Podcast
Questions and Answers
What should be assessed first during a patient examination?
What should be assessed first during a patient examination?
- Past medical history and present illness
- Patient's vital signs
- Medic alert jewelry or tags (correct)
- Patient's grooming and hygiene
Which of the following factors should be considered as risk factors for patient vulnerability?
Which of the following factors should be considered as risk factors for patient vulnerability?
- Age and functional impairment (correct)
- High socioeconomic status
- Employment status
- Healthcare access
What immediate information should be gathered if a change in mentation is observed?
What immediate information should be gathered if a change in mentation is observed?
- Family medical history
- Time of the last meal
- Previous hospital admissions
- Duration of the change and interventions provided (correct)
During a physical exam, which finding should be specifically assessed related to respiratory function?
During a physical exam, which finding should be specifically assessed related to respiratory function?
Which aspect is important in assessing patient decisional capacity?
Which aspect is important in assessing patient decisional capacity?
What should be considered if physical exam findings are deemed grossly abnormal?
What should be considered if physical exam findings are deemed grossly abnormal?
Which part of the physical exam assesses the likelihood of a stroke?
Which part of the physical exam assesses the likelihood of a stroke?
What type of screens should be considered during a mental health assessment?
What type of screens should be considered during a mental health assessment?
What should be done if a patient exhibits agitated delirium and refuses cooperation?
What should be done if a patient exhibits agitated delirium and refuses cooperation?
Who must consent to medical treatment for a minor in Illinois?
Who must consent to medical treatment for a minor in Illinois?
What factors are considered when a guardian requests transport to a facility other than the nearest one?
What factors are considered when a guardian requests transport to a facility other than the nearest one?
What is the status of an emancipated minor regarding medical consent?
What is the status of an emancipated minor regarding medical consent?
What should EMS personnel first determine when called to assist a minor?
What should EMS personnel first determine when called to assist a minor?
Which of the following is NOT a consideration for OLMC when approving transport requests?
Which of the following is NOT a consideration for OLMC when approving transport requests?
What should EMS personnel institute as needed before determining legal consent status for a minor?
What should EMS personnel institute as needed before determining legal consent status for a minor?
What policy does a guardian's request to transport a patient to another facility fall under?
What policy does a guardian's request to transport a patient to another facility fall under?
What is required for an adult with legal and decisional capacity who refuses assessment, care, and/or transportation?
What is required for an adult with legal and decisional capacity who refuses assessment, care, and/or transportation?
Which personnel are sufficient for processing a refusal of service for adults or minors receiving BLS care?
Which personnel are sufficient for processing a refusal of service for adults or minors receiving BLS care?
What aspect of insight is assessed in a patient regarding their situation?
What aspect of insight is assessed in a patient regarding their situation?
When a refusal of care is contested by EMS, what is the documentation requirement?
When a refusal of care is contested by EMS, what is the documentation requirement?
What level of staffing is required to process an ALS care refusal?
What level of staffing is required to process an ALS care refusal?
What must EMS personnel do when encountering a patient who refuses care?
What must EMS personnel do when encountering a patient who refuses care?
Which of the following is NOT assessed when determining a patient's insight?
Which of the following is NOT assessed when determining a patient's insight?
What documentation is needed for a refusal of care when two EMS practitioners witnessed the risk disclosure?
What documentation is needed for a refusal of care when two EMS practitioners witnessed the risk disclosure?
What does a refusal of care from the EMS System imply about potential consequences?
What does a refusal of care from the EMS System imply about potential consequences?
Who is released from liability when an individual or their guardian refuses care?
Who is released from liability when an individual or their guardian refuses care?
What does the document state about the evaluation provided by EMS personnel?
What does the document state about the evaluation provided by EMS personnel?
What must an individual demonstrate to refuse care according to the document?
What must an individual demonstrate to refuse care according to the document?
What is a potential consequence mentioned for refusing transportation?
What is a potential consequence mentioned for refusing transportation?
What does the phrase 'hold them completely harmless' imply about the responsibility of the EMS System?
What does the phrase 'hold them completely harmless' imply about the responsibility of the EMS System?
What is the effective date of the policy regarding consent/dissent to care?
What is the effective date of the policy regarding consent/dissent to care?
What does the policy imply about the relationship between EMS evaluations and treatment by a private practitioner?
What does the policy imply about the relationship between EMS evaluations and treatment by a private practitioner?
What is required for documenting a patient's refusal of care and/or transportation?
What is required for documenting a patient's refusal of care and/or transportation?
If a patient refuses to sign the paper Release form, what must be done?
If a patient refuses to sign the paper Release form, what must be done?
How must electronic signatures be documented if a patient refuses to sign?
How must electronic signatures be documented if a patient refuses to sign?
What is required in addition to the patient's signature on the Release form?
What is required in addition to the patient's signature on the Release form?
Which personnel is responsible for obtaining the patient's signature?
Which personnel is responsible for obtaining the patient's signature?
What should be done with call information for all refusals?
What should be done with call information for all refusals?
Who can be a second witness for a patient's refusal?
Who can be a second witness for a patient's refusal?
What must EMS personnel do when a patient refuses electronic signing?
What must EMS personnel do when a patient refuses electronic signing?
Study Notes
Patient Assessment and Evaluation
- Inspect for medical alert jewelry, body art, odors on breath, poor grooming, skin edema, discoloration, lesions, or rashes to identify potential health issues.
- Evaluate patient’s vulnerability factors: age (young/old), dementia, functional impairment, malnutrition, and substance use disorders.
- Gather comprehensive medical history, including the nature and duration of changes in the patient's condition. Focus on signs and symptoms (S&S) surrounding events of altered mentation.
Physical Examination
- Conduct physical assessments: glucose level, SpO2, ETCO2 values & waveform, ECG if necessary, and test pupils, eye movements, and sensory/motor responses.
- Look for signs of pain through facial expressions, body movements, muscle tension, or vocalizations.
- Perform stroke, suicide, and qSOFA screenings as indicated.
Decisional Capacity Assessment
- Evaluate memory (immediate, recent, remote), insight, and the patient’s ability to understand their situation and consequences of decisions.
- Determine if patients can articulate safe alternatives to recommended care.
Emergency Medical Services (EMS) Response
- EMS has an obligation to persuade patients for necessary assessment and care, especially if they display agitated delirium or combative behavior.
- Document refusals of care as “Against Medical Advice” if contested, requiring dual witness signatures—one must be an ALS provider.
Patient Consent and Refusal
- Adults with decisional capacity who refuse care must be informed of the risks involved.
- Minors require parental consent unless they are emancipated; EMS must assess health issues first under Emergency Doctrine and Implied Consent.
Liability Release
- Patients or guardians must acknowledge and release the EMS system from liability when refusing care, understanding they could suffer adverse health effects.
Documentation Requirements
- Ensure that patients sign the Release of Liability form; electronic forms must be time-stamped.
- In case of refusal to sign, complete “Refusal to Sign a Release Statement” requiring two witnesses.
- Document all refusals in EMS software within two hours post-incident, ensuring all details are captured accurately.
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Description
This quiz covers essential techniques for assessing patient health, focusing on various physical indicators such as hygiene, odors, and skin conditions. It also addresses the evaluation of patient vulnerability based on age, cognitive impairments, and past medical history. Prepare to enhance your skills in comprehensive patient evaluation.
