Chapter 3 Flashcards
A basic principle of emergency case is to first: ____________________.
Do no harm / do no further harm.
A health care provider usually avoids legal exposure if he or she acts: ________________ and __________________________________.
In good faith & According to an appropriate standard of care
____________ is permission to render care.
Consent
A person must give _______________ for treatment.
Consent
T/F: If the patient is conscious and rational, he or she has the legal right to refuse care.
True
What are two things necessary for a patient to give consent?
1.) The patient can understand the information provided.
2.) The patient can make an informed choice regarding medical care
T/F: Patient autonomy is when the patient is automatically denied care.
False: Autonomy is the right of the patient to make decisions about their health.
________________ is when the patient acknowledges he or she wants you to provide care or transport
Expressed Consent
T/F: In order for expressed consent to be valid, the patient must provide informed consent.
True
What three things must be discussed in an informed consent between the medical professional and the patient?
1.) What the treatment option is
2.) Risks of treatment
3.) Benefits of treatment
_______________ applies to patients who are unconscious or otherwise incapable of making an informed decision.
Implied Consent
T/F: Implied consent should always be used on patients, even for minor cases.
False; implied consent is ONLY used if there is a threat to life or limb.
The principle of implied consent is known as the ____________________.
Emergency Doctrine
If you (as an EMT) cannot retrieve informed consent from the patient, try to get consent from : _______________ or ________________.
Spouse or Relative
_____________________ applies to patients who are mentally ill, in behavioral crisis or developmentally delayed. In these cases, you have to obtain consent from a guardian or conservator.
Involuntary Consent
T/F: Involuntary consent is always possible and easy to obtain.
False; not always possible, so understand local provisions regarding this
Who gives consent for minors?
A parent or legal guardian may give consent.
In some states a minor can give consent if they are _________________.
Emancipated
If a true emergency exists for a minor patient and no consent is available how do you respond?
Treat the patient because consent is implied in this scenario
_________________ is sometimes necessary with a combative patient.
Forcible Restraint
T/F: Once applied do not remove restraints en route unless they pose a risk to the patient.
True
T/F: In the case of an extremely combative patient, you may consider calling ALS for backup to provide a chemical pharmacological restraint?
True
Do conscious, alert adults with decision making capacity have the right to refuse treatment?
Yes
Do conscious, alert adults with decision making capacity have the right to withdraw from treatment at any time, even if the result is death or serious injury?
Yes
T/F: Calls involving refusal are frequently litigated.
True
T/F: If a patient denies care, you do not have to document the consult.
False, always document and involve online medical control as well
What are a few ways you can assess the patient’s ability to make an informed decision?
1.) Ask and repeat questions
2.) Assess the patient’s answers
3.) Observe the patient’s behavior
T/F: If the patient appears confused or delusional, you cannot assume that the decision to refuse care is an informed refusal.
True
Which is a more defensible position legally: providing treatment or failing to treat a patient?
Failing to treat a patient.
T/F: You should always use the assistance of law enforcement, when you can, with unruly patients and do not endanger yourself unnecessarily.
True
Which of the following is correct before you leave a scene where a patient, parent or caregiver has refused care? (Select all that apply)
A.) Encourage the individual again to allow care.
B.) Ask the individual to sign a refusal of care form.
C.) Having a witness present will guarantee that the patient changes their mind, which makes them valuable.
D.) Document all refusals.
A, B and D are correct.
C is incorrect, witnesses are valuable to defend you against litigation but they are not guaranteed to change a patient’s mind about care.
Which of the following is not an example of confidential patient info?
A.) Patient history
B.) Assessment Findings
C.) Treatment Provided
D.) Name of emergency medical technician on the scene
D
What are the three times it is acceptable to disclose patient information?
1.) The patient signs a release
2.) A legal subpoena is presented
3.) It is needed for billing personnel
This act contains a section on patient privacy, strengthens privacy laws, safeguards patient confidentiality and considers info to be protected health information (PHI): ___________.
HIPAA (Health Insurance Portability and Accountability Act of 1966)
T/F: Failure to abide by the provisions of HIPAA laws can result in civil action but will never result in criminal action.
False, Failure to abide by HIPAA often results in civil and/or criminal action.
T/F: The general public is not permitted by law to record identifying and protected patient info and images.
False, the general public is permitted to do so. They are held to different standards that medical professionals such as EMTs.
T/F: While on social media, it is smart to avoid posting agency logos, uniforms, vehicles or other markings associated with your agency while off duty.
