Chapter 3 Flashcards
a health care provider usually avoids legal exposure if he or she acts: in good faith, according to an appropriate
standard of care
EMTs are the first link in the chain of
prehospital care
… is permission to render care
consent
if the patient is conscious and rational, and capable of making informed decisions, he/she has the legal right to …
refuse care
the foundation of consent is … capacity: the patient can understand and process info given, the patient can make an … choice regarding medical care
decision-making; informed
… is the patient’s right to make decisions about his/her health
patient autonomy
factors related to patient’s decision-making capacity:
mental … or …
if the patient is of legal age
if the patient is intoxicated, on drugs, impaired by a serious injury/illness
if the patient is experiencing sig pain
if patient has sign injury that could … them from more serious injury
hearing/visual problems
… barrier
if the patient understands/ is rational
limitation; dementia; distract; language
…: the patient acknowledges that he/she wants you to provide care/transport
expressed consent
to be valid, the patient must provide … consent, which means you have explained the treatment being offered, along with the potential risks, benefits, and alternatives, as swell as potential consequences of refusing
informed
always document when a patient provides informed consent, or have someone … the patient’s consent
witness
implied consent applies to patients who are:
…
otherwise incapable of making a …, … decision about care
unconscious; rational; informed
implied consent applies only when a serious medical condition exists and should never be used unless there is a threat ot … or …
life; limb
the principle of implied consent is known as the
emergency doctrine
it is a good idea to try to get consent from a …/… before treating a patient based on implied consent
spouse; relative
involuntary consent applies to patients who are:’
… ill
in a … (psychological) crisis
…. delayed
mentally; behavioral; developmentally
in cases of involuntary consent: obtain consent from the … or …–> It is not always possible to obtain such consent, so understand your local provisions. For example, many states have protective custody statutes that allow such a person to be taken, under law enforcement authority, to a medical facility.
guardian; conservator
for minors, the … or … gives consent: in every state, when a parent cannot be reached to provide consent, health care providers are allowed to give emergency care
parent; legal guardian
in some states, a minor can give consent. depends on … and …
age; maturity
emancipated minor: a person under legal age but is legally considered an …, occurs primarily when minors are …, if they are members of the .., or if they are …
adult; married; armed services; parents
teachers ands chool officals may act in place of parents (…) and provide consent for treatment to injuries that occur in a school/camp
in loco parentis
If a true emergency exists and no consent is available, the consent to treat the minor is .., just as with an adult.
implied
Necessary with a patient who is in need of medical treatment and transportation but is combative and presents a significant risk of danger to self or others: …
forcible restraint
forcible restraint is legally permissible: consult … for authorization, in some states, only a … may forcibly restrain an individual
medical control; law enforcement officer
restraint without legal authority exposes you to potential … and … penalties
civil; criminal
If restraint is utilized, it is essential to protect the patient’s …and monitor the patient’s … status to avoid asphyxia, aspiration, and other complications.
airway; respiratory
adults who are conscious, alert, and appear to have decision-making capacity: can … from treatment at any time, even if the result is death/serious injury
withdraw
a patient, parent, or caregiver’s decision to accept/refuse treatment should be based on info that you provide:
your assessment of what might be …
a description of the … you feel is necessary
any possible … of treatment
the availability of .. treatments
the possible consequences of … treatment: all of this information should be included in the patient care report
wrong; treatment; risks; alternative; refusing
when treatment is refused, you must assess the patient’s ability to make an informed decision:
- ask and repeat ..
- assess the patient’s …
- observe the patient’s …
questions; answers; behavior
if the patient appears confused or delusional, you cannot assume that the decision to refuse is an
informed refusal
patients who have attempted suicide or conveyed suicidal intent should not be regarded as having
normal mental capacity
when in doubt, providing … is a much more defensible position than failing to treat a patient
treatment
in most states, records may be released only:
if the patient signs a …
if a legal … is presented
if they are needed by …
release; subpoena; billing personnel
confidential info includes:
patient …
assessment …
… provided
history; findings; treatment
if you inappropriately release information, you may be liable for …, which is the disclosure of information without proper authorization
breach of confidentiality
HIPAA contains a section on patient privacy that strengthens privacy laws. safeguards patient confidentiality. provides guidance on: which types of information are …, the responsibility of health care providers regarding that protection, … for breaching that protection
protected; penalties
HIPAA considers all patient info you obtain in the course of providing medical treatment to a patient to be … (PHI); PHI includes medical info and any info that can be used to …
protected health information; identify the patient
there are certain situations when you may be legally mandated to report you findings, such as in the case of … or when you receive a …: only the min amount of info necessary should be released
child abuse; subpoena
A DNR order (also known as a “do not attempt resuscitation” order) gives permission …: “Do not resuscitate” does not mean “do not treat” even in the presence of a DNR order, you are still obligated to provide … (oxygen, pain relief, and comfort) to a patient who is not in cardiac arrest, whenever possible
not to resuscitate; supportive measures
an … specifies treatment should the patient become unconscious or unable to make decisions
advance directive
other names for advance directives: … and ..
