Legal Issues and Life Span Development Study Guide-1.pdf

Legal Issues and Life Span Study Guide 1. Define and differentiate the following terms: a. Scope of practice i. The actions and care that EMT’s are legally allowed to perform by the state in which they are providing emergency m...

Legal Issues and Life Span Study Guide 1. Define and differentiate the following terms: a. Scope of practice i. The actions and care that EMT’s are legally allowed to perform by the state in which they are providing emergency medical care b. Standard of care i. The care that is expected to be provided by an EMT with similar training when managing a patient in a similar situation ii. Also known as the “Reasonable Person” standard c. Duty to act i. Your legal obligation to provide service while on duty, whether you think the patient needs an ambulance or not d. Good Samaritan Law i. Protects a person who is not being paid for his services from liability for acts performed in good faith unless those acts constitute gross negligence ii. Does not protect from being sued 2. Medical direction a. Who provides medical direction i. Medical director – establishes medical direction (policies and protocols) ii. Base hospital – provides medical direction iii. Offline medical direction – standing orders (can do without contacting a base hospital) iv. Online medical direction – base hospital orders – must call a base hospital and request to provide a specific treatment b. Why do we need medical direction i. Establishes scope of practice c. When should you call medical direction i. Treatment options that are not standing orders (offline) ii. Patient disposition (transport destination, refusals) 3. Consent a. Define and differentiate i. Informed/Expressed 1. A conscious, rational patient who consents to your assessment and treatment ii. Implied 1. A patient who is unresponsive, disoriented, or an ill/injured minor would consent to care if they were conscious and rational iii. Minor 1. A minor cannot consent or refuse care, only a parent or legal guardian can 2. If a minor is ill or injured, and no parent can be reached, can treat under implied consent 3. A minor who is NOT ill or injured is not technically a patient, but you need to find a parent, legal guardian, or adult considered able to take care of patient until parents reached (law enforcement, school principal, etc) iv. Involuntary 1. A patient who cannot refuse care 2. A mentally incompetent adult or a person in custody b. Understand situations where a minor may be emancipated i. Married ii. Pregnant or a parent 1  Legal Issues and Life Span Study Guide iii. In armed forces iv. Financially independent v. Emancipated by court decree 4. Advanced Directives a. Define, differentiate, and understand i. Do Not Resuscitate (DNR) 1. States patient wishes if they were to go into cardiac arrest 2. Must be signed by patient/DPOA and physician ii. POLST 1. Similar to DNR, more options for the patient iii. Living will 1. Covers general healthcare issues, not used much in EMS iv. Durable Power of Attorney 1. Legally empowers a person to make health care decisions for the signer of the document if he is unable to do so 5. Against Medical Advice (AMA) a. Who can sign out AMA i. A patient who is competent to refuse care 1. Oriented to person, place, time, and event 2. Not under the influence of drugs or alcohol b. Know AMA checklist i. 1 and 2 above, plus 1. Patient understands their condition 2. Consequences of not going to hospital have been explained, up to and including death 3. Patient has been advised to recontact 911 if needed 4. Patient must sign form ii. Ensure that you completely and thoroughly document all AMA incidents 6. Legal Terms a. Define, differentiate, and understand i. Negligence 1. Created when an EMT breaches their duty to act or deviates from standard of care 2. Must prove that EMT a. Had a duty to act b. That duty to act was breached c. The patient suffered an injury d. The injury was related to the breach of a duty to act ii. Abandonment 1. Failure to transfer patient to another competent professional of equal or higher level of training iii. Assault 1. Willful threat to inflict harm on a patient iv. Battery 1. The act of touching a patient unlawfully without consent v. Kidnapping 1. Taking the competent, rational patient to the hospital against his wishes vi. Tort 1. The EMT knowingly committed the wrongdoing 2  Legal Issues and Life Span Study Guide 7. HIPAA a. Define i. Health Insurance Portability and Accountability Act ii. May only discuss patient specific information with individuals with whom it is medically necessary iii. A written release is required before releasing confidential information b. Why do we have HIPAA? c. Know who you can share info with and who you can’t share info with i. Can 1. Another health care worker to continue medical care 2. Mandatory reporting 3. Law Enforcement 4. Billing agencies 5. By legal subpoena ii. Cannot 1. Other family members without permission 2. Your friends and family 3. The press 4. Patient’s neighbors 8. Determination of Death a. What are the obvious signs of death (6 of them) i. Rigor mortis ii. Decapitation iii. Decomposition iv. Evisceration of a vital organ (heart or brain) v. Incinerated (burned beyond recognition) vi. Dependent lividity vii. Which one does not count in San Diego County? 1. Dependent lividity b. What are the instances where an EMT can pronounce a patient deceased? i. A patient in cardiac arrest, and 1. DNR/POLST present 2. Obvious sign of death 9. 5150 a. Who can put a patient on a 5150 hold? i. Physician ii. Law enforcement b. What are the 3 instances where a patient can be put on a hold? i. Danger to self ii. Danger to others iii. Gravely disabled (unable to care for oneself where leaving them alone would be dangerous) 10. Abuse reporting a. What is your legal obligation? i. To report observed or possible abuse b. What reporting must you file and when? i. Contact abuse agency (CPS, APS, etc) asap ii. Follow up with documentation within 36 hours 11. Life Span a. Understand the development stages, including vital signs (esp BP, Pulse, Respiratory rates for age ranges), physiologic and psychosocial changes 3 Legal Issues and Life Span Study Guide i. Neonates and infants (what’s the difference?) ii. Toddlers and Preschool-age children iii. School-Age Children iv. Adolescence v. Early adulthood vi. Middle adulthood vii. Late adulthood 4