Medical Legal Ethics in EMS
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Questions and Answers

A basic principle of emergency care is to do no further harm.

True (A)

A healthcare provider can usually avoid legal exposure if they act in what ways? (Select all that apply)

  • According to an appropriate standard of care (correct)
  • Without compensation
  • With malice
  • In good faith (correct)

    • What is the foundation of consent?

  • The ability to understand information
  • The ability to provide care
  • The ability to refuse care
  • The ability to make decisions (correct)

    • A patient has a legal right to refuse care if they’re conscious and rational.

    <p>True (A)</p> Signup and view all the answers

    What is patient autonomy?

    <p>The right of the patient to make decisions about their health.</p> Signup and view all the answers

    Expressed consent must be informed.

    <p>True (A)</p> Signup and view all the answers

    Implied consent can be used when a patient is unconscious.

    <p>True (A)</p> Signup and view all the answers

    Implied consent should only be used when there is a threat to life or limb.

    <p>True (A)</p> Signup and view all the answers

    Implied consent is also known as the emergency doctrine.

    <p>True (A)</p> Signup and view all the answers

    Involuntary consent applies to mentally ill patients who are in behavioral crisis.

    <p>True (A)</p> Signup and view all the answers

    Involuntary consent always requires consent from a legal guardian.

    <p>False (B)</p> Signup and view all the answers

    Emancipated minors can legally give consent.

    <p>True (A)</p> Signup and view all the answers

    If there’s a true emergency and no consent is available, you can assume implied consent for a minor.

    <p>True (A)</p> Signup and view all the answers

    When is forcible restraint sometimes necessary?

    <p>When a patient is combative (D)</p> Signup and view all the answers

    Forcible restraint is always legally permissible.

    <p>False (B)</p> Signup and view all the answers

    Once applied, restraints should not be removed en route unless there is a risk to the patient.

    <p>True (A)</p> Signup and view all the answers

    ALS backup can be used to provide chemical/pharmacological restraint.

    <p>True (A)</p> Signup and view all the answers

    A conscious, alert adult has the right to refuse treatment.

    <p>True (A)</p> Signup and view all the answers

    You can withdraw from treatment at any time, even if the result is death or serious injury.

    <p>True (A)</p> Signup and view all the answers

    Calls involving refusal should always include a consultation with medical control.

    <p>True (A)</p> Signup and view all the answers

    You can always assume that a patient’s decision to refuse is an informed refusal if they appear confused.

    <p>False (B)</p> Signup and view all the answers

    You should not endanger yourself during the refusal of care.

    <p>True (A)</p> Signup and view all the answers

    It’s more defensible to treat a patient than to fail to treat them.

    <p>True (A)</p> Signup and view all the answers

    You can use the assistance of law enforcement to deal with the patient refusing care?

    <p>True (A)</p> Signup and view all the answers

    You should always encourage an individual to allow care if they refuse it.

    <p>True (A)</p> Signup and view all the answers

    A refusal of care form should always be signed by a witness, even if a parent refuses care.

    <p>True (A)</p> Signup and view all the answers

    You must ensure that the patient understands all the risks, benefits and alternative treatments associated with the treatment before you administer it.

    <p>True (A)</p> Signup and view all the answers

    The information provided in the patient care report must remain confidential.

    <p>True (A)</p> Signup and view all the answers

    What is the name of the legislation that protects patient privacy?

    <p>HIPAA (C)</p> Signup and view all the answers

    HIPAA laws are designed to safeguard patient confidentiality.

    <p>True (A)</p> Signup and view all the answers

    A patient’s information can legally be disclosed without their consent if they sign a release.

    <p>True (A)</p> Signup and view all the answers

    A patient’s information can legally be disclosed without their consent if a legal subpoena is presented.

    <p>True (A)</p> Signup and view all the answers

    A patient’s information can legally be disclosed without their consent if it’s needed by billing personnel.

    <p>True (A)</p> Signup and view all the answers

    Failure to abide by the provisions of HIPAA laws can result in civil and/or criminal action.

    <p>True (A)</p> Signup and view all the answers

    The general public is not permitted by law to record identifying and protected patient information.

    <p>False (B)</p> Signup and view all the answers

    You should avoid displaying agency logos while off duty.

    <p>True (A)</p> Signup and view all the answers

    You should limit your discussion of patient cases to individuals who are directly involved.

    <p>True (A)</p> Signup and view all the answers

    An advance directive specifies treatment that should be provided if the patient becomes unconscious or unable to make decisions.

    <p>True (A)</p> Signup and view all the answers

    A DNR order is an advance directive that gives permission not to resuscitate.

    <p>True (A)</p> Signup and view all the answers

    A DNR order means "do not treat" the patient.

    <p>False (B)</p> Signup and view all the answers

    A DNR order must include a signature from the patient, legal guardian, and physician.

    <p>True (A)</p> Signup and view all the answers

    A DNR order can be used to prevent the use of advance cardiac life support (ACLS) medications.

    <p>False (B)</p> Signup and view all the answers

    Physicians orders for life-sustaining treatment (POLST) and medical orders for life-sustaining treatment (MOLST) explicitly describe acceptable interventions for a patient.

    <p>True (A)</p> Signup and view all the answers

    A POLST/MOLST form should be signed by an authorized medical provider.

    <p>True (A)</p> Signup and view all the answers

    You can assume that any patient has a surrogate who can make decisions for them.

    <p>False (B)</p> Signup and view all the answers

    Surrogates are also known as healthcare proxies.

    <p>True (A)</p> Signup and view all the answers

    What is the first step in determining death?

    <p>Determining the cause of death (A)</p> Signup and view all the answers

    Which of the following are considered presumptive signs of death? (Select all that apply)

    <p>Unresponsiveness to painful stimuli (B), Lowered blood pressure (D), Decreased body temperature (F)</p> Signup and view all the answers

    Dependent lividity is a sign of death caused by discoloration of the body from pooling of the blood in the lower body.

    <p>True (A)</p> Signup and view all the answers

    Rigor mortis is the stiffening that begins to occur throughout the body between 2-12 hours after death.

    <p>True (A)</p> Signup and view all the answers

    Algor mortis is the cooling of the body to match the ambient environment after the time of death.

    <p>True (A)</p> Signup and view all the answers

    A medical examiner is usually called in cases of a sudden or unexpected death.

    <p>True (A)</p> Signup and view all the answers

    Organ donors must always have a signed organ donor card.

    <p>False (B)</p> Signup and view all the answers

    When dealing with a patient who is an organ donor, your priority is to save the patient’s life.

    <p>True (A)</p> Signup and view all the answers

    You should always remember that organs need oxygen, even after death.

    <p>True (A)</p> Signup and view all the answers

    A medical identification insignia can indicate a patient’s allergies.

    <p>True (A)</p> Signup and view all the answers

    Some patients wear a medical bracelet with a USB flash drive.

    <p>True (A)</p> Signup and view all the answers

    Scope of practice is defined solely by state law.

    <p>False (B)</p> Signup and view all the answers

    The medical director develops protocols and standing orders to supplement scope of practice.

    <p>True (A)</p> Signup and view all the answers

    Carrying out procedures outside of your scope of practice can be considered a crime.

    <p>True (A)</p> Signup and view all the answers

    Standards of care are established by the federal government.

    <p>False (B)</p> Signup and view all the answers

    Which of the following are standards of care established by law? (Select all that apply)

    <p>Ordinances (A), Statutes (C), Case law (D), Administrative regulation (E)</p> Signup and view all the answers

    Professional or institutional standards are established by textbook guidelines.

    <p>False (B)</p> Signup and view all the answers

    Standards of care are established by states through the Medical Practices Act.

    <p>True (A)</p> Signup and view all the answers

    The EMT has a legal duty to act once they’ve started providing treatment, even if they weren’t the ones who initiated it.