True
T/F: You only need to conduct yourself professionally when you’re on duty.
False, you need to conduct yourself in a professional manner at all times as you are representing your agency on and off duty.
T/F: Free speech means that everyone has a right to say anything under any circumstances and without repercussions.
False, there are limitations to this.
___________ specifies treatment should the patient become unconscious or unable to make decisions.
Advanced Directive
A ___________ order is an advance directive that gives permission not to resuscitate.
DNR (Do not resuscitate)
What are two other names for advance directives?
1.) Living will
2.) Health Care Directive
DNR orders must meet which of the following requirements? (Select all that apply)
A.) Statement of the patient’s medical problems
B.) Signature of the patient or legal guardian
C.) Signature of the physician or health care provider
D.) Not expired
All of the Above
These two types of orders for life sustaining treatment explicitly describe acceptable interventions for the patient, must be signed by an authorized medical provider and if needed guidance can be given if medical control is contacted: ____________ & ___________.
POLST (Physician orders for life-sustaining treatment)
&
MOLST (Medical orders for life-sustaining treatment)
T/F: Some patients may have named surrogates to make decisions for them.
True
What is the named surrogate(s) to make decisions for patients?
Durable powers of attorney for health care
AKA -
Health care proxies
T/F: You are more than likely to encounter a durable power of attorney for health care with the growing number of hospice home health programs that exist today.
True
A ____________ determines the cause of death.
Physician
Name four “presumptive” signs of death?
1.) Unresponsive to painful stimuli
2.) Lack of carotid pulse or heartbeat
3.) Absence of breath sounds
4.) No deep tendon or corneal reflexes
Name four “physical” signs of death?
1.) Absence of eye movement
2.) No systolic blood pressure
3.) Profound cyanosis (Bluish hue to skin)
4.) Lowered or decreased body temp
What are the five “definitive” signs of death?
1.) A Body in parts (ex. decapitation)
2.) Dependent lividity (blood settling)
3.) Rigor Mortis (stiffening)
4.) Algor Mortis (cooling of the body until it matches the ambient environment)
5.) Putrefaction (decomposition)
How soon does putrefaction occur?
A. 20-46 hours after death
B. 40-96 hours after death
C. 100-146 hours after death
D. Immediately after death
B (40-96 hours after death)
T/F: Involvement of the EMT depends on the nature/scene of death.
True
In what cases is the medical examiner notified of patient death? (Select all that apply)
A.) Suicide
B.) DOA (Dead on arrival) or DOS (dead on scene)
C.) Suicide
D.) Violent Death
E.) Poisoning, known or suspected
F.) An 85 year old passing in a hospital after battling cancer for 5 years
A-E, not F.
What additional cases is the medical examiner notified of patient death? (Select all that apply)
A.) Death from accidents
B.) Suspicion of criminal act
C.) Infant and child deaths
All of the Above
_________________ express a wish to donate their organs which may be evidenced on a driver’s license or donor card.
Organ Donor
T/F: For organ donors your responsibility is the save the patient’s life and to remember that organs need oxygen.
True
What are some examples of medical ID insignia?
Bracelet, necklace, keychain or card on person.
What can be determined from medical ID insignia?
DNR Order, allergies, diabetes, epilepsy or other serious condition
T/F: Some patients wear a medical bracelet with a USB flash drive.
True
_________________ outlines the care you are able to provide.
Scope of Practice
T/F: Scope of practice is determined by federal law.
False, it is usually determined by state law (every state has different rules for providers)
How can a medical director further define the scope of practice?
Creating protocols and standing orders
T/F: Carrying out procedures outside the scope of practice may be considered negligence or a criminal offense?
True
__________________ is the manner in which you must act or behave, and shows you are concerned about the safety and welfare of others.
Standard of Care
Which of the following are standards of care established by? (Select all that apply)
A.) Local custom
B.) Law
C.) Professional or Institutional Standards
D.) Textbooks
All of the Above
Name some examples of standards of care established by law?
Statues, ordinances, administrative regulation or case law
Name an example of standards of care established by professional or institutional standards?
AHA CPR guidelines
Name an example of standards of care established by a textbook?
NHTSA Textbook
What are four standards of care imposed by states?
1.) Medical Practices Act
2.) Certification
3.) Licensure
4.) Credentialing
A _________________ is the individual’s responsibility to provide patient care.
