Medical-Legal Flashcards
Duty to Act
While on-duty, EMTs are required by law to care for a patient who requires and consents to it. Different states have different policies for off-duty EMTs, but most will not require an off-duty EMT to help a patient. However, if the EMT does stop to help, then he or she is required by law to continue helping the patient until care is transferred to someone with the appropriate expertise, such as a paramedic or a doctor.
Scope of Practice
Defines what an EMT with the appropriate licensure can and cannot do by law. It is illegal to perform operations outside your scope of practice.
Standard of Care
Defined as the level of care at which the average, prudent provider in a given community would practice.
Medical Direction
EMTs must follow medical direction at all times. This includes off-line directions such as protocols approved by medical direction and on-line directions directly communicated by the doctor. When in doubt, always ask for medical direction.
Patient Consent
The conscious, mentally competent adult has the right to accept or refuse emergency medical care. Thus, always make sure that the patient consents before beginning emergency care. There are three types of consents: expressed, implied, and that which deals with a minor. Expressed consent is made by conscious, mentally competent adults. Implied consent is automatically assumed if a patient is unresponsive or unable to make a rational decision (e.g. altered mental status). To treat a minor, an EMT must obtain the consent of the parent or guardian. If the parent or guardian is unreachable, then implied consent is assumed.
Patient Refusal or Withdrawal of Treatment
Always ask the patient to fill out sign a refusal form, including documentation of what was told to the patient and his or her response. However, before this, the EMT should have persuaded the patient to receive care and then made certain that the patient is indeed mentally competent and capable of making rational decisions. When in doubt, ask for medical direction.
Advanced Directives
these are instructions given in advance such as a DNR (Do Not Resuscitate) order. These directions should be honored if clear, unambiguous documentation exists.
Confidentiality
laws exist that protect a patient’s privacy. The HIPAA (Health Insurance Portability and Accountability Act) of 1996 is a federal law that protects the confidentiality of patient health care information. HIPAA training is required for all EMTs. As a general rule, do not disclose information obtained during emergency care to family, friends, or anyone else.
COBRA and EMTALA
The Consolidated Omnibus Budget Reconciliation Act and the Emergency Medical Treatment and Active Labor Act prevents hospital discrimination of emergency patients based on the ability or inability to pay. All patients should be transported to the nearest medical facility regardless of their ability to pay. Always obtain the proper documentation when transferring patients between facilities.
Tort
a wrongful act, injury, or damage. Negligence is an example of a tort.
Negligence
occurs when all four of the following conditions are met: The EMT had a duty to act.
The EMT breached that duty.
Harm or damages were caused to the patient.
The harm or damages were caused by the breach of duty.
Abandonment
When an EMT begins treating a patient, but stops without transferring the care to someone with appropriate expertise.
Assault
can occur as an act or a threat to inflict harm on a patient
Battery
the act of touching a patient without consent.
False Imprisonment
keeping and transporting the patient without consent.
