Ch03 eec3
- 1. Medical/Legal and Ethical Issues Three Chapter
- 2. Scope of practice Advanced directives Patient consent and refusal issues Assessment and care at crime scenes Three Chapter CORE CONCEPTS
- 3. A set of rules and duties that define your role as an EMT-Basic S COPE OF PRACTICE
- 4. Patient Medical direction State legislation EMT-B Is Responsible To:
- 5. Make patient’s needs a priority. Maintain skills, knowledge. Critically review performance Prepare honest reports. (seek ways to improve) . Ethical Responsibilities
- 7. Advance Directives: Do-Not-Resuscitate Orders Patient has the right to Usually requires written (Continued) refuse resuscitative efforts. physician order.
- 8. Become familiar with When in doubt, resuscitate. protocols prior to need. Advance Directives: DNR Orders
- 9. DNR Order
- 10. P ATIENT CONSENT AND REFUSAL
- 11. Patient is of legal age and rational. Patient must be informed. Expressed consent must be obtained from conscious, competent adults before treatment. Consent: Expressed
- 12. Consent is implied for unconscious patient. It is based on the assumption the patient would consent if conscious. Consent: Implied
- 13. Consent is required from Consent: Children and Incompetent Adults (Continued) parent or guardian.
- 14. Consent: Children and Incompetent Adults Consent is implied in life-threatening emergency in absence of parent/guardian. Follow state regulations for age and emancipation.
- 15. Patients have the right to Patient Refusal Patients may revoke (Continued) refuse treatment. consent at any time.
- 16. Refusals must be made by Patient must be fully informed of risks and consequences. (Continued) competent adults. Patient Refusal
- 17. Patient must sign a When in doubt, err in favor “ release form.” of providing care. Patient Refusal
- 18. Documentation is key to Thoroughly note all assessment Patient Refusal: Documentation findings. liability prevention. (Continued)
- 19. Patient Refusal: Documentation Document attempts to Document risks and consequences you outlined for patient. persuade patient to accept care.
- 21. Abandonment K EY TERM Termination of care of a patient without ensuring continuation of care at the same or higher level
- 22. Negligence Deviation from accepted standard of care, resulting in injury to a patient K EY TERM
- 23. Duty to act Breach of the duty Injury or damages inflicted (physical or psychological) Damages caused by actions or omissions by EMT-B Negligence: Components
- 24. Unlawfully touching patient without consent can be Providing care without consent can also be battery. battery. Assault / Battery
- 25. Legal or contractual requirement to provide care Formal duty: Implied duty: Call to 911, beginning care for patient Contractual obligation between agency and municipality Duty to Act
- 26. Off duty Out of your EMS system, but in an ambulance Duty to Act: Ethical/Moral
- 27. Patient history Assessment findings Treatment rendered Written release required to release information Confidential Information (Continued)
- 28. Exceptions to written release: Subpoena Other health care personnel treating patient Mandatory reporting (rape, abuse) Insurance Confidential Information
- 29. Ambulance collisions are a significant source of liability for EMTs. They also have potential to produce serious injury. The “rush” of driving an emergency vehicle for a new EMT can be overwhelming. Be sure to remind new drivers of the need for caution, the danger of high speeds, and the potential for liability. Don’t forget to be a good example when you drive! P RECEPTOR P EARL
- 30. Requires signed donor form. Driver’s license shows Organ Donation intent.
- 31. EMT-B Role in Organ Donation Organ donor patients are treated the same as other patients. Identify potential donors. Notify medical direction. Provide care to maintain vital organs.
- 32. Medical Identification Devices Heart Diabetes Allergies Epilepsy Others Alert EMT-B to medical conditions Conditions
- 33. E MS AT CRIME SCENES
- 34. Patient care is the priority. Do not enter the crime scene Remain alert for evidence and Crime Scenes (Continued) until it is safe. signs of repeated violence.
- 35. Be observant. Minimize your impact on the scene. Remember what you touch. Plan and communicate with the police. Crime Scenes
- 36. Crime Scenes: Documentation Avoid opinions. Use objective statements. Place words of others in quotes.
- 37. Abuse (child, spouse, elderly) Sexual assault Gunshot wound Infectious disease (Continued) exposure Special Reporting Situations
- 38. Restraint MCI Other unusual situations Mandatory reporting laws from state to state vary Special Reporting Situations
- 39. 1. Define scope of practice. 2. Explain the purpose of the DNR order. 3. Discuss forms of patient consent and when patients can refuse your care. 4. Explain how assessment and care may differ at a crime scene. R EVIEW QUESTIONS