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