Chapter 3 Flashcards
You have responded to a “man down” call one winter morning. Upon arrival, you find an elderly male patient lying parallel to the sidewalk, in a bank of shoveled snow. It appears as if the man was walking and either tripped or fell into the snowbank. The patient is in cardiac arrest. In this scenario, which finding would not be considered a presumptive sign of death?
A: Low body temperature
B: Absent reflexes
C: Closed eyes
D: No pupillary response
Low body temperature
You have been called to a local emergency department to transfer a 67-year-old male to another facility. At the hospital, the emergency physician informs you that the patient and his family have requested the transfer because his doctor is affiliated with the other hospital. At the patient’s bedside, you see that the patient is receiving an antibiotic through an intravenous (IV). Although your state does allow emergency medical technicians (EMTs) to perform nonemergent transports of patients receiving normal saline through an IV, it does not allow transport of patients receiving IV medications. When informed of this restriction, the physician states that the antibiotic will be done in 10 minutes and that he will give written permission to start the transport while the medication is infusing. Which EMT action would be most appropriate at this time?
A: Transfer the patient once all the medication is infused
B: Stop the IV infusion and transport the patient
C: Recognize a Health Insurance Portability and Accountability Act (HIPAA) violation and refuse the
transport.
D: Follow the doctor’s order as long as he writes and signs it.
Transfer the patient once all the medication is infused.
You are pulling into the ambulance bay at a local hospital. On board, you have a patient with behavioral problems who continually seeks treatment at this particular hospital. Before the patient can be unloaded, the physician comes out and states that the patient must be taken to another hospital. As an EMT, you should:
A: Recognize a violation of the Emergency Medical Treatment and Labor Act (EMTALA) statute
B: Take the patient to the facility specified by the doctor
C: Call the supervisor to report a Health Insurance Portability and Accountability Act (HIPAA)
violation
D: Ask the patient which hospital he wants to be taken to
Recognize a violation of the Emergency Medical Treatment and Labor Act (EMTALA) statute.
In a community park near his home, a 10-year-old boy has fallen from the top of a slide. His right wrist is deformed and he is in pain. He states that he lives with his mother and she is working. He does not know her work number. The EMT’s best action would be to:
A: Have the police take custody of the boy and give permission to treat
B: Obtain permission from the park director
C: Treat the patient under the guidelines of implied consent
D: Do not treat the patient until his mother can be contacted
Treat the patient under the guidelines of implied consent.
An EMT is currently enrolled in a paramedic program and is halfway completed. He is also working part-time as an EMT for some extra money and patient exposure. One day he is in the back with a patient who just went into cardiac arrest. The EMT knows how to intubate since this has already been covered in class. What should the EMT do?
A: Contact medical direction for permission to intubate
B: Intubate the patient
C: Intubate the patient but then remove the endotracheal tube before entering the ED
D: Do not intubate the patient
Do not intubate the patient.
You have been called for a 96-year-old female with altered mental status. At the scene, you find that the patient is unresponsive, not breathing, and pulseless. The family provides you with a valid Do Not Resuscitate (DNR) order. What could you document as a presumptive sign of her death?
A: Agonal breathing
B: Absent blood pressure
C: Poor or weak reflexes
D: Closed eyes
Absent blood pressure
Which patient may be treated under the guideline of implied consent?
A: A 2-year-old boy who fell down a flight of stairs and whose parents want him taken to the hospital.
B: A 47-year-old female with severe abdominal pain who is refusing transport after placing the call
to 911 for help.
C: An adult patient with chest pain and shortness of breath who is refusing treatment and transport
by EMS
D: An unresponsive 33-year-old female who is suspected of taking recreational drugs
An alert and oriented patient complaining of a severe headache is refusing all treatment as well as transport by the EMTs. After having signed the refusal, the patient suddenly seizes and becomes unresponsive prior to EMS providers leaving the home. The EMT should:
A: Honor the patient’s wishes and leave the scene
B: Place the patient into the family’s car for transport to the hospital
C: Contact medical direction for permission to treat
D: Provide care under the guideline of implied consent
Provide care under the guideline of implied consent.
If an individual is bringing a lawsuit against your EMS system for perceived improper care, which type of liability action will it probably be?
A: State
B: Federal
C: Civil
D: Criminal
Civil
A male patient who has the capacity to make rational decisions, although he is dizzy, complains of a headache, and then vomits, declines your care and will not sign the refusal of care form. What is your best action?
A: Have your partner sign on behalf of the patient
B: Document that the patient refuses to sign and leave
C: Inform the patient that by law he must sign the form
D: Have a family member sign as a witness to the refusal
Document that the patient refuses to sign and leave.
