

so obvious burden of proof moves to defendant instead of Plaintiff

False imprisonment /kidnapping

taking the patient to the hospital or other medical care facility against his wishes. If not able to consent/decline immunity is enacted for "good faith"

Abandonment

termination of care of the patient without assuring continuation of care at same/higher level

Defamation

the action of damaging the good reputation of someone; slander (verbal) or libel (written).

Expressed Consent

verbal or non-verbal-should be informed (must be informed if research)

High risk refusals

Age greater than 65 years or less than 2 months, Pulse >120 or <50Systolic BP >200 or <90Respirations >29 or <10, Serious chief complaint (e.g. chest pain, SOB, syncope, neurologic deficit), Significant mechanism of injury/high index suspicion, Fever in newborn or infant < 8weeks

Medical Practice Act

An act that usually defines the minimum qualifications of those who may perform various health services, defines the skills that each type of practitioner is legally permitted to use, and establishes a means of licensure or certification for different categories of health care professionals.

Refusal/ sign offs

Children (<18) cannot refuse without parental consent. Altered mental state can barr a refusal, Competency/ ability to understand condition and risks.

privileged communications

Ie. people who might be informed of confidential info. Transfer care (need to know basis), Legally mandated (reports), Third party billing (insurance), Patient release of info.

Implied Consent

Incapacitated, parental absence

Medical Control

Physician instruction to EMS team. Listen unless out of scope of practice.

Special reporting

You are a mandated reporter for child abuse. You may also report abuse/crime situations, public health events (infectious disease, animal bites), penetrating trauma, childbirth, deceased victims). YOU CAN BE HELD LIABLE (misdemeanor) for not reporting.

Duty to Act

an obligation to provide care to a patient (actual). Duty to act begins when you accept a dispatch (implied). There is no duty to act when not on the clock. Formal duty to act is a contract.

Civil law

complaint by an individual against another for an illegal act or wrongdoing

Involuntary Consent

consent that is assumed when the patient has an altered mental state or is incarcerated.

Standards of Care

defines duty to act and behavior standards. May be defined by localEMT norms, local or state statutes, professional organization guidelines, agency(institutional) regulations, textbook guidelines

Negligence

deviation from normal care →injury or harm

DNR

do not resuscitate order. Comfort care is allowed.

Breach of duty

failure to meet the standard of care

Contributory negligence

if action/inaction did not directly cause harm but increased risk or added to a cause of injury