EMS Ops

Cardiac Arrest PCR

• The LEAST descriptive element in a cardiac arrest PCR (Patient Care Report) is "Followed ACLS protocols".

Bystander Physician Scope

• A bystander physician must ride in an ambulance if they perform procedures outside the EMS scope.

Qualified Immunity

• Paramedics are liable under qualified immunity if they knowingly violate clearly established law.

Expressed Consent

• Expressed consent is demonstrated when a patient rolls up their sleeve.

Minors and Medical Care

• Minors cannot consent to or refuse medical care.

Ethics in EMS

• In the context of EMS, ethics refers to the philosophy of right and wrong.

Patient Refusal of Care

• The first action to take when a patient refuses care is to ask why they are refusing.

Overwhelmed with Calls

• When call volume is overwhelming, using mutual aid is the appropriate response.

Off-Duty Paramedics

• Off-duty paramedics can act with legal protection.

Physician Orders

• Refuse physician orders outside the scope of your training and ask for an alternative.

EMS Lawsuits

• Most EMS lawsuits involve ambulance collisions.

Patient Autonomy

• Patient autonomy is the right to direct their care and end-of-life wishes.

Drug Interactions and Legal Defense

• In the event a drug interaction causes near-death, contributory negligence is a legal defense.

Proximate Cause

• Proximate cause means the action caused the injury.

Scope of Practice Defined

• Scope of practice includes state-approved procedures EMS may perform.

Forcing a Patient into Ambulance

• Forcing a competent patient into the ambulance is considered battery.

Role of the Court

• When someone is harmed, the court's job is to assign legal responsibility.

EMT Code of Ethics

• The EMT code of ethics emphasizes the welfare of others.

Medical Law

• All four elements of negligence must be proven in medical law.

Liability in Paramedic-Physician Relationships

• Paramedics are responsible for their actions in paramedic-physician relationships.

DNR Orders

• In the setting of an apneic patient with a pulse, but no visible DNR, but the nurse states "family doesn't want resuscitation", you should begin airway management and ventilations.

DNR Confirmation

• If a signed DNR is found in a cardiac arrest patient's home, confirm its validity and follow it.

Negligence Lawsuit Requirements

• A patient's written refusal is not required for a negligence lawsuit.

Assault Defined

• Assault is best defined as threatening bodily harm.

Battery Defined

• Battery is best defined as unlawful physical contact.

Involuntary Consent Application

• Involuntary consent may apply if the patient is intoxicated.

Legal Duty

• The legal term for an obligation to act is the duty to act.

Documentation Alteration

• Documentation that is altered after the fact may be seen as falsification.

Breach of Duty

• It is a breach of duty to fail to secure an airway, fail to document vitals, or give the wrong medication.
• It is not a breach of duty to delay CPR for safety.

Abandonment Defined

• Abandonment includes transferring care to a less-qualified provider without consent.

Implied Consent Application

• Implied consent applies when a patient is unresponsive and cannot refuse.

Valid DNR Order

• Withhold resuscitative efforts if provided with a valid DNR.

False Imprisonment

• Forcing treatment with no legal basis best describes false imprisonment.

Documentation of Medical Errors

• Documentation of medical errors must be honest and complete.

Advance Directive

• An advance directive is a legal document expressing patient wishes.

Civil Lawsuits Against EMS

• Most civil lawsuits against EMS involve ambulance collisions and patient refusal issues.

Informed Consent Defined

• Consent granted after explaining care and consequences is informed consent.

Durable Power of Attorney

• A durable power of attorney for healthcare allows a designated person to make decisions.

Court Order for Care

• A court order to care for someone against their will is a psychiatric hold or order.

Patient Withdrawal of Consent

• If a patient withdraws consent, let them sign a refusal.

Documentation Errors

• Documentation errors should be crossed out with a line and initialed.