    <p>True (A)</p> Signup and view all the answers

    Negligence is the failure to provide the same care that a person with similar training would provide.

    <p>True (A)</p> Signup and view all the answers

    All four of the following elements must be present for negligence to apply: Duty, Breach of duty, Damages, and Causation.

    <p>True (A)</p> Signup and view all the answers

    Res ipsa loquitur means the cause of the injury was in the control of the EMT, generally does not occur unless there’s negligence.

    <p>True (A)</p> Signup and view all the answers

    Negligence per se refers to conduct that violates a statute.

    <p>True (A)</p> Signup and view all the answers

    Torts are civil wrongs.

    <p>True (A)</p> Signup and view all the answers

    Abandonment is the unilateral termination of care by an EMT, without the patient’s consent or ensuring continuing care.

    <p>True (A)</p> Signup and view all the answers

    Abandonment can happen at the scene, or in the emergency department.

    <p>True (A)</p> Signup and view all the answers

    Assault is unlawfully touching a person without consent.

    <p>False (B)</p> Signup and view all the answers

    Unlawfully confining a person without their consent is called battery.

    <p>False (B)</p> Signup and view all the answers

    A Good Samaritan Law provides immunity from liability based on negligence.

    <p>True (A)</p> Signup and view all the answers

    You can always rely on Good Samaritan Immunity.

    <p>False (B)</p> Signup and view all the answers

    Good Samaritan laws only apply to EMTs working in a volunteer capacity.

    <p>False (B)</p> Signup and view all the answers

    For a Good Samaritan Law to apply, which conditions must be met? (Select all that apply)

    <p>You must be acting in good faith (B), You must be acting within your scope of training (C)</p> Signup and view all the answers

    An EMT can only claim sovereign immunity if they are a volunteer.

    <p>False (B)</p> Signup and view all the answers

    Sovereign immunity provides complete protection from liability.

    <p>False (B)</p> Signup and view all the answers

    An action not recorded is considered not performed.

    <p>True (A)</p> Signup and view all the answers

    Incomplete or untidy reports provide evidence of poor emergency medical care.

    <p>True (A)</p> Signup and view all the answers

    The National EMS Information System (NEMSIS) is designed to improve the speed and accuracy of data collection.

    <p>True (A)</p> Signup and view all the answers

    You should never leave the scene after a competent adult has refused care.

    <p>False (B)</p> Signup and view all the answers

    You should always obtain a signature on your patient care report.

    <p>True (A)</p> Signup and view all the answers

    You are legally obligated to treat any person who is unconscious, regardless of their age.

    <p>True (A)</p> Signup and view all the answers

    An EMT has a legal duty to act if they’re on duty and are dispatched on a call.

    <p>True (A)</p> Signup and view all the answers

    An EMT has a legal duty to act if they are paid for their services, but are not on duty.

    <p>False (B)</p> Signup and view all the answers

    The EMT's patient care report does not become a part of the patient’s hospital record because the treatment was given outside of the hospital.

    <p>False (B)</p> Signup and view all the answers

    The most important safeguard against legal problems is a complete and accurate patient care report.

    <p>True (A)</p> Signup and view all the answers

    Unlawfully placing someone in fear of immediate bodily harm is considered assault.

    <p>True (A)</p> Signup and view all the answers

    When an EMT tells a patient who refuses treatment that he or she will be restrained by the police if they don’t consent, this would be considered an example of assault.

    <p>True (A)</p> Signup and view all the answers

    An EMT can legally transfer care to a lower level provider.

    <p>False (B)</p> Signup and view all the answers

    If a person is off-duty but witnesses a major car accident, what is their legal obligation?

    <p>They have a moral obligation to act (B)</p> Signup and view all the answers

    You should never treat a patient for a serious medical condition unless they have given consent.

    <p>False (B)</p> Signup and view all the answers

    In an emergency situation, if a minor is injured and consent cannot be obtained from their parents or legal guardian, you should immediately contact medical control for guidance.

    <p>False (B)</p> Signup and view all the answers

    HIPAA laws only apply to hospitals and clinics.

    <p>False (B)</p> Signup and view all the answers

    You are legally obligated to inform your patient about any serious risks and complications associated with their treatment, regardless of their condition or mental capacity.

    <p>True (A)</p> Signup and view all the answers

    A basic principle of emergency care is __________.

    <p>to do no further harm (B)</p> Signup and view all the answers

    A person must always give consent for treatment.

    <p>True (A)</p> Signup and view all the answers

    Which type of consent is commonly applied when a patient is unconscious or incapable of giving consent?

    <p>Implied Consent (C)</p> Signup and view all the answers

    Which of these is NOT a requirement for a valid DNR order?

    <p>Signature of the EMT (B)</p> Signup and view all the answers

    What does the term "patient autonomy" refer to?

    <p>A patient's right to make decisions about their own healthcare.</p> Signup and view all the answers

    Which of the following situations would typically NOT require notification to the medical examiner?

    <p>A patient who is unconscious (C)</p> Signup and view all the answers

    In a true emergency situation, consent from a minor's parent or guardian is always required for treatment.

    <p>False (B)</p> Signup and view all the answers

    What legal action might result from providing treatment without a patient's consent?

    <p>Battery (A)</p> Signup and view all the answers

    What is the term for an act of care that falls below the expected standard of a reasonable professional with similar training?

    <p>Negligence (C)</p> Signup and view all the answers

    Good Samaritan laws provide immunity from liability for ANY actions taken while providing aid.

    <p>False (B)</p> Signup and view all the answers

    The EMT has a legal duty to act ONLY if they are on duty and dispatched on a call.

    <p>True (A)</p> Signup and view all the answers

    Which of the following is NOT a common defense in a medical negligence case?

    <p>Vicarious Liability (A)</p> Signup and view all the answers

    What is meant by the phrase "Res Ipsa Loquitur"?

    <p>The thing speaks for itself.</p> Signup and view all the answers

    What is a basic principle of emergency care?

    <p>Do no further harm (B)</p> Signup and view all the answers

    A patient must give consent for treatment.

    <p>True (A)</p> Signup and view all the answers

    What is the right of the patient to make decisions about his or her health called?

    <p>Patient Autonomy (D)</p> Signup and view all the answers

    To be valid, what must a patient provide when consenting to treatment?

    <p>Informed Consent (A)</p> Signup and view all the answers

    Implied consent applies to patients who are:

    <p>Both A &amp; B (C)</p> Signup and view all the answers

    What is the principle of implied consent known as?

    <p>Emergency doctrine</p> Signup and view all the answers

    What should you do if the patient appears confused or delusional when refusing treatment?

    <p>Not assume that the refusal is informed (C)</p> Signup and view all the answers

    It is more defensible for EMTs to provide treatment than to fail to treat a patient.

    <p>True (A)</p> Signup and view all the answers

    EMTs should only treat patients if their identity is known and verified.

    <p>False (B)</p> Signup and view all the answers

    Before leaving a scene where a patient has refused care, what should you do?

    <p>All of the above (D)</p> Signup and view all the answers

    What are the three main types of legal consent?

    <p>Expressed, Informed, Implied (D)</p> Signup and view all the answers

    It is acceptable to post pictures of a patient who is obviously in pain, on social media for awareness and educational purposes.

    <p>False (B)</p> Signup and view all the answers

    Confidentiality is an ethical, but not a legal requirement.

    <p>False (B)</p> Signup and view all the answers

    What law contains a section on patient privacy?

    <p>HIPAA (Health Insurance Portability and Accountability Act) (C)</p> Signup and view all the answers

    What are the three levels of ethical considerations?

    <p>Ethics, Morality, Bioethics (C)</p> Signup and view all the answers

    It is acceptable for an EMT to refuse to treat a patient if they are in an area outside of their jurisdiction and have no medical license in that area.

