*(Chapter 4) Medical, Legal, And Ethical Issues, And Ems Research Flashcards
What is cultural competence in EMS?
The ability to care for patients with diverse values, beliefs, and behaviors.
What does HIPAA stand for, and what does it protect?
Health Insurance Portability and Accountability Act; protects sensitive patient health information.
What is negligence in EMS?
Deviation from the standard of care expected from a reasonable professional.
What is the scope of practice?
Defines what actions a provider is legally allowed to perform.
What is the standard of care?
The degree of care expected of a provider with similar training in a similar situation.
What is medical direction?
EMS operates under a physician medical director.
What are the types of medical direction?
- Direct (Online) via phone/radio
- Indirect (Offline) through written protocols
What influences the standard of care?
- National EMS standards
- State protocols
- Employer policies
- Textbooks
- Local norms
What is informed consent?
Patient must understand the care and risks to accept or refuse treatment.
What is express consent?
Verbal or nonverbal agreement from a competent patient.
What is implied consent?
Assumes consent for emergency care when the patient is unconscious or unable to respond.
When is minor consent required?
For patients under 18, unless emancipated or in an emergency.
What is involuntary consent?
Consent for patients under law enforcement custody or mentally incompetent.
What is a DNR order?
Do Not Resuscitate; prevents CPR but does not affect other treatments.
What is a living will?
A document broader than a DNR, covering all healthcare wishes.
What are Good Samaritan Laws?
Protect providers offering care in good faith from legal liability.
What is criminal liability in EMS?
Includes assault (intent to harm) and battery (physical contact without consent).
What is civil liability in EMS?
Lawsuits for negligence or harm during care.
What are the four elements of negligence?
- Duty to act
- Breach of duty
- Damage
- Causation
What does HIPAA protect?
Patient records are private unless required for billing, care continuity, subpoenas, or abuse/crime reporting.
What are COBRA and EMTALA?
Federal laws preventing patient dumping and ensuring equal access to emergency care.
What must be obtained for interfacility transports?
- Transfer documentation
- Destination confirmation
- Patient or guardian consent
What are signs of death?
- Decapitation
- Decomposition
- Rigor mortis
- Lividity
What guides ethics in EMS?
Ethics guide actions and decisions for patient care.
How should conflicts in EMS be managed?
Prioritize patient needs, follow laws, and seek guidance when needed.
Why is cultural competency important in EMS?
Key to providing care for diverse populations and addressing healthcare disparities.
What are examples of disadvantaged populations in healthcare?
- Economically disadvantaged
- Minorities
- Vulnerable populations
How have EMS protocols evolved?
From physician recommendations to evidence-based medicine.
What does informed consent require?
Patient understanding of care, risks, and ability to make decisions.
When is implied consent used?
In emergencies when the patient is unconscious or unable to respond.
What does a DNR order specify?
Prevents CPR but does not restrict other life-saving treatments.
What should be documented during interfacility transport?
- Transfer paperwork
- Destination details
- Scope of practice compliance
What should EMS do when a patient refuses treatment?
Ensure the patient understands risks, document refusal, and obtain signatures.
What is the purpose of Good Samaritan Laws?
To protect individuals providing emergency care in good faith.
What is the main purpose of HIPAA?
To protect patient health information from being shared without consent.
What is the role of evidence-based research in EMS?
Improves protocols and outcomes through valid medical research.
What is abandonment in EMS?
Terminating patient care without ensuring a transfer to equal or higher-level care.
What is false imprisonment in EMS?
Restraining or transporting a competent patient against their will.
What is gross negligence?
Indifference to legal responsibility, often involving reckless actions leading to clear danger to the patient.
What are the consequences of gross negligence?
Can result in civil or criminal charges.
What protocols should be followed for hospital destinations?
Follow protocols, avoid financial considerations, and document reasons for bypassing closer facilities.
When can patients refuse treatment?
When they are oriented to person, place, time, and events, and not impaired by drugs, alcohol, or illness.
What documentation is required for patient refusals?
A refusal form signed by the patient and a witness.
What should EMS do when faced with a treatment refusal?
Follow protocols, document thoroughly, and seek ALS backup or medical direction if needed.
What are the exceptions to HIPAA confidentiality?
- Continuity of care
- Billing
- Legal subpoenas
- Reporting abuse/crime
What do COBRA and EMTALA ensure?
Equal access to emergency care and prevention of patient ‘dumping’ due to inability to pay.
What does a DNR prevent?
Cardiopulmonary resuscitation (CPR) while allowing other life-saving measures.
What are key considerations for interfacility transports?
- Obtain transfer documentation
- Confirm destination details
- Assess patient needs
What signs indicate death in EMS?
- Decapitation
- Decomposition
- Rigor mortis
- Lividity
How should EMS confirm organ donor status?
Through signed donor documentation.
What are key ethical principles in EMS?
- Prioritize patient welfare
- Seek guidance for conflict resolution
Which populations benefit most from cultural competence in EMS?
- Disadvantaged groups
- Minorities
- Vulnerable populations
What was the focus of historical EMS protocols?
Hospital-focused, often ineffective in prehospital settings.
What are modern EMS protocols based on?
Evidence-based practices to improve patient outcomes.
What must EMS obtain for interfacility transports?
A transfer report from the originating facility.
What must be confirmed during interfacility transports?
The exact destination, including the department or physician.
How should patient care be handled during interfacility transports?
Ensure the care remains within your scope of practice.
What consent is required for interfacility transports?
Consent from the patient or their guardian.
What should EMS follow for death determination?
Local protocols; consult medical direction if needed.
What are signs of obvious death?
- Decapitation
- Decomposition
- Rigor mortis
- Lividity
What is decapitation?
The head is separated from the body.
What is decomposition?
Physical decay of the body.
What is rigor mortis?
Stiffening of the body after death.
What is lividity?
Settling of blood after death.
When should authorities be notified by EMS?
For deceased persons, suicide attempts, assaults, abuse, or suspected crime scenes.
How are organ donors typically identified?
Through signed donor cards or driver’s licenses.
How should organ donors be treated by EMS?
Like any other patient, while notifying receiving personnel.
What is the first priority at a crime scene?
Ensure scene safety before entering.
What should EMS prioritize after ensuring safety at a crime scene?
Patient care.
How should EMS handle crime scenes?
Avoid disturbing the scene unnecessarily and document everything touched.
What should EMS report to law enforcement at a crime scene?
Anything suspicious.
How should sexual assault victims be treated at a crime scene?
Avoid allowing them to change or shower until evidence is collected.
What are the key principles of professional ethics in EMS?
Guides for patient care aligning with the EMT Code of Ethics.
What should EMS do when ethical conflicts arise?
Prioritize patient welfare, follow laws and protocols, and seek guidance.
How does cultural competence improve patient care?
By respecting diverse values, beliefs, and behaviors.
Which populations often face healthcare disparities?
- Economically disadvantaged individuals
- Minorities
- Children
- Elderly
- Victims of abuse
