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EM R Complete: A Worktext Second Edition Chapter 3 Medical, Legal, and Ethical Issues Copyright © 2014 Pearson Education, Inc. All Rights Reserved Topics Providing Legal and Ethical Care Advance Directives Ethics Liability and Negligence EM S at the Crime Scene Copyright © 2014 Pearson Education, In...

EM R Complete: A Worktext Second Edition Chapter 3 Medical, Legal, and Ethical Issues Copyright © 2014 Pearson Education, Inc. All Rights Reserved Topics Providing Legal and Ethical Care Advance Directives Ethics Liability and Negligence EM S at the Crime Scene Copyright © 2014 Pearson Education, Inc. All Rights Reserved Introduction Encountering legal and ethical issues Copyright © 2014 Pearson Education, Inc. All Rights Reserved Providing Legal and Ethical Care (1 of 2) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Figure 3.1 There must be a witness when a patient signs a refusal of care form Copyright © 2014 Pearson Education, Inc. All Rights Reserved Providing Legal and Ethical Care (2 of 2) Do you need permission to help someone? Can you treat a minor without the consent of the parents? Can you let someone die? Can you discuss details of a call with others? Copyright © 2014 Pearson Education, Inc. All Rights Reserved Scope of Practice Definition Who sets scope of practice Protocols Copyright © 2014 Pearson Education, Inc. All Rights Reserved Medical Oversight Off-line medical direction On-line medical direction Copyright © 2014 Pearson Education, Inc. All Rights Reserved Consent Expressed consent Implied consent Emancipated minors Copyright © 2014 Pearson Education, Inc. All Rights Reserved Refusal of Care (1 of 2) Must meet specific criteria Must make an informed decision Documentation Copyright © 2014 Pearson Education, Inc. All Rights Reserved Refusal of Care (2 of 2) When should a patient not be allowed to refuse – Altered mental status – Under the influence of drugs or alcohol – Impaired judgment due to medical conditions Copyright © 2014 Pearson Education, Inc. All Rights Reserved Confidentiality (1 of 3) Health Insurance Portability and Accountability Act (HIPA A) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Confidentiality (2 of 3) Times when it is acceptable to disclose PH I – Transferring relevant and pertinent information to others directly involved in patient care – Upon patient approval to insurers and those responsible for payment – Operational reasons within EM S agencies including quality improvement and research Copyright © 2014 Pearson Education, Inc. All Rights Reserved Confidentiality (3 of 3) Times when it is acceptable to disclose PH I – Mandatory reporting situations, such as crimes of violence, abuse, or public health situations – When required to do so by legal subpoena Copyright © 2014 Pearson Education, Inc. All Rights Reserved Advance Directives (1 of 2) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Prehospital Do Not Resuscitate Orders Copyright © 2014 Pearson Education, Inc. All Rights Reserved Advance Directives (2 of 2) Do not resuscitate order (DN R) Living will Durable power of attorney Health care proxy Copyright © 2014 Pearson Education, Inc. All Rights Reserved Ethics (1 of 2) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Ethics (2 of 2) Define things that an EM R should not do Based on morals – Honesty – Kindness and compassion – Advocacy Copyright © 2014 Pearson Education, Inc. All Rights Reserved Liability and Negligence (1 of 2) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Liability and Negligence (2 of 2) Tort Assault and battery Abandonment Negligence Copyright © 2014 Pearson Education, Inc. All Rights Reserved Four Components of Negligence Duty to act Breach of duty Harm was caused Proximate causation Know and remember these ! Copyright © 2014 Pearson Education, Inc. All Rights Reserved E M S at the Crime Scene Copyright © 2014 Pearson Education, Inc. All Rights Reserved Figure 3.5b As an EMR, you may provide treatment to an injured perpetrator Copyright © 2014 Pearson Education, Inc. All Rights Reserved Evidence Identification and Preservation Fingerprints Blood and body fluids Wounds Conditions at the scene Statements made at the scene Copyright © 2014 Pearson Education, Inc. All Rights Reserved Taser (1 of 2) Device that uses electrical current to disrupt muscle control and incapacitate a violent individual. Copyright © 2014 Pearson Education, Inc. All Rights Reserved Taser (2 of 2) Ensure your own safety. Ensure patient's AB Cs. Carefully monitor them throughout the call. Assess patient's complaint and injuries. Do not remove taser electrodes unless you have been trained to do so. Copyright © 2014 Pearson Education, Inc. All Rights Reserved Mandated Reporting Child abuse or neglect Domestic violence Elder abuse Sexual assault Gunshot wounds or other violence Infectious diseases Copyright © 2014 Pearson Education, Inc. All Rights Reserved Copyright This work is protected by United States copyright laws and is provided solely for the use of instructors in teaching their courses and assessing student learning. Dissemination or sale of any part of this work (including on the World Wide Web) will destroy the integrity of the work and is not permitted. The work and materials from it should never be made available to students except by instructors using the accompanying text in their classes. All recipients of this work are expected to abide by these restrictions and to honor the intended pedagogical purposes and the needs of other instructors who rely on these materials. Copyright © 2014 Pearson Education, Inc. All Rights Reserved

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