1 - Intro

Question 1

Who makes the emergency medicine rules about who is seen, transport between facilities, etc?

Answer 1

EMTALA–emergency medical treatment and active labor act

Question 2

How many triage levels are there? Which is most urgent?

Answer 2

5 levels, 1 being most emergent

Question 3

Who is exempt from EMTALA laws?

Answer 3

Shriners, VA

all hospitals that accept Medicare/Medicaid must adhere to EMTALA regulations

Question 4

Under what conditions could you transfer a patient prior to stabilizing them? What must you do in these cases?

Answer 4

1) You’ve reached the limit of your facility’s capabilities
2) physician declares benefit of transfer to outweigh risk
3) patient request (AMA despite counseling)
MUST:
1) discussed case with receiving facility who agrees to accept
2) send records
3) use qualified transfer service with appropriate equipment, etc.

Question 5

physician’s obligation to provide tx according to accepted standard of care

Answer 5

duty of care

Question 6

failure to do something that a reasonable person similarly situated would do, or doing something that a reasonable person similarly situated would not do

Answer 6

negligence

Question 7

physician is obligated to provide tx with knowledge, skill, and care ordinarily used by reasonable well-qualified physicians practicing in similar circumstances. A physician specializing in a given field will be held to standard of other specialists in same field

Answer 7

breach of duty

Question 8

proof that negligence more likely than not caused the injury sustained; connection must be made between negligent act/omission and injury must be foreseeable and probable in natural course rather than possible

Answer 8

proximate cause

Question 9

awarded as compensation for loss or injury suffered as a proximate result of negligent conduct

Answer 9

damages

Question 10

time within which a lawsuit must be initiated, to promote timely filing of claims, usually 2 years in most states

Answer 10

statute of limitations

Question 11

You can imply consent in these 4 circumstances if action must be taken emergently

Answer 11

1) unconscious/unstable
2) intoxicated
3) minor
4) psych

Question 12

These are the reportable events:

Answer 12

1) animal bite
2) STD and communicable dz
3) Child abuse
4) sexual assault

Question 13

let the master answer: confers legal liability on employer for actions of employee

Answer 13

respondant superior

Question 14

Physician or hospital may be liable for negligent conduct of employees or agents

Answer 14

vicarious liability

Question 15

Plaintiff in malpractice case must prove cause and must provide direct factual evidence showing negligence
- prove injury would not have occurred if there was no negligence, caused by agency or instrumentality within control of defendant, patient did nothing to contribute to the injury

Answer 15

res ipsa loquitur

Question 16

you are the ER provider and parents bring in child who has suffered trauma and is bleeding out. They won’t consent to blood transfusion due to their Jehova views. What do you do?

Answer 16

Contact hospital counsel and take temporary protective custody of child based on child neglect. Administer lifesaving care

Question 17

you are the ER provider and a 32 year old male comes in also bleeding out. He refuses transfusion based on religious beliefs. On general survey you detect slurred speech. What do you do?

Answer 17

Administer lifesaving care. Slurred speech may be indication of intoxication or neuro deficit and patient should be presumed to be incompetent.