    <p>False (B)</p> Signup and view all the answers

    EMTs are expected to provide the same level of care that any other EMT with similar training would provide, in the same situation.

    <p>True (A)</p> Signup and view all the answers

    What are the four elements that must be present for negligence to apply?

    <p>Duty, Breach of duty , Damages, Causation (D)</p> Signup and view all the answers

    It is acceptable for an EMT to 'self-treat' a patient who has refused service.

    <p>False (B)</p> Signup and view all the answers

    What is the unilateral termination of care without a patient's consent, while making provisions for continuing care called?

    <p>Abandonment (B)</p> Signup and view all the answers

    A patient cannot be restrained without a legal order, if they have refused care.

    <p>False (B)</p> Signup and view all the answers

    What are the two types of defamation?

    <p>Libel and Slander (B)</p> Signup and view all the answers

    Good Samaritan laws prevent any legal liability for an EMT who is providing emergency medical care.

    <p>False (B)</p> Signup and view all the answers

    What is a legal document that records all care from dispatch to hospital arrival called?

    <p>Both A and B (B)</p> Signup and view all the answers

    A complete and accurate report is a safeguard against legal complications.

    <p>True (A)</p> Signup and view all the answers

    Untidy and incomplete reports are always considered evidence of poor emergency medical care.

    <p>True (A)</p> Signup and view all the answers

    The National EMS Information System (NEMSIS) improves the speed and accuracy of data collection.

    <p>True (A)</p> Signup and view all the answers

    Which of these is not a mandatory reporting requirement in most states?

    <p>Use of tobacco in a residential area (A)</p> Signup and view all the answers

    An EMT can refuse care to a patient who is involved in an action that is considered a crime.

    <p>False (B)</p> Signup and view all the answers

    The EMT should always be neutral during testimony in court.

    <p>True (A)</p> Signup and view all the answers

    Which of these is not a valid defense for an EMT who is being sued?

    <p>Contributory malfeasance (D)</p> Signup and view all the answers

    A basic principle of emergency care is to do no further harm. Which of the following actions can help a health care provider avoid legal issues?

    <p>All of the above (D)</p> Signup and view all the answers

    Patient autonomy means the patient has the right to be transported to a hospital.

    <p>False (B)</p> Signup and view all the answers

    Which of the following must the patient provide in order for their consent to be considered valid?

    <p>Informed consent (D)</p> Signup and view all the answers

    In which of the following situations would implied consent be applicable?

    <p>A patient who is unconscious (B)</p> Signup and view all the answers

    When can consent from a guardian or conservator be required?

    <p>When the patient is mentally ill (D)</p> Signup and view all the answers

    In a true emergency, it is legal to assume consent for a minor patient if no consent from a parent or guardian is available.

    <p>True (A)</p> Signup and view all the answers

    It is always inappropriate to restrain any combative patient.

    <p>False (B)</p> Signup and view all the answers

    A patient has the right to refuse treatment, even if the refusal could lead to death or serious injury.

    <p>True (A)</p> Signup and view all the answers

    When a patient is confused or delusional, it is best to:

    <p>Assess their decision-making capacity before assuming informed consent (B)</p> Signup and view all the answers

    Providing treatment in a situation where the patient has refused is generally considered less risky for EMTs than not providing treatment.

    <p>True (A)</p> Signup and view all the answers

    What types of information are considered confidential?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the primary function of the Health Insurance Portability and Accountability Act (HIPAA)?

    <p>Ensuring confidentiality of protected health information (A)</p> Signup and view all the answers

    Violating HIPAA regulations can result in criminal charges.

    <p>True (A)</p> Signup and view all the answers

    The general public is prohibited from recording identifiable patient information.

    <p>False (B)</p> Signup and view all the answers

    What does an advance directive specify?

    <p>The patient's desired treatment in case of incapacitation (C)</p> Signup and view all the answers

    A do not resuscitate (DNR) order means that no treatment can be provided to the patient.

    <p>False (B)</p> Signup and view all the answers

    Which of the following can be considered as an advance directive?

    <p>All of the above (D)</p> Signup and view all the answers

    A DNR order must be signed by the patient and the physician.

    <p>True (A)</p> Signup and view all the answers

    POLST and MOLST forms allow EMTs to determine a patient's preferred facility for transport.

    <p>False (B)</p> Signup and view all the answers

    A surrogate decision-maker is authorized to make decisions for a patient with an advance directive.

    <p>True (A)</p> Signup and view all the answers

    The primary reason for conducting an EMS patient care report is for billing purposes.

    <p>False (B)</p> Signup and view all the answers

    Which of the following is a definitive sign of death?

    <p>Dependent lividity (B)</p> Signup and view all the answers

    Rigor mortis refers to the cooling of the body after death.

    <p>False (B)</p> Signup and view all the answers

    In cases of death, EMTs are always responsible for determining the cause of death.

    <p>False (B)</p> Signup and view all the answers

    Which of the following situations typically requires the involvement of a medical examiner?

    <p>Death due to apparent suicide (B)</p> Signup and view all the answers

    What is the primary focus of EMTs when treating a patient who has expressed a desire to be an organ donor?

    <p>Prioritize the patient's life-saving care (C)</p> Signup and view all the answers

    EMTs are typically responsible for procuring and transporting organs for donation.

    <p>False (B)</p> Signup and view all the answers

    The scope of practice for EMTs can vary depending on their level of certification or state laws.

    <p>True (A)</p> Signup and view all the answers

    EMT's level of certification is a determining factor in their scope of practice.

    <p>True (A)</p> Signup and view all the answers

    What is a standard of care?

    <p>The level of care expected of a reasonably prudent EMT (C)</p> Signup and view all the answers

    What do professional or institutional standards for care typically establish?

    <p>The essential procedures for treating certain conditions (B)</p> Signup and view all the answers

    State medical practices acts define the legal responsibilities for EMTs and other healthcare providers.

    <p>True (A)</p> Signup and view all the answers

    The duty to act is limited to the scope of practice for EMTs.

    <p>False (B)</p> Signup and view all the answers

    Negligence is a legal cause of action that directly equates to a criminal offense.

    <p>False (B)</p> Signup and view all the answers

    A tort is a criminal wrong.

    <p>False (B)</p> Signup and view all the answers

    Negligence can be applied if a person can prove that they experienced harm due to the EMT's actions.

    <p>False (B)</p> Signup and view all the answers

    The concept of "res ipsa loquitur" implies that the EMT is always liable for injuries incurred during their care.

    <p>False (B)</p> Signup and view all the answers

    Negligence per se is established when the EMT violates a specific statute.

    <p>True (A)</p> Signup and view all the answers

    Abandonment refers to the EMT's unauthorized termination of care before reaching the patient.

    <p>False (B)</p> Signup and view all the answers

    What is an example of an act that would be considered unlawful touching, or battery?

    <p>Providing care without consent (B)</p> Signup and view all the answers

    Transporting a patient against their will is considered kidnapping.

    <p>True (A)</p> Signup and view all the answers

    False imprisonment involves the intentional unlawful placing of a person in fear of harm.

    <p>False (B)</p> Signup and view all the answers

    Defamation refers to the communication of harmful false information about a person that affects their reputation.

    <p>True (A)</p> Signup and view all the answers

    Good Samaritan laws are generally applicable only to health professionals who are on duty.

    <p>False (B)</p> Signup and view all the answers

    Gross negligence is considered to be a direct violation of a legal statute or regulation.

    <p>False (B)</p> Signup and view all the answers

    Governmental immunity provides complete protection from legal claims for EMTs employed by governmental agencies.

    <p>False (B)</p> Signup and view all the answers

    It is crucial to maintain well-organized detailed records for each patient encounter.