living ill; health care directive
to be valid, DNR orders must meet the following requirements:
clear statement of the patient’s …
signature of the … or …
signature of one or more … or other licensed …
DNR orders with expiration dates must be dated in the preceding … to be valid
medical problems; patient; legal guardian; physicians; health care providers; 12 months
you may encounter … (POLST) and … (MOLST) forms when caring for patients with terminal illnesses
physician orders for life-sustaining treatment; medical orders for life-sustaining treatment
POLST and MOLST orders explicitly describe acceptable interventions for the patient, such orders must be signed by an authorized … to be valid, if you encounter these documents, contact … for guidance
medical provider; medical control
some patients may have named … to make decisions for them when they can no longer make their own:
- durable … for health care
- also known as …
surrogates; powers of attorney; health care proxies
determination of the cause of death is the medical responsibllity of a
physician
in the absence of physician orders, the general rule is "if the body is still ... and ..., initiate emergency medical care" cold temperature (...) emergencies are an exception to this rule. the patient should not be considered dead until he or she is ... and ...
warm; intact; hypothermia; warm; dead
presumptive signs of death:
- unresponsiveness to … stimuli
- lack of a … or …
- absence of chest … and …
- no deep … or .. reflexes
- absence of … reactivity;
- no … blood pressure
- profound …
- lowered or decreased …
painful; carotid pulse; heartbeat; rise; fall; tendon; corneal; pupillary; systolic; cyanosis; body temperature
definitive signs of death: obvious mortal injury (...) dependent .. (blood ...) ... (...) ... (...)
decapitation; lividity; settling; rigor mortis; stiffening; putrefaction; decomposition
rigor mortis occurs between … and … hours after death
putrefaction, depending on temps, occurs between … and … hours after death
2; 12; 40; 96
medical examiner/coroner must be notified in following cases: patient is ... on arrival/on scene patient died without previous ..., or when physician is unable to state the ... of death cases of ... ... death ..., known or suspected death from ... suspicion of a ... act ... and ... deaths
dead; medical care; cause; suicide; violent; poisoning; accidents; criminal; infant; child
wish to donate organis expressed on … and/or the person’s …
your priority is still to save the patient’s life
organ donor card; driver’s license
organs need
oxygen
medical id insignia: bracelet, necklace, keychain, or card indicating …, …, or other serious medical condition hat may be helpful in assessing and treating this patient
some patients wear a medical bracelet with a …
DNR order; allergies; USB flash drive
… outlines the care you are able to provide and is usually defined by state law
scope of practice
medical director further defines the scope of practice by developing … or …
exceeding your scope of practice may be considered …
protocols; standing orders; negligence
…: the manner in which you must act or behave–> what a reasonable EMT in a similar situation would do
standards of care
standards of care established by: ... custom ... ... or ... standards ... standards imposed by ..
local; law; professional; institutional; textbooks; states
Medical Practices Act: in some states, the EMt is exempt from the … requirements of the Medical Practices Act
licensure
…is an established process to determine the qualifications necessary tob e allowed to practice a particular profession, or to function as an organization
credentialing
Duty to act is an individual’s responsibility to provide …
an Emt has a duty to act: once your ambulance …. and when treatment is …
patient care; responds to a call; begun
… is failure to provide standard of care.
all four elements must be present for negligence to apply:
…
…
…
…
negligence; duty; breach of duty; damages; causation
abandonment: unilateral termination of care by EMT without the patient’s … and without making … for continuing care
consent; provisions
abandonment may take place at the … or in the …
always obtain a signature on the patient care record when transferring care
scene; emergency department
…: unlawfully placing person in fear of immediate bodily harm
assault
…: unlawfully touching a person
battery
seizing, confining, abducting, or carrying away by force: …
kidnapping
unauthorized confinement of a person: …
false imprisonment
…; communication of false info that damages the reputation of a person
written form: …
spoken form: …
the run report should be accurate, relevant and factual
defamation; libel; slander
Good Samaritan actions: acted in ... no expectation of ... within ... did not act in grossly ... manner
good faith; compensation; scope of practice; negligent
gross negligence is conduct that constitutes … or .. disregard for duty/standard of care
willful; reckless
courts consider:
an action that was not recorded was not …
incomplete or untidy reports are evidence of …
performed; poor emergency medical care
special mandatory reporting requirements: child/older person ... injury during a ... ...-related injuries ... attempted ... ... bites certain ... diseases ... ... violence sexual ... or ... exposures to .. disease ... patient ... scene ...
abuse; felony; drug; childbirth; suicides; dog; communicable; assaults; domestic; assault; rape; infectious; restrained; crime; deceased
philosophy of right and wrong, moral duties, ideal professional behavior: …
ethics
code of conduct affecting character, conduct, and conscience: …
morality
addresses issues that arise practice of health care:
bioethics
whenever called to testify, notify your … and …
service director; legal counsel
as a witness: remain …, review the … before court
neutral; run report
as a defendant, an ... is required potential defenses: ... of .. governmental ... contributory ...
attorney; statute; limitations; immunity; negligence
… allows both sides to obtain more information through:
…–> written requests/questions
…–> oral requests/questions
discovery; interrogatories; depositions
damages that may be awarded in court: … or …
compensatory; punitive