A patient with diabetes has an elevated blood sugar (545 mg/dL) and based on your assessment of his condition, will require an injection of insulin. Your EMT partner also has diabetes and administers insulin injections to himself throughout the day as needed. Although the Scope of Practice lists nothing about EMTs giving insulin, your partner administers the insulin injection to the patient. The patient’s blood sugar comes down and her condition improves. Given this information, which statement is true?
A: It was permissible for your partner to give the insulin since he has diabetes and knows how to
give the injections.
B: Since the patient benefited from the insulin, your partner acted appropriately.
C: Your partner violated the Scope of Practice and may have his certification revoked.
D: Because your partner used the patient’s insulin rather than his own, he cannot be reprimanded.
Your partner violated the Scope of Practice and may have his certification revoked.
In any situation in which a question arises regarding the scope or direction of care the Emergency Medical Technician (EMT) should provide to a patient, the EMT should:
A: Notify the on-duty Emergency Medical Services supervisor
B: Summon an advanced life support (ALS) intercept and allow the paramedics to make the care
decisions
C: Provide no treatment so as to “not cause harm,” and transport the patient
D: Contact medical direction at the receiving facility to which the patient is being transported
Contact medical direction at the receiving facility to which the patient is being transported.
The EMT shows they understand “Do Not Resuscitate” (DNR) orders and living wills when they state:
A: “A DNR applies to resuscitation issues only, such as when a patient stops breathing or the heart
ceases to beat, whereas a living will pertains to long-term life support care and equipment.”
B: “If the patient has a living will, it can legally be used as a substitute for a DNR order by the EMT
as long as it is properly dated and signed.”
C: “If a patient has a valid DNR, the EMT should withhold all care and transport the patient to the
hospital. If a living will is present, the EMT should do exactly what it says.”
D: “A living will is a form of DNR; only a living will states exactly how the patient wants to
be resuscitated.”
“A DNR applies to resuscitation issues only, such as when a patient stops breathing or the heart ceases to beat, whereas a living will pertains to long-term life support care and equipment.”
A woman calls the station and asks if you transported a patient named Patricia Gardner earlier in the day. She says that she is her friend and wants to know if she is okay. An appropriate response would be:
A: “Although I do not doubt that you are her friend, I cannot release that information.”
B: “I can tell you that she was transported to the hospital, but I cannot tell you why.”
C: “She was treated for chest pain, but I cannot release her diagnosis for admission.”
D: “I cannot tell you that, but her family is at home and they can give you more information.”
“Although I do not doubt that you are her friend, I cannot release that information.”
A local politician has been involved in a motor vehicle collision. Witnesses state that they saw this man leave a bar, and repeatedly stumbled until he got to his vehicle. Then, just two miles down the road, he struck a utility pole head-on. At the scene and throughout transport, the patient is confused and combative. When you are leaving the hospital, a reporter asks you what happened. You state that it looks as though the politician may be drunk, but you are not sure. Your statement is printed in the newspaper. Later, it is determined that the man was not drunk, but rather has diabetes and had low blood sugar at the time of the accident. Which charge could the politician levy against you?
A: Assault
B: Battery
C: Litigation
D: Slander
Slander
An intoxicated 72-year-old male with an alcoholic history has fallen at home and has a laceration on the back of his head. He states that he does not want treatment and becomes combative when you try to talk to or assess him. What is your next best course of action?
A: Transport him against his will, but do not provide treatment
B: Have him sign a refusal of care form
C: Transport him by permission of family
D: Contact medical direction
Contact medical direction.
A female paramedic was late in re-registering and now, according to the state EMS agency, must function as an EMT until all of the re-registration requirements are satisfied. As an EMT, she is on the scene of a motor vehicle accident and taking care of a critically injured teenager. While waiting for a paramedic to arrive, she starts an intravenous (IV) since the patient is so critical and the EMT is worried about the patient surviving, but does not hang the IV fluid that will be used to help stabilize the patient. This is immediately done by another paramedic once they arrive. As such, which of these is true?
A: The paramedic/EMT violated the scope of practice but cannot be held accountable since the
patient was stabilized by her actions.
B: The paramedic/EMT did not violated the scope of practice since the patient was critically injured
and required lifesaving care.
C: The paramedic/EMT violated the scope of practice and can be held accountable even though
the patient survived.
D: The paramedic/EMT did not violate the scope of practice since she is experienced with IV
therapy
The paramedic/EMT violated the scope of practice and can be held accountable even though the patient survived.
An adult male patient with the capacity to make his own decisions has cardiac-type chest pain and is refusing all treatment. What would be the EMT’s most appropriate response?