    <p>True (A)</p> Signup and view all the answers

    The National EMS Information System (NEMSIS) improves the accuracy of data collection.

    <p>True (A)</p> Signup and view all the answers

    It is legal to withhold life-saving care if a parent refuses treatment for a child with a medical directive.

    <p>False (B)</p> Signup and view all the answers

    Medical identification insignia can provide vital information about the patient, including allergies, medical conditions, and DNR orders.

    <p>True (A)</p> Signup and view all the answers

    EMTs are legally obligated to report incidents of suspected child abuse or neglect.

    <p>True (A)</p> Signup and view all the answers

    EMTs have a moral obligation to act when they witness an accident off duty, but no legal obligation.

    <p>True (A)</p> Signup and view all the answers

    Failure to document an action is interpreted as it not being performed.

    <p>True (A)</p> Signup and view all the answers

    A complete and detailed patient care report can become part of the patient's permanent hospital record.

    <p>True (A)</p> Signup and view all the answers

    EMTs must avoid using radio codes when communicating with medical control.

    <p>True (A)</p> Signup and view all the answers

    It is acceptable for an EMT to blindly follow an order from medical control without confirmation or clarification.

    <p>False (B)</p> Signup and view all the answers

    It is generally not advisable to use radio codes while communicating with medical control.

    <p>True (A)</p> Signup and view all the answers

    An EMT's legal actions are not affected if a patient is injured due to an "act of God" or from unavoidable circumstances.

    <p>False (B)</p> Signup and view all the answers

    EMTs are not required to report potential criminal acts or assaults to law enforcement unless they are on duty.

    <p>False (B)</p> Signup and view all the answers

    It is acceptable for an EMT to terminate care without the patient's consent if the EMT feels that the patient is not cooperating with treatment.

    <p>False (B)</p> Signup and view all the answers

    When a health care provider forces their cultural values onto their patients because they believe their values are better, they are displaying:

    <p>Cultural imposition. (D)</p> Signup and view all the answers

    When communicating with an older patient, you should:

    <p>Approach the patient slowly and calmly. (B)</p> Signup and view all the answers

    While caring for a 5-year-old boy with respiratory distress, you should:

    <p>Allow a parent or caregiver to hold the child if the situation allows. (B)</p> Signup and view all the answers

    Which of the following pieces of patient information is of LEAST pertinence when giving a verbal report to a nurse or physician at the hospital?

    <p>The patient's family medical history (C)</p> Signup and view all the answers

    Which of the following statements about the patient care report (PCR) is true?

    <p>It helps ensure efficient continuity of patient care. (A)</p> Signup and view all the answers

    A device that receives a low-frequency signal and then transmits it at a relatively higher frequency is called a:

    <p>Repeater. (A)</p> Signup and view all the answers

    When treating a potentially hostile patient, you should try to diffuse the situation by:

    <p>Speaking calmly, confidently, and slowly. (D)</p> Signup and view all the answers

    All of the following are functions of the emergency medical dispatcher, EXCEPT:

    <p>Providing medical direction to the EMT in the field. (A)</p> Signup and view all the answers

    You arrive at the scene of an older woman complaining of chest pain. In assessing her, she holds her arm out for you to take her blood pressure. This is an example of:

    <p>Expressed consent. (B)</p> Signup and view all the answers

    Which of the following is an example of abandonment?

    <p>An AEMT transfers care of a patient to an EMR. (A)</p> Signup and view all the answers

    The unauthorized confinement of a person is called:

    <p>False imprisonment. (A)</p> Signup and view all the answers

    Failure of the EMT to provide the same care as another EMT with the same training is called:

    <p>Negligence. (A)</p> Signup and view all the answers

    An 8-year-old boy was struck by a car, is unconscious, and is bleeding from the mouth. A police officer tells you that he is unable to contact the child's parents. You should:

    <p>Continue to treat the child and transport as soon as possible. (D)</p> Signup and view all the answers

    An advance directive is:

    <p>A written document that specifies the care you should provide if the patient is unable to make decisions. (D)</p> Signup and view all the answers

    Which of the following patients is competent and can legally refuse EMS care?

    <p>A conscious and alert woman who is in severe pain from a broken leg (D)</p> Signup and view all the answers

    You are treating a patient with an apparent emotional crisis. After the patient refuses treatment, you tell him that you will call the police and have him restrained if he does not give you consent. Your actions in this case are an example of:

    <p>Assault. (D)</p> Signup and view all the answers

    The EMT has a legal duty to act if he or she is:

    <p>A volunteer, is on duty, and is dispatched on a call. (A)</p> Signup and view all the answers

    Which of the following statements about records and reports is FALSE?

    <p>Your patient care report does not become a part of the patient's hospital record because your treatment was provided outside the hospital. (B)</p> Signup and view all the answers

    A basic principle of emergency care is to do no further harm. When a health care provider acts in good faith and according to an appropriate standard of care, they are typically protected from legal exposure. What else must be present for this protection to be granted?

    <p>The provider must have acted within the scope of their training and licensure. (D)</p> Signup and view all the answers

    When a patient is conscious and rational, they have a legal right to refuse care. This is based on the principle of:

    <p>Patient autonomy. (A)</p> Signup and view all the answers

    Which of the following situations would NOT typically require consent from a guardian or conservator?

    <p>A patient suffering from a drug overdose and in need of immediate care. (B)</p> Signup and view all the answers

    Emancipated minors can legally give consent for their own medical treatment, even if their parents object.

    <p>True (A)</p> Signup and view all the answers

    Which of the following is considered a crucial element of the process of obtaining informed consent?

    <p>The patient being informed of any possible risks and benefits associated with the treatment. (A)</p> Signup and view all the answers

    Which of these actions is considered a violation of a patient's right to refuse treatment?

    <p>Requesting law enforcement assistance to help restrain a patient who is combative. (A)</p> Signup and view all the answers

    If you are unable to contact a minor's parents or legal guardian in a life-threatening situation, you should:

    <p>Proceed with care based on the principle of implied consent. (B)</p> Signup and view all the answers

    Which of the following is generally considered a legally permissible action in the case of a combative patient who poses a risk to themselves or others?

    <p>Using physical restraint to prevent the patient from harming themselves or others. (A)</p> Signup and view all the answers

    Which of these actions is MOST likely to lead to charges of battery?

    <p>Providing CPR without gaining informed consent. (A)</p> Signup and view all the answers

    You must be concerned about the safety and welfare of others. Which of the following is an example of an EMT's responsibility to act in a manner consistent with "standards of care"?

    <p>Providing medical care using accepted protocols and guidelines for the specific situation. (A)</p> Signup and view all the answers

    Duty to act applies when:

    <p>Both B and C. (D)</p> Signup and view all the answers

    Which of the following is a necessary element for negligence to apply?

    <p>The patient must have suffered damages as a result of the EMT’s actions. (D)</p> Signup and view all the answers

    What is res ipsa loquitur?

    <p>A legal doctrine that presumes negligence when something happens that would not ordinarily occur without negligence. (A)</p> Signup and view all the answers

    Which of the following situations is LEAST likely to be considered abandonment?

    <p>An�EMT transfers care of a patient to a paramedic at�the hospital. (A)</p> Signup and view all the answers

    Which of the following is the best example of unlawful confinement?

    <p>Transporting a patient against their will to a psychiatric facility. (D)</p> Signup and view all the answers

    Which of the following is a type of defamation that is written?

    <p>Libel. (D)</p> Signup and view all the answers

    Which of the following is NOT typically a condition under which a Good Samaritan law in the emergency medical services setting might protect an EMT from liability?

    <p>The EMT acted in gross negligence. (D)</p> Signup and view all the answers

    What legal defense is common in legal cases involving EMS systems that are funded by local governments?

