Medical, Legal and Ethical Issues / Blood Pressure

Question 1

How does standard of care differ from scope of practice?

Answer 1

Standard of Care: the level and type of care that a reasonably competent healthcare professional would provide in similar circumstances.

Scope of Practice: This defines the specific procedures, actions, and responsibilities that a healthcare provider is permitted to undertake based on their professional licensing and training.

Question 2

List three findings that would indicate presumptive signs of death.

Answer 2

Rigor mortis
Dependent lividity
Putrefication

Question 3

You arrive on scene to find a patient lying motionless on the ground. What legal provision allows you to assess and treat this patient?

Answer 3

Implied consent

Question 4

What does a blood pressure measure?

Answer 4

The pressure of circulating blood against the arterial walls

Question 5

To prove that an EMT was negligent in providing care there must be:

Answer 5

Duty to act, breach of duty, damages, causation

Question 6

Police have requested a medical evaluation for a person in custody. You arrive on scene to find a 33-year-old patient who is handcuffed and sitting in the back of the police vehicle. The patient has several bruises on their arms and a small laceration on the forehead. Your assessment reveals the patient is alert and oriented but is refusing any care. How should you proceed with your assessment/treatment of this patient?

Answer 6

Assess the patient for mental status using AEIOU-TIPS. If mental status is ok and treatment is still refused, inform the patient of risks of refusal. If still refusing you must respect the patient’s right to refuse. Document everything in a report.

Question 7

What are two of the body’s compensatory mechanisms for a drop in blood pressure?

Answer 7

Increased heart rate

Vasoconstriction

Question 8

While treating a combative 24-year old, your EMT partner is being verbally abusive toward the patient and threatens to punch them if they don’t cooperate. Is this behavior unethical or illegal, if so what laws or ethical codes may have been violated?

Answer 8

It is both unethical and illegal. Ethically it is a breach of professional ethics and threatening the patient with use of force. Legally this would be considered assault and negligence.

Question 9

The diastolic pressure measures:

Answer 9

Pressure in your blood vessels when your heart is resting between beats.
(the heart at rest)

Question 10

List two reasons to avoid taking a blood pressure on one of a patient’s arms.

Answer 10

Patient has a stent /catheter

The arm has been damaged/injured

Question 11

You are dispatched to a scene by a passerby who dialed 9-1-1. Witnesses saw a 15-year-old fall off a skateboard. The patient was not wearing a helmet, has a bruise on the forehead and can’t move their left arm. The patient says, “you can’t touch me and I’m not going to the hospital.”How should you proceed with the management of this emergency scene?

Answer 11

Since the patient is a minor, attempt to contact a parent, legal guardian. If responsible party cannot be contacted, first inform medical control, then continue to treat. Minors do not have the right to refuse care. Document everything in the patient report.

Question 12

What purpose does HIPAA serve?

Answer 12

Protection of patient privacy (information, treatments, medical records)

(Health Insurance Portability and Accountability Act)

Question 13

You ask a patient if you can check his blood pressure and he extends his arm towards you. What type of consent is being displayed.

Answer 13

Expressed consent

Question 14

You are dispatched to a residence for a patient who is experiencing difficulty breathing. While you are assessing the patient, a family member shows you the patient’s DNR order. The patient is unconscious and showing signs of slow and shallow respirations. How should you proceed with your assessment and/or treatment?

Answer 14

Since the patient is still showing signs of breathing the DNR is ineffective. Continue life saving treatment

Question 15

You’ve been dispatched to a bus stop where you are assessing a mentally challenged adult patient who cannot tell you where they are. There is no caregiver present. The patient appears to be calm but is refusing any care. What is the most effective way to manage this situation? What legal provisions allow you to assess and treat this patient without their consent?

Answer 15

Involuntary Consent

Since the patient is mentally challenged, proceed with treatment. If the patient is defiant call for Police assistance.

Question 16

A blood pressure (BP) cuff that is too large may result in reading that is:

Answer 16

Lower than the actual BP level