intro into advanced practice Flashcards
Stages of grief
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
These do not come in particular order
Inductive reasoning
Drawing a general conclusion from a set of specific observations
Draw a causal link between a premise and hypothesis
Ex: In the summer, there are ducks on our pond. Therefore, summer will bring ducks to our pond.
(found thru google)
Expressed consent
A type of informed consent where the pt does or says something that demonstrates he or she is giving you permission to provide emergency care
Abandonment
Is a form of negligence that involves the termination of medical care without the pt’s consent
Pt had a continuing need for medical treatment and that a sudden stop of said treatment caused injury or death
Pts who do not need transportation is not considered abandonment so long as the pt consents
Page 116
Malfeasance
Unauthorized act committed outside the scope of medical practice defined by law
something I am not trained as a paramedic to do
1977
First paramedic curriculum created by US DOT
Standard of care
Describes what a reasonable paramedic with training would do in the same or a similar situation
Harm / Harm resulted
Plaintiff must prove that they were harmed Physical harm is easier to prove More are filing for: emotional distress loss of income loss of enjoyment of life loss of spousal consortium loss of household services loss of future earning capacity The plaintiff would have to prove that the medics
EMTALA
Emergency Medical Treatment and Active Labor Act
A federal law enacted in 1989 to combat the practice of pt dumping (hospitals refusing to admit seriously ill pts or women in labor who could not pay, forcing EMS providers to dump the pts at another hospital).
Page 129
Slander
Aka Defamation
Making statements both verbal or written that injure a person’s good name
Page 102, 127
Ryan White Act
Created in 1990
Hospitals have a legal requirement to give information to EMS on if the pt had a disease that is/was contagious when that information is requested
Created so that health care workers had a way to report when possibly exposed to certain diseases
Human immunodeficiency virus, acquired immunodeficiency syndrome, tuberculosis, hepatitis B, meningitis, diphtheria, hemorrhagic fevers, plague, and rabies
Requires health care companies to have a way for employees to notify if they were possibly exposed
To have a designated infection control officer that helps assist all employees who may have gotten exposed
Access to medical records of the pt who was the source of the exposure
Defamation
Intentionally making a false statement, through written or verbal communication, which injures a person’s good name or reputation
Public health
The practice of preventing disease and promoting good health within groups of people.
Deductive reasoning
Making an inference based on widely accepted facts or premises
When you take two true statements, or premises, to form a conclusion
Ex: A is equal to B. B is also equal to C. Given those two statements, you can conclude A is equal to C using deductive reasoning.
(found thru google)
Proximate cause
aka Failure to act appropriately
plaintiff will have to prove that the medics improper action, or failure to act, was the cause of the injury
Careful documentation can help show that an injury happened before you arrived vs what you did or what you didn’t do
In loco parentis
“In the place of the parent”
Adults in like school, daycare, summer camp are able to make treatment and transport decisions if the parents are not available
Use of restraints
Only use restraints if the pt is a danger to themselves or others
(Should probably call law enforcement in these situations)
Page 113
Refusal of care
Pt must have decision-making capacity
Pt must be AxO 4
Pt must meet criteria for informed consent
Pt must understand what is going on, the risks of refusing care and the possible outcomes
page 109-111
HIPAA
Health Insurance Portability and Accountability Act
Created in 1996 to provide privacy requirements for pt information.
Medical info can be disclosed only if it is necessary for a pt’s treatment, payment/medical billing, or when authorized in writing by the pt or lawful representative
page 104-106
1970
NREMT started to get used
Helicopters more available
Ethics
A set of values in society that differentiates right from wrong
Making sure that pt comes first and needs
To make sure pt care confidentiality happens
Page 97-99
Morbidity
Number of non fatal injuries and subsequent disability
Tort
a wrongful act that gives rise to a civil lawsuit
Breach of Duty
Paramedic failed to perform within the standard of care (what a reasonable medic in the same or similar situation would have done)
Careful documentation is critical to show what you did do. If it wasn’t written down, you didn’t do it.
Battery
When you touch the pt without permission in a harmful or offensive way
Charges can happen if you just touch the pt without permission
Example: putting on a 12 lead on a female without permission and telling her what you are doing so you are just lifting up her breast and moving it around
Page 101
Common infection control
Hand washing Gloves Gown Eye protection Mask - surgical, N95 Sharps container Cleaning reused equipment between each pt
page 47
Non-Urgent move
-Eg. Pt has a sprained ankle so taking our time will not worsen pts outcome
Informed consent
Pt’s voluntary agreement to be treated knowing about what is going on and what the treatment options are.