    <p>Governmental Immunity. (A)</p> Signup and view all the answers

    Which of these conditions typically requires a medical examiner to be involved in a death investigation?

    <p>Suspected suicide in a public park. (D)</p> Signup and view all the answers

    You arrive at a scene where a patient has died and a family member states the patient had an organ donor card. What should you do?

    <p>Continue treatment as usual to try to save the patient’s life. (B)</p> Signup and view all the answers

    Which of the following is a common example of a situation where the EMT is required to file a special report, often mandated by state laws?

    <p>A patient who has�been the victim of sexual assault. (D)</p> Signup and view all the answers

    A patient care report is a legal document that provides a comprehensive record of your interaction with a patient. Which of the following is NOT typically a component of a patient care report?

    <p>The patient’s social security number. (B)</p> Signup and view all the answers

    Patient care reports are primarily intended for use by hospital staff and are not considered legal documents.

    <p>False (B)</p> Signup and view all the answers

    Which of the following is NOT one of the six functions served by a patient care report?

    <p>Professional development and self-improvement. (D)</p> Signup and view all the answers

    You're dispatched to a scene for a car accident with multiple patients involved. How can the EMTs at the scene manage their efforts more effectively?

    <p>Establishing a shared mental�model among the EMTs at the scene. (C)</p> Signup and view all the answers

    Which of the following is a common communication tool that EMTs use to ensure understanding during a medical handover?

    <p>Summary. (B)</p> Signup and view all the answers

    What is one main objective of the SBAR communication model?

    <p>To facilitate a clear and structured handover of patient care. (B)</p> Signup and view all the answers

    When providing care to a patient who is hearing-impaired, EMTs should increase the volume of their voice to ensure the patient understands.

    <p>False (B)</p> Signup and view all the answers

    When responding to a scene with a potentially hostile patient, it's essential to make direct eye contact to demonstrate confidence, but avoid staring.

    <p>True (A)</p> Signup and view all the answers

    Which of the following is the best example of an "open-ended question" that effectively promotes communication with an older patient in a medical setting?

    <p>How would you describe the pain? (B)</p> Signup and view all the answers

    What is the most important factor for preventing or decreasing the risk of a possible legal issue in your career as an EMT?

    <p>Thorough documentation and accurate recordkeeping. (D)</p> Signup and view all the answers

    When dealing with a patient who is a minor, which of these individuals is typically considered to be legally able to provide informed consent for the patient's medical treatment?

    <p>The�patient’s parent or legal�guardian. (D)</p> Signup and view all the answers

    When providing care to a patient who is visually impaired, the EMT should avoid making physical contact as it may cause discomfort.

    <p>False (B)</p> Signup and view all the answers

    Which of the following is the best example of a non-English speaking patient who is likely competent enough to provide informed consent?

    <p>A patient who can clearly communicate their needs and understanding with gestures and pointing. (A)</p> Signup and view all the answers

    In most cases involving legal issues related to EMT actions, a thorough patient care report is often helpful but not always mandatory.

    <p>False (B)</p> Signup and view all the answers

    Of the following, which is the most important reason for the EMT to communicate with medical control during a 911 call?

    <p>To receive medical orders and advice on appropriate treatment. (B)</p> Signup and view all the answers

    Which of the following procedures typically requires the EMT to obtain medical direction from a physician before providing treatment?

    <p>Administering medications that are not within the EMT’s scope of practice. (D)</p> Signup and view all the answers

    What is the most common reason that EMTs may be called to testify in a legal case?

    <p>To provide information about their interaction with a patient during a call. (D)</p> Signup and view all the answers

    Which of the following is a common legal defense that EMTs may raise in a negligence case?

    <p>Contributory Negligence. (B)</p> Signup and view all the answers

    Which of the following is a common situation where it is essential for the EMT to involve law enforcement in order to protect the well-being of the patient?

    <p>Treating a highly emotional patient who is refusing to go to the hospital. (A)</p> Signup and view all the answers

    The EMT is responsible for knowing their scope of practice. What two things does a medical director typically use to define the scope of practice for EMTs?

    <p>Protocols and standing orders. (D)</p> Signup and view all the answers

    What�is�the term for the process used to verify that a health care provider’s credentials are valid and compliant?

    <p>Credentialing. (B)</p> Signup and view all the answers

    You are treating a patient who is in a mental health crisis. You strongly believe they need immediate medical help, but they refuse treatment. You are legally entitled to restrain them and provide treatment against their will.

    <p>False (B)</p> Signup and view all the answers

    The EMT has a legal duty to act  if they are off duty and witness a major accident.

    <p>False (B)</p> Signup and view all the answers

    A basic principle of emergency care is to do no further harm. This is also known as what?

    <p>Nonmaleficence (B)</p> Signup and view all the answers

    Which of the following is an example of abandonment in EMT?

    <p>An AEMT transfers care of a patient to an EMR. (D)</p> Signup and view all the answers

    The right of the patient to make decisions about his or her health is known as patient autonomy.

    <p>True (A)</p> Signup and view all the answers

    An action not recorded was not performed.

    <p>True (A)</p> Signup and view all the answers

    What are the six functions that the patient care report (PCR) serves?

    <p>Continuity of Care, Compliance and Legal Documentation, Administrative Information, Reimbursement, Education, Data Collection (B)</p> Signup and view all the answers

    What are the typical 10 elements commonly included in the patient report to medical control?

    <p>Unit Identification, Level of Service, Alert, Receiving Hospital, ETA, Patient's Age, Patient's Gender, Patient's Chief Complaint, Brief Summary of Care Given, Any Questions or Orders (C)</p> Signup and view all the answers

    Which of the following is a type of advance directive? (Select all that apply)

    <p>Health Care Directive (A), Living Will (B), Physician Orders for Life-Sustaining Treatment (POLST) (C), Medical Orders for Life-Sustaining Treatment (MOLST) (D)</p> Signup and view all the answers

    The EMT is required to obtain a signature from the patient on the patient care report.

    <p>True (A)</p> Signup and view all the answers

    When a patient can understand information provided and can make informed choice regarding medical care, they have _____ capacity.

    <p>Decision-Making (A)</p> Signup and view all the answers

    What are the common signs of death? (Select all that apply)

    <p>No systolic blood pressure (A), Lack of a carotid pulse or heartbeat (B), No deep tendon or corneal reflexes (C), Absence of eye movement (D), Unresponsiveness to painful stimuli (E), Absence of breath sounds (F), Lowered or decreased body temperature (G), Profound cyanosis (H)</p> Signup and view all the answers

    It is acceptable to perform procedures that are beyond the scope of practice, if it is in the patient's best interest.

    <p>False (B)</p> Signup and view all the answers

    Always maintain an objective, accurate, and professional manner when documenting patient information.

    <p>True (A)</p> Signup and view all the answers

    What are the three types of consent described in the EMT text?

    <p>Expressed, Implied, Involuntary (C)</p> Signup and view all the answers

    Always obtain a witness when a patient refuses care.

    <p>True (A)</p> Signup and view all the answers

    The federal communications commission (FCC) regulates radio operations in the United States.

    <p>True (A)</p> Signup and view all the answers

    What are the three types of radio systems in the EMT text?

    <p>Base Station, Mobile, Portable (D)</p> Signup and view all the answers

    What is the term used to describe the space or proximity, between people when communicating?

    <p>Proxemics (A)</p> Signup and view all the answers

    When treating a potentially hostile patient, maintain good eye contact, but do not stare.

    <p>True (A)</p> Signup and view all the answers

    What are the four attributes of emotional intelligence?

    <p>Self-Awareness, Self-Regulation, Motivation, Social Skills (D)</p> Signup and view all the answers

    Most states have a legal requirement to report suspected physical or sexual abuse.