Duty to Act
Duty to act applies to these two situations:
1.) Once your ambulance responds to a call
2.) Once treatment is begun
________________ is failure to provide same care that person with similar training would provide in a same or similar situation.
Negligence
Which four elements must be present for negligence to be determined?
1.) Duty
2.) Breach of Duty
3.) Damages
4.) Causation
______________ is the cause of the injury was in the control of the EMT. This generally does not occur unless there is negligence.
Res ipsa loquitur
_______________ is the conduct of the person being sued is alleged to have been in clear violation of a statute.
Negligence per se
____________ are civil wrongs
Torts
__________________ is unilateral termination of care by EMT without patient’s consent and without making provisions for continuing care.
Abandonment
T/F: Abandonment may take place at the scene or in the emergency department.
True
T/F: In terms of preventing abandonment litigation, always obtain a signature on your patient care record.
True
______________ is unlawfully placing a person in fear of immediate bodily harm.
Assualt
______________ is unlawfully touching a person.
Battery
What is an example of battery when working as an EMT?
Providing care without consent
________________ is seizing, confining, abducting, or carrying away by force.
Kidnapping
What is an example of kidnapping as an EMT?
Transporting patient against their will
_______________ is unauthorized confinement of a person.
False Imprisonment
________________ is communication of false information that damages the reputation of a person.
Defamation
What is written defamation?
Libel
What is spoken defamation?
Slander
What are Good Samaritan Laws?
If you reasonably help another person, you will not be held liable for errors or omissions.
Which of the following are conditions to be met for Good Samaritan Law? (Choose all that apply)
A.) Good Faith
B.) Without expectation of compensation
C.) Within the scope of training
D.) Did not act in a grossly negligent manner
All of the Above
__________________ is conduct that constitutes willful or reckless disregard.
Gross Negligence
_______________ statues apply to EMS systems that are considered governmental agencies.
Immunity
______________ immunity provides limitations on liability and immunity is not complete.
Sovereign (Essentially, the government cannot be sued without it’s consent)
T/F: It is an important safeguard against legal complications to compile a record of all incidents involved sick or injured patients.
True
T/F: An action not recorded will hold up in court.
False, legally speaking, if a medical action was not recorded, it is considered not performed.
T/F: Incomplete or untidy reports is evidence of poor emergency medical care.
True
______________ provides the ability to collect, store and share standardized EMS data and is used to improve the speed and accuracy of data collection.
NEMSIS (National EMS Info System)
Most states have a reporting obligation (mandatory reporting) of these specific types of cases:
1.) Abuse of children, older adults and others
2.) Injury during commission of a felony
3.) Drug-related injuries
4.) Childbirth
5.) Attempted Suicides
6.) Dog Bites
7.) Communicable Diseases
8.) Assaults
9.) Domestic Violence
10.) Sexual assault or rape
11.) Exposures to infectious diseases
12.) Transport of patients in restraints
13.) Scene of a crime
14.) The deceased
________________ is the philosophy of right and wrong, moral duties and ideal professional behavior
Ethics
______________ is the code of conduct affecting character, conduct and conscience
Morality
_____________ specifically addresses issues that arise in the practice of health care
Bioethics
______________ responsibilities require you to evaluate and apply ethical standards of your own and those of the profession.
Ethical responsibilities
T/F: You should allow rules, laws and policies to guide your decision making.
True
T/F: An EMT may end up in court, but only as a witness.
False, you may end up in court as a witness or a defendant.
Cases against EMTs can only be civil.
False, cases against EMTs can be civil or criminal.
Whenever an EMT is called to testify in court, you should notify these two people: ____________ & _____________.
Your service director & Legal counsel
T/F: As a witness it is best for an EMT to remain neutral and review the run report before court.
True
T/F: As a defendant, an attorney is optional.
False, an attorney is required.
What are three examples of defenses that can be used in court by an EMT?
1.) Statue of limitations
2.) Governmental immunity
3.) Contributory negligence
Discovery in court allows both sides to obtain more info through: ______________ & _______________.
Interrogatories & Depositions
____________ are written requests or questions for court.
Interrogatories
_________________ are oral request or questions for court.
Depositions
Most legal cases are settled following the _______________ phase during the settlement phase.
Discovery
T/F: If not settled, a case will automatically proceed to trial.
True
What are the two types of damages that may be awarded in court?
Compensatory damages
&
Punitive damages
T/F: An EMT charged with a criminal offense should secure the services of a highly experienced criminal attorney immediately.
True
