Chapter 3 Flashcards by Gail I

a health care provider usually avoids legal exposure if he or she acts: in good faith, according to an appropriate

standard of care

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EMTs are the first link in the chain of

prehospital care

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… is permission to render care

consent

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if the patient is conscious and rational, and capable of making informed decisions, he/she has the legal right to …

refuse care

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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

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… is the patient’s right to make decisions about his/her health

patient autonomy

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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

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…: the patient acknowledges that he/she wants you to provide care/transport

expressed consent

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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

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always document when a patient provides informed consent, or have someone … the patient’s consent

witness

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implied consent applies to patients who are:
…
otherwise incapable of making a …, … decision about care

unconscious; rational; informed

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implied consent applies only when a serious medical condition exists and should never be used unless there is a threat ot … or …

life; limb

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the principle of implied consent is known as the

emergency doctrine

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it is a good idea to try to get consent from a …/… before treating a patient based on implied consent

spouse; relative

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involuntary consent applies to patients who are:’
… ill
in a … (psychological) crisis
…. delayed

mentally; behavioral; developmentally

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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

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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

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in some states, a minor can give consent. depends on … and …

age; maturity

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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

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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

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If a true emergency exists and no consent is available, the consent to treat the minor is .., just as with an adult.

implied

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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

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forcible restraint is legally permissible: consult … for authorization, in some states, only a … may forcibly restrain an individual

medical control; law enforcement officer

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restraint without legal authority exposes you to potential … and … penalties

civil; criminal

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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: 1. ask and repeat .. 2. assess the patient's ... 3. 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: 1. durable ... for health care 2. 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: 1. unresponsiveness to ... stimuli 2. lack of a ... or ... 3. absence of chest ... and ... 4. no deep ... or .. reflexes 5. absence of ... reactivity; 6. no ... blood pressure 7. profound ... 8. 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