    <p>True (A)</p> Signup and view all the answers

    If the patient is hard of hearing, face the patient so he or she can read your lips and speak loudly.

    <p>False (B)</p> Signup and view all the answers

    What is the communication technique used when you focus attention on the present moment?

    <p>Mindfulness (C)</p> Signup and view all the answers

    What are the two common formats of medical documentation?

    <p>CHART, SOAP (D)</p> Signup and view all the answers

    The EMT is required to report special situations, such as hazardous materials situations and rescues in progress to medical control.

    <p>True (A)</p> Signup and view all the answers

    When giving a report to medical control or requesting medical direction, the EMT should avoid using radio codes.

    <p>True (A)</p> Signup and view all the answers

    All EMTs are required to maintain their licenses.

    <p>True (A)</p> Signup and view all the answers

    Flashcards

    Consent

    Permission granted by a patient for treatment.

    Expressed Consent

    When a patient clearly states they want care.

    Implied Consent

    Assumption of consent due to emergency situations.

    Involuntary Consent

    Consent for those unable to provide it due to mental illness.

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    Advance Directives

    Legal documents specifying a patient's treatment preferences.

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    DNR Order

    A do not resuscitate order preventing resuscitative measures.

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    Confidentiality

    Protecting a patient's private health information.

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    Negligence

    Failure to provide the standard of care expected.

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    Duty to Act

    Legal obligation to respond and provide care.

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    Abandonment

    Unilateral termination of care without consent.

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    Assault

    Threatening or causing fear of bodily harm.

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    Battery

    Unlawfully touching a person without consent.

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    False Imprisonment

    Unlawful confinement of a person.

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    Defamation

    False information that damages someone's reputation.

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    Good Samaritan Laws

    Laws protecting those who provide emergency assistance.

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    Mandatory Reporting

    Legal obligation to report specific situations.

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    Ethics

    Philosophy of right and wrong in medical practice.

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    Record Keeping

    Documenting all patient interactions and treatments.

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    Evidence Preservation

    Maintaining and protecting evidence for legal cases.

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    Statutory Responsibilities

    Duties mandated by law for healthcare providers.

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    Physical Signs of Death

    Indicators that a person has passed, such as unresponsiveness.

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    Medical Examiner Cases

    Circumstances requiring notification of a medical examiner.

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    Scope of Practice

    Defines the level of care an EMT can provide.

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    Standards of Care

    Expected level of care in the EMS profession.

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    Forcible Restraint

    Using physical force to control a combative patient.

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    End-of-Life Issues

    Considerations regarding care of patients nearing death.

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    Torts

    Civil wrongs leading to legal liability.

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    Professional Standards

    Guidelines ensuring quality of care in practice.

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    Patient Autonomy

    The right of patients to make decisions about their care.

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    Mental Capacity

    Ability of a patient to understand and make decisions.

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    Emergency Doctrine

    Principle allowing implied consent in emergencies.

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    Health Insurance Portability and Accountability Act (HIPAA)

    Federal law ensuring patient confidentiality and privacy.

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    Therapeutic Communication

    Principles of communicating with patients to build a positive relationship.

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    Shannon-Weaver Model

    A communication model describing message encoding and feedback.

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    Nonverbal Communication

    Communication consisting of body language and facial expressions.

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    Open-ended Questions

    Questions requiring detailed responses from the patient.

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    Closed-ended Questions

    Questions that can be answered with a simple 'yes' or 'no'.

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    Cultural Imposition

    Forcing your own cultural values onto others.

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    Ethnocentrism

    Evaluating other cultures based on one's own cultural standards.

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    Emotional Intelligence

    The ability to understand and manage your emotions and others'.

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    Patient Care Report (PCR)

    A legal document detailing all care from dispatch to hospital.

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    SBAR Technique

    Structured method for handover communication: Situation, Background, Assessment, Recommendation.

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    Documentation

    The process of recording patient findings and care delivered.

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    Nonverbal Cues

    Signals sent without words, including gestures and posture.

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    Communication Barriers

    Obstacles that hinder proper communication, such as language and culture.

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    Active Listening

    Fully concentrating, understanding, and responding thoughtfully to a speaker.

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    Medical Control

    Physicians guiding paramedics or EMTs over the radio.

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    Digital Equipment in EMS

    Tools like telemetry for transmitting patient data electronically.

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    Patient Hand-Over

    The process of transferring patient information and responsibility between providers.

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    Verbal Report to the Hospital

    Key elements of communication including patient's condition and treatment given.

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    Mobile Data Terminals

    Devices in ambulances for real-time information sharing.

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    Repeater Systems

    Radio systems that amplify weak signals between units.

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    HIEs

    Health Information Exchanges facilitate the sharing of data among providers.

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    Crisis Communication

    Effectively conveying information in high-pressure situations.

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    Family Presence during Care

    Involving family members in the patient's care process.

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    Caring Touch

    Using touch to convey empathy and compassion in patient interactions.

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    Reporting Errors

    Correcting mistakes in documentation properly to maintain integrity.

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    Communicating with Special Needs Patients

    Tailoring communication strategies for patients with unique challenges.

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    Emergency Medical Dispatcher

    Coordinates EMS response and provides medical instructions.

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    Mental Model

    A shared understanding among team members regarding a situation.

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    Patient Confidentiality

    Protecting a patient's private health information.

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    Interviewing Techniques

    Methods like open-ended questions to gather patient information effectively.

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    Documentation Practices

    Recording patient findings and care delivered for legal and medical purposes.

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    Verbal Communication with Patients

    Using clear, friendly language to foster understanding and cooperation.

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    Communication Techniques for Older Patients

    Strategies to engage and understand elder patients effectively.

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    Communication with Visually Impaired Patients

    Strategies to assist and engage patients who cannot see well.

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    Communication with Hearing-Impaired Patients

    Using clear speech, writing, and gestures to support understanding.

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    Providing Feedback

    Giving constructive responses to encourage effective communication and improvement.

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    Communication Tools

    Various methods to effectively interact, including facilitation and clarification techniques.

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    Base Station Radios

    Fixed radios used in healthcare to communicate vital information.

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    Mobile Radios

    Radios installed in vehicles for communication en route or at scenes.

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    Medical Terminology

    Foundational anatomical and medical terms used in communication with healthcare staff.

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    Mission-Critical Communications

    Essential communications where disruption leads to task failure.

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    Golden Rules of Communication

    Essential guidelines for effective patient communication including eye contact and clear language.

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    Communicating with Older Patients

    Strategies to engage and effectively interact with elderly patients.

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    Communicating with Children

    Specific strategies for interacting with young patients to reduce fear.

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    Patient Care Hand-Over

    Transfer of patient information and responsibility between care providers.

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    Telemetry

    Technology that allows electronic signals to transmit patient data remotely.

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    Health Information Exchanges (HIEs)

    Systems that improve data sharing between EMS and healthcare providers.

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    Repetition in Communication

    The act of repeating orders back word for word for clarity.

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    Parent Involvement in Care

    Allowing parents to hold or comfort children during treatment.

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    Patient Demographics on PCR

    Includes details like age, gender, and chief complaint in patient care report.

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    Common Communication Pitfalls

    Mistakes like using jargon or interrupting during patient interactions.

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    Workforce Safety

    The set of practices designed to ensure the safety and health of EMS personnel.

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    Personal Protective Equipment (PPE)

    Gear worn to minimize exposure to hazards and reduce risks of injury or illness.

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    Stress Management

    Strategies and techniques used to control and reduce stress in emergency situations.

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    Eustress

    Positive stress that can motivate and enhance performance.

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    Distress

    Negative stress that can hinder performance and well-being.

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    Wellness

    The active pursuit of good health across physical, mental, and emotional dimensions.

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    Resilience

    The ability to recover from stress or adversity.

