Emergency Medical Services Compliance and Restraint

Restraint Issues in EMS

• Restraint is necessary when a patient's behavior requires physical or chemical restraint.
• Special concerns include excited delirium syndrome (ExDS) and restraint or positional asphyxia.
• Safe restraint techniques must be understood and practiced.
• Medical restraint is a high-risk issue.

Confidentiality in EMS

• Patient medical or personal information must not be released without explicit permission from the patient or legal guardian.
• Release is permissible under specific conditions:
  • Patient consent
  • Need-to-know by other medical providers
  • Legal requirements (e.g., releasing records)
  • Third-party billing requirements

HIPAA Compliance in EMS

• HIPAA (Health Insurance Portability and Accountability Act) changes how EMS providers handle insurance and Medicare payments, adding privacy protections for patients.
• All EMS employees must be trained in HIPAA compliance.
• Patient rights regarding health records are protected.

Defamation in EMS

• Defamation occurs when someone makes false statements harming another's reputation.
• Libel involves false statements in writing.
• Slander involves spoken false or malicious statements.

Invasion of Privacy in EMS

• Invasion of privacy involves releasing confidential patient information without legal justification, potentially causing ridicule, notoriety, or embarrassment.

Social Media and Patient Information

• Using social media to share patient or employment information carries risks.

Consent in EMS

• Consent is the permission to treat.
• Legal requirement: Patient consent before treatment or transport.
• Patient must be competent to give or refuse consent. "Competent" means lucid and able to make informed decisions.

Informed Consent in EMS

• Informed consent needs full disclosure of information:
  • Nature of illness or injury; recommended treatment options.
  • Risks, dangers, and benefits of treatments and alternatives.
  • Dangers of refusing treatment and/or transport.

Expressed Consent

• Most common type; direct permission to treat (verbal, nonverbal, written).

Implied Consent

• Patient needs emergency intervention but isn't able to consent (mentally, physically, or emotionally).

Involuntary Consent

• Court orders treatment, even without patient consent.
• Adults in police custody retain the right to make medical decisions.

Special Considerations for Minors

• Details on consent for minors is missing from this excerpt.