EMT CH 4

advance directive

a DNR order; instructions written in advance of an event

tort:

a civil, not a criminal, offense; an action or injury caused by negligence from which a lawsuit may arise

organ donor:

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

what is a medical identification device?

it is a device such as a necklace, bracelet, or card that alerts the EMT and other health care professionals that the individual has a particular medical condition and it may indicate a number of conditions including: 1. heart conditions 2. allergies 3. diabetes 4. epilepsy

res ipsa loquitur

latin term meaning "the thing speaks for itself" - this is a foundational concept in negligence because it allows a finding of negligence even where there is no specific evidence of a negligent act.

what is the leading cause of lawsuits against EMS agencies and providers?

leaving a patient who will not accept care or transport

what is one situation where consent is not needed from a parent or guardian?

when a child care provider or school authority who may act as a in loco parentis (in place of a parent) when the parents are not physically present.

who can give their own consent?

- adults of legal age - parents - in loco parentis - emancipated minors - those minors who are married - minors who have children - minors who are in the armed forces

what are some reasons that a patient will deny care?

- denial - fear - failing to understand the seriousness of the situation - intoxication and more

When can a person/ patient be transported against their will?

- police officer decision - mental health workers ( these are when the patient presents a risk for self harm) - result of a court order

what can you do to preserve evidence at the crime scene?

- remember what you touch - minimize you impact on the scene - work with the police

what are all the circumstances that prove an EMT was negligent?

- the EMT has a duty to the patient (duty act) - the EMT did not provide the standard of care-- may include failure to act; did not provided needed care as would be expected of an EMT in your locality (failure to act is a major cause of legal actions against EMS) - there was proximate causation (damages to the patient were result of EMT) -- harm can be physical or psychological

what is considered evidence at a crime scene?

- the condition of the scene - the patient - fingerprints and footprints - microscopic evidence

what are the three types of consent?

1. expressed 2. implied 3. consent to treat minors or incompetent patients

what are the requirements for a patient to refuse care or transport?

1. patient must be legally able to consent (legal age or emancipated minor) 2. patient must be awake and oriented (no condition that impairs judgement) 3. patient must be fully informed (able to understand risks) 4. patient will be asked to sign a "release" form (this form releases the EMT from liability-- legal responsibility--

two most common lawsuits against EMTS:

1. patient refusal 2. ambulance crashes/ collisions

what can you do to try and convince a patient to receive care who has already declined/refused care?

1. spend time speaking with the patient 2. listen carefully to try to determine why the patient is refusing care 3. inform the patient of the consequences of not going to the hospital 4. consult medical direction 5. ask the patient if it is all right is you call a family member- or advise the patient that you would like to call a family member 6. call law enforcement personnel if necessary

negligence

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 the EMT was not provided, and that harm was caused to the patient as a result.

safe haven law:

a law that permits a person to drop off an infant or child at a police, fire, or EMS station or to deliver the infant or child to any available public safety personnel. the intent of the law is to protect children who may otherwise be abandoned or harmed

do not resuscitate (DNR) order

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

what is a proxy?

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.

good samaritan laws:

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

scope of practice:

a set of regulations and ethical considerations that define the scope, or extent and limits, of the EMTs job.

duty to act:

an obligation to provide care to a patient

liability

be held legally responsible

battery

causing bodily harm to or restraining a person

expressed consent:

consent given by adults who are of legal age and mentally competent to make a rational decision in regard to their medical well-being-- it must be obtained expressed consent must be informed consent: meaning the patients understand the risks associated with the care they will receive.

libel:

false injurious information in written form

slander:

false injurious information stated verbally

standard of care:

for and EMT providing care for a specific patient in a specific situation, the care that would be expected to be provided by an EMT with similar training when caring for a patient in a similar situation.

in loco parentis:

in place of a parent, indicating a person who may give consent for care of child when the parents are not present or able to give consent

abandonment:

leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training EX: is a paramedic has begun advanced care then turns the patient over to an EMT for transport, abandonment (on the part of the paramedic) has occurred.

does the care of an organ donor change from a patient who is not a donor?

no, all emergency measures must be taken

consent:

permission from the patient for care or other action by the EMT consent is required for any treatment or action by an EMT

physician order for life-sustaining treatment (POLST)

physician orders that state not only the patient's wishes regarding resuscitation attempts but also the patient's wishes of artificial feeding, antibiotics, and other life-sustaining care if the person is unable to state his desire later

assault

placing a person in fear of bodily harm

ethical:

regarding a social system or social or professional expectations for applying principles of right or wrong

moral:

regarding personal standards or principles of right and wrong

standard of care vs. scope of practice:

standard care refers to what you should do in a particular situation and how you should do it vs scope of practice refers to what you should be able to do.`

HIPAA:

the Health Insurance Portability and Accountability Act, which includes the Privacy Rule protecting the privacy of patient-specific health care information and providing the patient with control over how this information is used and distributed.

implied consent:

the consent it is presumed a patient or patient's guardian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed. - applies to unconscious patients or mentally incapacitated

crime scene:

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

confidentiality:

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.

What is the primary ethical consideration of an EMT?

the primary ethical consideration of an EMT is to make patient care and well-being a priority.

How can rules and regulations vary?

the skills and medical interventions the EMT may perform are defined by legislation, which can vary from state to state. it can sometimes even within the same state from district to district