Pt has decision making capacity
1966
National academy of sciences and the national research council released “the white paper”
Helped with funding BLS and ALS services/programs
National highway safety act of 1966
US DOT created
Revolutionized the way we view and manage injury in America
(Need more info)
Misfeasance
An appropriate act performed in an improper manner, such as medication administered at the wrong dose
Justice
Treat all pts fairly
The 4 E’s of prevention
Education
Enforcement
Engineering/environment
Economic incentives
Signs and Symptoms of Depression
Numbed, dazed state, quiet, keeping to themselves, sad, hopeless, restless, irritable, sleep or eating disruptions, low energy, slumped posture, slow movements, speaking in a flat/monotone voice
Page 57, 528
CQI
Continuous quality improvement
Helps make sure we are always improving
Ex: -looking at statistics of pt’s results when they leave the hospital
-looking over certain things like intubations and seeing how we can improve them
-having an environment where it feels like a safe place to admit you did wrongdoing and that when someone else corrects you, you accept the criticism to improve your pt care
Urgent move
- Pt is sick and needs to be moved ASAP
- Can take some time to plan out the move and quickly grab equipment
Infectious disease VS Contagious disease
Infectious - Only some infectious disease is contagious. Example: pneumococcus bacteria is infectious but cannot spread from one person to another.
Contagious- All contagious disease is infectious. Example: Hepatitis B virus (HBV) is a infectious and contagious disease that can spread from one person to another
Involuntary consent
Situations in which law enforcement officers or legal guardian grants permission to treat someone who is under arrest, (or in custody), incapacitated, a minor or for other reasons
Chronic stress signs
Fatigue, Depression, Headaches, insomnia, ulcers, acne, asthma, diabetes, arthritis
Page 467
Negligence
Must meet all four tenets
Duty to act
Breach of duty
Failure to act appropriately/Proximate cause
Harm resulted
Communicable disease
A disease that can be spread from one person or species to another
Qualitative
Involves a descriptive judgment using concept words instead of numbers
Ex: gender, country name, animal species, and emotional state
Secondary prevention
Pt has sustained injury or illness and our goal is to prevent it from getting worse
This is the main thing EMS does and has done since the beginning
Beneficence
aka Benefit
our (the medics) responsibility to “do good” for the pt
Emancipated minors
Are under the legal age (18) but can be treated as legal adults because of qualifying circumstances
Other criteria is if the minor is married or pregnant or active military serivice
Emergency/Emergent Move
- Pt is at life or limb risk and needs to be moved immediately
- Anyway possible to save life or limb
- benifits should out weigh the risks every time
Interpersonal Justifiability Test
Are you able to justify or defend your actions to others?
Without violating your own morals and ethics?
Do you feel good about doing this and can you justify it to others
Nonmaleficence
The medics responsibility to not harm the pt
First do no harm
Quantitative
Involves a measurable quantity–numbers are used
Ex: length, mass, temp, and time
Universalizability Test
This test helps make sure you are withing standard of care
Autonomy
Pt’s right of self-determination - Deciding whats best for themselves
(So long as the pt meets the criteria)
Implied consent
When the pt is unable to consent due to being unconscious or too ill to consent verbally
We assume the pt would want to have life saving treatment
Duty / Duty to act
Prescribed by the law: it is what the paramedic must do and how we must do it
Do no more harm to the pt
“An obligation, to which law will give recognition and effect; to conform to a particular standard of conduct toward another”
Must perform to a standard of care if we do stop to provide care when clocked out
Must stay with the patient until other
Do not:
In most states, we do not have a duty to stop at a roadside crash when clocked out
We do not have to put a sticker on that we are a medic on personal vehicles
Impartiality Test
Would you agree to the same thing if you were the pt?
Reciprocity
The process of granting licensure or certification to a provider from another state or agency
Primary prevention
Keeping an injury or illness from occurring
Innovative ways to secure resources
Partnering with local media to create prevention messages, especially related to seasonal injuries or hazards
Seeking grants from regional, state, or national sources, such as the EMSC program (contacting your state EMS office about grant programs is a good place to start)
Seeking sponsorships from local nonprofit service organizations or commercial firms
Ex: showing new parents how to properly secure a baby into a car seat and the car seat to the car