A: “I am sorry, but since 911 was called, we must transport you to the hospital. You can refuse
treatment there.”
B: “I will need to have you sign this refusal of care form and a family member sign as a witness.”
C: “Before you refuse, I need to tell you that this could be a heart attack and you could die.”
D: “Since you are oriented and rational, it is your right to refuse. Please sign this refusal of
care form.”
“Since you are oriented and rational, it is your right to refuse. Please sign this refusal of care form.”
While off duty, an EMT happens upon the scene of a motor vehicle collision in which a car rolled over the side of an embankment. A young man has been seriously injured; he appears unresponsive and is bleeding from the head and face. The EMT is alone with his infant baby daughter in the car and cannot leave her to provide help. Therefore, the EMT alerts 911 of the emergency and remains in his car with his daughter until EMS arrives. Later in the week, he finds out that the patient died. Which statement is true regarding this incident?
A: The EMT violated the state standard of care by not providing some form of care.
B: The EMT had a legal obligation to help and can be held liable for the death.
C: The EMT had no duty to act and cannot be held liable for the man’s death.
D: The EMT must go to court and explain that he did not help because of his daughter.
The EMT had no duty to act and cannot be held liable for the man’s death.
You have responded to a “man down” call one winter morning. Upon arrival, you find an elderly male patient lying parallel to the sidewalk, in a bank of shoveled snow. It appears as if the man was walking and either tripped or fell into the snowbank. The patient is in cardiac arrest. In this scenario, which finding would not be considered a presumptive sign of death?
A: Applying oxygen to a patient who is not complaining of shortness of breath
B: Obtaining a refusal of care from a patient without obtaining vital signs
C: Transporting an alert and oriented patient who does not want transport to the hospital
D: Obtaining an informed and signed refusal of care form from an alert and oriented patient with
abdominal pain
Obtaining a refusal of care from a patient without obtaining vital signs.
You have been called to a local emergency department to transfer a 67-year-old male to another facility. At the hospital, the emergency physician informs you that the patient and his family have requested the transfer because his doctor is affiliated with the other hospital. At the patient’s bedside, you see that the patient is receiving an antibiotic through an intravenous (IV). Although your state does allow emergency medical technicians (EMTs) to perform nonemergent transports of patients receiving normal saline through an IV, it does not allow transport of patients receiving IV medications. When informed of this restriction, the physician states that the antibiotic will be done in 10 minutes and that he will give written permission to start the transport while the medication is infusing. Which EMT action would be most appropriate at this time?
A: When an EMT is working for a volunteer EMS system and performs an act of gross negligence
B: When the EMT stops to help a collapsed person at a park while off duty by providing CPR, but
the patient still dies
C: When a nurse or physician who is off duty stops to assist at an EMS call where paid EMTs
are present, but the patient still dies
D: When an EMT is off duty, but stops to assist at a motor vehicle collision and functions in good
faith
When an EMT is working for a volunteer EMS system and performs an act of gross negligence.
You are pulling into the ambulance bay at a local hospital. On board, you have a patient with behavioral problems who continually seeks treatment at this particular hospital. Before the patient can be unloaded, the physician comes out and states that the patient must be taken to another hospital. As an EMT, you should:
A: The scope is what the EMT should do; the standard is what the EMT is legally bound to do
B: The scope includes which actions the EMT can legally take, while the standard of care is what
an EMT should do in an Emergency Medical Services system with similar training and protocols
C: The scope of practice is decided by the medical director, while the standard of care is defined
by state regulations
D: There is no clinically relevant difference between the scope of practice and the standard
of care, as both define what the EMT should do in the exact same situation
The scope includes which actions the EMT can legally take, while the standard of care is what an EMT should do in an Emergency Medical Services system with similar training and protocols.
In a community park near his home, a 10-year-old boy has fallen from the top of a slide. His right wrist is deformed and he is in pain. He states that he lives with his mother and she is working. He does not know her work number. The EMT’s best action would be to:
A: The patient can be transported without further permission
B: Informed consent has been obtained by the EMT
C: The EMT has gained implied consent
D: The EMT has obtained expressed consent
The EMT has obtained expressed consent.
An EMT is currently enrolled in a paramedic program and is halfway completed. He is also working part-time as an EMT for some extra money and patient exposure. One day he is in the back with a patient who just went into cardiac arrest. The EMT knows how to intubate since this has already been covered in class. What should the EMT do?
A: Once the EMT makes physical contact with the patient
B: Once the EMT is dispatched to the call
C: Once the patient consents to be treated
D: Once the EMT begins to provide physical care
Once the EMT is dispatched to the call.