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    Nutrition

    Consuming balanced meals to support overall health and energy needs.

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    Exercise

    Regular physical activity that enhances health and stress management.

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    Sleep Recommendations

    Guidelines suggest 7 to 9 hours of sleep for optimal health.

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    Disease Prevention

    Methods focusing on medical care and personal practices to avoid disease effects.

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    Communicable Disease

    An illness that can spread from person to person.

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    Infection Control

    Routine practices to prevent the spread of infections in healthcare settings.

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    Immunization

    Vaccinations aimed at preventing specific infections and diseases.

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    Exposure

    Coming into contact with bodily fluids or infectious agents.

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    Routes of Transmission

    Ways infectious agents are spread, including direct and indirect contact.

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    Critical Incident Stress

    Stress resulting from specific traumatic events experienced by EMS workers.

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    Posttraumatic Stress Disorder (PTSD)

    A condition triggered by experiencing a traumatic event, leading to anxiety and re-experiencing symptoms.

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    Compassion Fatigue

    Emotional exhaustion resulting from continual exposure to suffering and trauma.

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    Scene Safety

    Practices ensuring the safety of EMS personnel at emergency scenes.

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    Hazard Recognition

    Identifying potential dangers at an emergency scene.

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    Cultural Diversity in EMS

    Working effectively with individuals of varying backgrounds and beliefs.

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    Workplace Issues

    Challenges faced in the EMS workplace including communication, harassment, and substance abuse.

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    Standard Precautions

    Preventative measures taken to protect healthcare workers from exposure to infectious diseases.

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    Employer Responsibilities

    Duties of employers to ensure a safe working environment for their staff.

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    Financial Wellness

    Managing personal finances to reduce stress and increase overall well-being.

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    Exposure Report

    Documentation of any exposure to infectious materials by healthcare workers.

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    General Adaptation Syndrome

    The body's three-stage response to stress: alarm, resistance, and exhaustion.

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    Hand Hygiene

    The practice of washing hands to prevent disease transmission.

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    Stressful Situations

    Events causing significant pressure and demands on EMS providers.

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    Burnout

    A combination of exhaustion, cynicism, and reduced performance from long-term stress.

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    Mental Health Support

    Services available to help EMS providers cope with stress and trauma.

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    Coping Strategies

    Methods employed to manage stress and emotional responses.

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    Professional Development

    Continued training and education for EMS providers to enhance skills.

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    Legal Responsibilities

    The duties mandated by law that EMS providers must adhere to.

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    Emergency Response Plan

    A pre-established guideline to follow during emergency incidents.

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    Cultural Competence

    The ability to understand, communicate, and interact effectively with people from diverse cultures.

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    Debriefing

    A structured process to review actions taken and impacts after critical incidents.

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    Trauma-Informed Care

    An approach that recognizes and responds to the impact of trauma.

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    Study Notes

    • A basic principle of emergency care is to "do no further harm."
    • Health care providers usually avoid legal exposure by acting in good faith and according to appropriate standards of care.
    • Examples of situations requiring good faith and professional standards are:
      • Providing immediate care or life support in response to a clear emergency while waiting for patient consent.
      • Treatment of a minor child in a real emergency, while following proper medical protocols for the condition.
      • Having a patient with a DNR order.

    National EMS Education Standard Competencies (Preparatory)

    • Essential knowledge of the EMS system, EMT safety/well-being, and medical/legal/ethical concepts in emergency care.
    • Understanding how to make ethical decisions while upholding professional standards should be emphasized.

    National EMS Education Standard Competencies (Medical/Legal and Ethics)

    • Consent/refusal of care
    • Confidentiality
    • Advance directives
    • Tort and criminal actions
    • Evidence preservation
    • Statutory responsibilities
    • Mandatory reporting
    • Ethical principles/moral obligations
    • End-of-life issues
    • Medical/legal and ethical considerations applicable to a range of scenarios
    • Procedures and actions within the scope of practice, including identifying and following protocols and standing orders.
    • Communication (verbal and nonverbal) with patients of all backgrounds, ages, and conditions.
      • Examples of situations requiring professional, ethical communication are:
        • Talking to a distraught patient
        • Dealing with a combative patient
        • Communicating with a patient who has language barriers
        • Respecting cultural differences
        • Understanding a patient's reluctance to cooperate with treatment while still providing appropriate and comprehensive care. Following protocols and standing orders.

    • Permission to render care

    • Conscious, rational patients have the legal right to refuse care.

    • Consent is based on decision-making capacity and understanding of treatment information.

    • Patient autonomy is the right to make health care decisions.

    • Expressed consent: Patient verbally or nonverbally agrees to care/transport.

      • Example: A patient who speaks to the EMT and agrees to be transported to the hospital is providing expressed consent.

    • Implied consent: Applies when a patient is unconscious or incapable of making decisions.

      • Example: An unconscious patient who is involved in a serious accident and requires immediate treatment is considered to have implied consent. An EMT must follow the applicable protocols and standards and get approval from medical control when required or if there is an issue of ambiguity or doubt about the patient's condition.

    • Implied consent needs to be used only in life- or limb-threatening situations. -Example: A patient experiencing a heart attack, a patient with severe bleeding, or a patient in respiratory distress. All of these situations require swift and decisive action while adhering to correct medical protocols.

    • Attempt to get consent from family members whenever possible.

      • Example: An individual is unresponsive and the EMT contacts a family member to obtain expressed consent for treatment if possible.

    • Involuntary consent: Applicable to patients with mental illness, behavioral crisis, or developmental delays; consent must be obtained from a legally authorized guardian or conservator.

      • Example: A person involved in a behavioral health crisis may lack decision-making capacity, so contacting authorized family members to obtain consent before providing treatment is needed.
    • A parent or legal guardian provides consent for minors.
      • Example: A teenager is injured in a car accident. The EMT needs to contact the parent or legal guardian to obtain consent for medical treatment or transport.
    • In some states, minors (married; in the armed forces; emancipated) can provide consent.
      • Example: A 17-year-old who is legally emancipated can give informed consent to treatment or transport.
    • Teachers and school officials can sometimes act on behalf of parents' consent.
      • Example: A student injured during school activities. A teacher or school official can grant consent for treatment on behalf of the student’s parents (following school protocols and procedure).
    • EMTs must treat a minor in a true emergency situation, even without consent from parents/guardian; implied consent is valid in this case.
      • Example: A child is seriously injured. If the parents cannot be reached, the EMTs will proceed with treatment in accordance with the established policies and standards of their agency, following the principle of implied consent.

    Forcible Restraint

    • May be necessary in cases of combative patients.

    • Legally permissible.

    • Consultation with medical control is required before using force.

      • Example: A patient exhibiting violent behavior. The EMT calls the supervisor to seek guidance on the course of action and how to proceed according to the agency's policies and procedures.

    • Law enforcement may be required.

      • Example: If the patient's behavior puts themselves or others at risk, the EMT should seek appropriate help. Contact the local police, sheriff's department, or another law enforcement agency and inform them about the patient's condition and behavior.

    • Do not remove restraints, unless necessary due to risk to the patient. Be aware of the potential for the patient to inflict harm on themselves or others. Follow protocols. If there is danger or a threat of harm, medical control should be consulted, and law enforcement may be required.

