Chapter 3: Medical , Legal, and Ethical Issues

In the eyes of the courts, an incomplete or untidy patient care form indicates:

inadequate patient care was administered

In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor:

is self-supporting and lives by him or herself

To minimize the risk of litigation, the EMT should:

provide competent care that meets current standards

Battery

touching a person without consent

Which of the following patients has decision-making capacity and can legally refuse emergency medical treatment?

A conscious and alert woman with severe abdominal pain

Shortly after loading your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. He is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?

A mentally competent adult can withdraw his or her consent to treat at any time

Which of the following MOST accurately defines negligence?

Deviation from the standard of care that may result in further injury

Where would you MOST likely find information regarding a patient's wishes to be an organ donor?

Drivers License

Which of the following components are needed to prove negligence?

Duty to Act, breach of duty, injury/damages, and causation

Which type of consent is involved when a 39 year old mentally competent female with a severe headache asks you to take her to the hospital?

Expressed

You suspect that a pregnant 16 year old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. Which type of consent is her agreement considered?

Expressed

Which of the following is generally NOT considered confidential?

The location of the emergency

In which of the following circumstances can the EMT legally release confidential patient information?

The patient is competent and signs a release form

When is forcible restraint permitted?

When the patient poses a significant threat to self or others

In which of the following situations does a legal duty to act clearly exist?

A call is received 15 mins prior to shift change

Which of the following scenarios MOST accurately depicts abandonment?

A paramedic transfers patient care to an EMT

To help protect patients, EMS agencies are required to have _______.

A privacy officer to answer questions

Standard of Care

Accepted level of care consistent with training

Which of the following situations requires you to notify the appropriate authorities?

Attempted suicide

You respond to the home of a 59 year old man who is unconscious; has slow, shallow breathing and has a weak pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient, but they are unable to locate it. You should:

Begin treatment and contact medical control as needed

When you and your partner arrive at the residence of a man in cardiac arrest , you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should:

Begin two rescuer CPR and apply the AED as soon as possible

You respond to a single-vehicle crash on the highway west of town. Upon arrival you find a 33-year-old man with an open forearm fracture who has self-extricated from his pickup, which is down the roadside embankment. He does not appear to have suffered any other injuries, is fully coherent, and refuses all medical care. In an effort to obtain consent to treat this patient, you should:

Clearly explain the consequences of not accepting medical treatment

You are called to attend to an elderly patient with an extensive medical history who is now in cardiac arrest. The patient's family tells you that the patient has a DNR order. There is no paperwork available but the patient does have a MedicAlert bracelet indicating DNR. You should:

Confirm the patient identity and then confirm the DNR by calling the MedicAlert Foundation on the bracelet

Which of the following statements about the patient care report is correct?

It is difficult to prove actions were performed if they are not included on the report

Implied Consent

Legal assumption that treatment was desired

As an EMT, the standards of emergency care are often partially based on:

Locally accepted protocols

The EMT's scope of practice within his or her local response area is defined by the:

Medical director

When caring for a 65 year old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of:

Negligence

Definitive r conclusive signs of death that are obvious and clear to even nonmedical persons include all of the following, EXCEPT:

Profound cyanosis

Which aspect of the HIPAA MOST affects EMS personnel?

Protecting patient Privacy

You arrive at the scene of a motor vehicle-versus-pedestrian accident. The patient, a 13 year old male, is unconscious and has multiple injuries. As you are treating the child, a law enforcement officer advises you that the child's parents will be at the scene in 15 minutes. What should you do?

Transport the child immediately and have the parents meet you at the hospital

Assault

Unlawfully placing a patient in fear of bodily harm.

Advance Directive

Written documentation that specifies treatment

Which of the following general statements regarding consent is correct?

a patient can consent to transport but can legally refuse to be threatened

Good Samaritan laws generally are designed to offer protection to persons who render care in good faith. They do not offer protection from:

acts of negligence

As an EMT, the performance of your duties will be compared to that of:

another EMT

During your monthly internal quality(QI) improvement meeting, you review several patient care reports(PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you:

are in violation of HIPPA because you did not remove the PHI from the PCR before

A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should:

assess whether the patient's mental condition is impaired

The process by which an individual, an institution, or a program is evaluated and recognized as meeting certain standards is called:

certification

While transporting a women with diabetes, you inadvertently give her oral glucose even though her blood glucose was high. You reassess the patient and note that her condition did not change; she remained stable. You should:

contact medical control and notify them of the error

While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. You should:

continue transporting your patient and notify the dispatcher of the crash

Putrefaction is defined as:

decomposition of the body's tissues

When performing his or her duties, the EMT is generally expected to:

exercise reasonable care and act prudently

You and your partner arrive at the scene of a major motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, is not breathing, and does not have a palpable carotid pulse. You should:

have your partner check for a pulse to confirm that the patient is deceased

Maintaining the chain of evidence at the scene of a crime should include:

not cutting through holes in clothing that were caused by weapons

You are treating a man who assaulted and has a closed head injury. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should:

proceed with treatment and utilized law enforcement for assistance if necessary

You are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:

quickly move the coffee table so you can access and treat the patient

Negligence is based on the EMT's duty to act, cause, breach of duty, and:

real or perceived damages

Medicolegal

relating to law or forensic medicine

Expressed Consent

specific authorization to provide care expressed by the patient

An important safeguard against legal implication is:

writing a complete and accurate run report