Principles of Emergency Med - Exam 1 Flashcards
What body parts are considered a limb?
4 extremities, eyes and penis
What are the 5 levels of triaging?
level 1: critical!!! requires immediate life-saving intervention
2-3: emergent: illness/injury may progress if treatment is not initiated soon
4-5: non urgent
What is an example of a treatment that can assist in the diagnosis?
narcan
Do you always need to make a diagnosis in emergency medicine?
NO! okay to treat their symptoms and exclude emergency conditions without making a specific diagnosis
What is EMTALA? Who does it apply to?
Emergency Medical Treatment and Labor Act:
duty to provide emergency care regardless of the pt’s ability to pay
applies to any facility which has a “medicare contract” and receives payment from medicare or medicaid
What is the minimum qualification required to satisfy EMTALA?
Any person arriving to the ED seeking care MUST be provided a “medical screening exam” (MSE) by “qualified medical personnel”
If an emergent condition is ruled out, then the duty to the patient under EMTALA ends
Under EMTALA, if an emergency condition does exists, what is the facility required to do?
If an emergency condition exists, the duty continues to stabilize the patient and either admit or transfer
What are the rules under EMTALA regarding transfer of care?
A receiving hospital or physician, especially with specialized capabilities, may not refuse an appropriate transfer, unless they do not have the capacity or there is another facility that can manage the patient
What are the 5 components of informed consent?
patient’s diagnosis
purpose of the treatment
risks and expected outcomes of treatment
alternative treatments and their risks
consequence of no treatment
What are the 6 exceptions to informed consent?
_______ can be invoked (rarely) when a patient is so anxious or fragile that full disclosure might cause serious emotional or physical harm. Is it used frequently?
Doctrine of therapeutic privilege
Who can obtain informed consent?
the medical professional who is doing the procedure
T/F: All adults are presumed competent but may be deemed incompetent based on altered mental status due to physical/mental illness, intoxication or other causes of diminished consciousness
TRUE!! drunk people are not competent
T/F: Pts in police custody are not competent and their legal advocate must sign all informed consent paperwork
FALSE!!
Incarcerated or impending incarceration does not affect their rights to informed consent
What 2 patient populations may NOT leave AMA even if they are competent adults?
Psychiatric patients who pose a threat to self or others
Narcotic overdoses treated with naloxone (Narcan) who want to leave AMA must be held 1 - 1 ½ hours (1 half-life of naloxone dose) after administering narcan to see if they will need any additional doses
T/F: Parents have the right to withhold life-saving treatment from their child
FALSE!! need to call legal counsel for assistance. Will need to get temporary custody of the child
Courts typically DO NOT allow parents to withhold life-saving treatment from a minor for any reason
Give 9 examples of reportable events
child/elder abuse
rape
gunshot
stab wounds
assaults
seizures
STDs
HIV
animal bite
What 6 additional things need to be included in an emergency medicine note?
Time and means of arrival: EMS, PMV, walked
Any emergency care given prior to arrival
ER course: interventions, changes in patient status (VS, S/S ect.), discussions with other providers
Medical decision making: differential diagnosis
final disposition: where/whom
patient condition on discharge/transfer