    The Right to Refuse Treatment

    • Conscious, alert adults with decision-making capacity have the right to refuse treatment.
    • Refusal calls are often litigated.
      • Example: A patient with a known medical history of an allergy to a specific medication refuses to accept further treatment. The EMT should document any information about the patient’s condition as they proceed with care.
    • Assess the patient's ability to make informed decisions; observe the patient's behavior.
      • Example: If a patient appears confused or delusional, you cannot assume that their refusal of treatment is an informed refusal. The EMT should be cautious and document any observations showing the specific behaviour or indication of confusion.
    • Providing treatment is more defensible than failing to treat.
    • Do not endanger yourself.
    • Use assistance of law enforcement if needed, but be aware that this can take additional time and increase the risk of further injury.
      • Example: A patient who refuses treatment may escalate to a crisis. The EMT must document and document all actions while in contact with the patient and any witnesses. In case the patient is combative or dangerous, the EMT can request assistance from law enforcement.
    • Document refusals; witnesses are valuable; document all refusals and include any reasons for refusal. Ensure a formal refusal of care form is signed by the patient. If a witness is present, ensure the witness signs the refusal of care form.

    Confidentiality

    • Confidential information includes patient history, assessment findings, treatment information.
    • Information can only be disclosed for patient release, subpoena, or billing purposes (if permissible).
      • Example: Sharing a patient’s health information without consent is a violation of the patient’s privacy and confidentiality, which is inappropriate.
    • HIPAA (Health Insurance Portability and Accountability Act): Contains a section on patient privacy that strengthens privacy laws and safeguards patient confidentiality, protects protected health information (PHI).
    • Failure to abide by HIPAA can result in civil and/or criminal penalties.
      • Example: Sharing a patient’s health information in a public manner (e.g., through loud radio discussions or use of public devices) violates a patient’s HIPAA rights and could result in disciplinary action or lawsuit.
    • Be careful with social media; avoid agency logos, uniforms, vehicles, or other markings when not on duty.
      • Example: Posting a photo of a patient on social media, showing personal information such as the patient’s name or location, without the patient's consent, is against HIPAA and could result in disciplinary action or a lawsuit.

    Advance Directives

    • Specifies treatment in cases of unconsciousness or inability to make decisions.
    • DNR (Do Not Resuscitate) order is an advance directive that permits EMTs not to resuscitate a patient.
    • POLST (Physician Orders for Life-Sustaining Treatment) and MOLST (Medical Orders for Life-Sustaining Treatment) explicitly define acceptable interventions for the patient under specific medical conditions; must be signed by an authorized medical provider; contact medical control for guidance.
      • Example: If a patient has a DNR order, the treatment that can be performed is limited to the specific medical conditions listed in the POLST order. Additional examples of advance directives: Living will, health care directive
    • Patient may have designated surrogates (health care proxies or durable powers of attorney for health care) to make decisions on their behalf.
      • Example: If a patient has a designated health care proxy, this proxy can make medical decisions on the patient's behalf, if the patient cannot independently make their own medical decisions.

    Physical Signs of Death

    • Physician determines cause of death.
    • Presumptive signs include:
      • Unresponsiveness to stimuli
      • Lack of pulse/heartbeat
      • Absence of breathing
      • No reflexes
    • Definitive signs include:
      • Decapitation
      • Blood settling
      • Rigor mortis (stiffening), occurs between 2-12 hours after death
      • Algor mortis (cooling of the body)
      • Putrefaction (decomposition), occurs between 40–96 hours after death

    Medical Examiner Cases

    • Examiner involvement depends on the situation.
    • Cases include:
      • Death without prior medical care
      • Suicide
      • Violent death
      • Poisoning (known or suspected)
      • Accidents
      • Suspicion of a criminal act
      • Infant/child deaths

    Scope of Practice

    • Outlines the care EMTs can provide, usually defined by state law with further guidance and procedures from medical control/supervisors; it's important to follow local protocols.
      • Example: If a situation or case is complicated, for example, if a patient has a rare condition, the appropriate steps need to be followed. Consult medical control for guidance.

    Standards of Care

    • Manner in which EMTs must act or behave, considering the safety and welfare of others
      • Example: An EMT must follow specific standards of care for all patients and their actions must meet the care standards to avoid legal issues.
    • Established by; local customs, statutes, ordinances and institutional standards (e.g., AHA CPR guidelines and related training materials; NHTSA), and medical practices act.
    • Also includes medical certifications, training certifications, licensures and accreditations.

    Duty to Act

    • EMTs have a duty to provide patient care.
    • This duty applies when the EMT is dispatched on a call, once treatment begins, and in some cases, when off-duty if acting as a volunteer or when harm or threat of harm is present.

    Negligence

    • Failure to provide the same care a similarly trained EMT would provide in the same situation
      • Example: If a patient sustains a concussion, the EMT must follow the protocols to assess and stabilize the condition appropriately. Failing to follow these standard procedures and protocols could lead to negligence

    Abandonment

    • Unilateral termination of care by EMT without consent or provisions for continued care.
      • Example: An EMT leaves the scene without notifying or connecting with a qualified medical professional

    Assault and Battery

    • Assault: unlawfully placing a person in fear of immediate harm (i.e., threatening to restrain a patient if they don't cooperate)
    • Battery: unlawfully touching a person; this includes inappropriately touching or restraining a person without their consent; touching a patient without consent can be considered assault and/or battery unless there is a legitimate medical need (if authorized).

    Kidnapping

    • Kidnapping: seizure or confinement and abduction of a person or property against the person's will. (This includes unlawful or unauthorized movement of a patient)

    Defamation

    • Communication of false information that damages reputation.
    • Libel: written; Slander: spoken.
      • Example: Writing false or untrue information about a patient or EMT in a report is a form of libel, and verbal defamation is slander

    Good Samaritan Laws and Immunity

    • Protects EMTs acting in good faith while reasonably assisting others without seeking compensation.
    • Gross negligence: willful or reckless disregard that can cause harm

    Records and Reports

    • Complete records of all incidents are crucial to protect against legal issues; records should be accurate and thorough.
      • Example: When there is a medical emergency, ensure EMTs follow the proper procedure and notify the proper authorities as part of the incident report
    • Include information about care and actions.
    • NEMSIS (National EMS Information System) helps improve efficiency of collecting and sharing data
    • Incomplete records can cause legal problems or legal implications.

    Ethical Responsibilities

    • Ethics, morality, and bioethics guide EMT actions; these principles should be employed when making decisions related to patient safety and well-being.
      • Example: EMTs must always uphold ethical principles to balance legal and medical guidelines in their practice.
    • Including rules, laws, and policies to guide decision making; these should be followed to maintain legitimacy, especially to minimize personal risks.

    EMT in Court

    • EMTs can be witnesses or defendants in court.
    • Notice should be given to supervisor and legal counsel; these steps ensure appropriate support and protection in case of court appearance.
    • EMTs should review run reports before court; this ensures the EMT addresses and understands the key points
      • Example: If a patient sues the EMT for negligence or malpractice, thorough documentation is key and essential for defense and to comply with the proper procedures.
    • Defenses include: statute of limitations, governmental immunity, and contributory negligence.
      • Example: A patient files a lawsuit against the EMT, based on negligence or another issue, The EMT's legal defense may include proving that the statute of limitations has expired, or that the EMT's actions complied with the applicable legal guidelines and medical standards, or that the actions/behavior of the patient are contributing towards the negligence claims; complete documentation of the incident is required
    • Discovery allows for additional information collection (interrogatories, formal questions, depositions)
    • Most cases are settled during the discovery phase. If not settled, the case goes totrial. Damages that may be awarded to the patient include:
      • Compensatory damages
      • Punitive damages

    Review (Examples)

    • The review section is where examples or scenarios can be added to the existing notes, to clarify specific medical or legal situations and illustrate how concepts and principles apply in practice.
    • Example: Review questions and answers regarding various medical, legal, and ethical concepts and principles, such as consent, abandonment, negligence, along with examples, case studies, and practice questions.

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    Medical, Legal, and Ethical Issues PDF
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    Description

    Explore the fundamental principles of medical, legal, and ethical issues relevant to emergency medical services (EMS). This quiz covers consent, confidentiality, ethical principles, and the responsibilities of healthcare providers in emergency care.

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