102 Flashcards
“What is the definition of an ““adult”” in bcehs P / P?”
Adults are 19 years or older
What is the definition of competent? How can you determine if a patient is not competent?
A competent person is an adult with the mental capacity to provide consent.Paramedics must assume a person is competent unless obviously incompetent.
What is the definition of consent?
”"”Consent”” means a competent adult’s voluntary consent, through words or conduct, to treatment, after being informed of his or her medical condition, the nature of the proposed treatment, the risks and benefits of receiving or not receiving treatment, and any other significant factors affecting his or her condition or the proposed treatment.”
What is the definition of a child in BCEHS?
Under 19 years old
Of the drugs carried by CCP:
Which are schedule 1 CTS medications?
Which are schedule 4 drugs?
Which does BCEHS treat as CTS, but they aren’t actually?
Morphine, Fentanyl, and Ketamine are schedule 1Midazolam and lorazopam are schedule 4Haldol and propafol are not technically CTS but they are treated as such by BCEHS
What is the BCEHS definition of a vulnerable adult?
A person over the age of 19 who receives assistance in performing ADLs and can’t provide for their own care
In BCEHS policy 6.7 (reporting gun shot wounds), what are two circmstances where a paramedic is not required to report a gunshot wound or stabwound?
1) If the patient is transported by ambulance to the hospital2) In regards to stab wounds only, if the paramedics believe it was accidental or self-inflicted
What are two circumstances where a paramedic is not legally obligated to provide treatment or transport of a patient in police custody?
1) if a competent patient in custody refuses treatment and/or transport after being warned of the risks
2) if the police refuse to allow the patient to be treated and or transported.
(If police transrport the patient this is documented as a refusal by paramedics)
Are patient in police custody considered vulnerable or not?
Yes, they are vulnerable because they are completely dependent on the police for necessities of life
What must paramedics do for patients in police custody if a competent patient refuses transport, the police refuse a patient to be transported or if the police decide to transport the patient themselves?
1) Notify EPOS as per guideliens
2) Document epcr and read aloud the refusal section
3) have PD and patient sign the form (PD to sign refusal if they are transporting or witness if patient is refusing)
4) complete occurrence report document reasons for refusal
5) notify PD to contact dispatch if patient condition worsens
What is the definition of a substitute decision maker?
A “substitute decision maker” is a person with the authority to consent to treatment on behalf of an incompetent adult and who is appointed as
(a) a committee or personal guardian by the court, or
(b) a personal representative in a representation agreement,but does not include a person having an incompetent adult’s Power of Attorney.
What are the two requirements in which a paramedic is not legally obligated to provide treatment to an incompetent adult?
1) If substitute decision maker refuses to consent
2) Substitute decision maker can provide a copy of representation agreement or a court order indicating that they are the substitute decision maker for the incompetent adult
What should paramedics do if an incompetent adult refuses treatment?
1) Request PD attend
2) Advise PD that patient is incompetent and refusal of treatment could endanger the patient
3) Request PD apprehend patient under mental health act
4) Request PD come with patient to hospital
What is the definition of a competent child?
A competent child is one who is mentally capable of giving or refusing consent
What factors much a paramedic consider when deciding whether a child is competent?
1) Age and maturity of the patient
2) Noticeable fear of the treatment
3) Parental, familiar influence
4) Ability to understand paramedic instructions
5) Discomfort pain or stress
6) other listed in other policies
Under which circumstances can you leave a child at home alone?
Over the age of 12 if the paramedic believes their age, maturity and level of development suggests they are capable of caring for themselves
What is the federal law that allows CCPs to possess and administer narcotics?
Narcotics controlled regulation
Define controlled substances
Morphine, Fentanyl, Ketamine, Lorazepam (Ativan), Midazolam (Versed)
What is the structure of the EMALB board and their mandate?
1 lawyer, physian and paramedic - mandate is to manage examinations, license issuance and renewal, practice oversight and complaints
What are the required vs recommended times to contact epos?
Recommended (3):
1) Developing transport/management plan with external agency
2) Non-transport of vulnerable patient when legal guardian made decision
3) Clinical uncertainty or dilemma
Required (10)
1) Termination of arrest
2) Early transport
3) Refusal of in-custody patient
4) Non-transport of patient with no legal guardian
5) Research trial enrollment
6) Local bypass authorizations
7) CCP level authorization for drug/procedure not in regulation
8) Treatment guideline requirement
9) JRCC request medical consult
10) Uncertainly about DNR/MOST, Advanced directives etc
Under which age must paramedics never leave a child alone
Under 12 - otherwise children can be left alone if the maturity and level of development demonstrates an ability to care for themselves
what defines CCP scope of practice in terms of provincial law?
All services listed under ACP scope in schedule 2 of EMA Regulations plus starting arterial lines and providing heat by inbutators
Under narcotics control regulations, how long does a person have to keep records?
2 years
What is the difference between gross negligence and negligence?
Gross negligence is commision (intentially doing the wrong thing) while negligence is omission (not doing something that you should have done)
Define controlled substance, analogue, practitioner, prescribed
Controlled substance - Substances in schedule of CDSA
Analogue - Similar structure to controlled substance
Practioner - Registered and entitled under laws of a province to practice medicine
Prescribed - Prescribed by the regulations
