Wellbeing of the EMT: Legal and Ethical Issues Flashcards
General Things to be aware of
Affect of adrenaline on self Be in peak mental, emotional, physical condition
Physical Risks
Hazard- Weapons Hazard- Environmental (electrical wires, chemicals, unstable buildings, etc) Hazard- Exposure to communicable diseases (Hepatitis, AIDS, tuberculosis, SARS, etc) Vehicle- pathogens (bloodborne, airborne)
Why stay mindful of physical risks?
To not complicate response to emergency in which an EMT is now a patient that requires attention (two more teams required for care)
Physical Risk: Precautions and Preventions
Prevention- Inoculations
Prevention- Wearing protective equipment (gloves, masks, etc)
Precaution- Avoid contaminated items (hypodermic needles, clothing, etc)
Mental and Emotional Risks
Hazard- Trauma and PTSD Hazard- Death and Dying are frequent
Why stay mindful of Mental/ Emotional Risks?
Ability to function at job and in life, especially when dealing with PTSD
Mental/ Emotional Risks PTSD
Post-traumatic stress disorder Symptom- irritability, isolation Symptom- inability to concentrate Symptom- difficulty sleeping/ dreams Symptom- guilt Symptom- loss of appetite, sexual desire Serious after a few days
Mental/ Emotional Risks Stages of Grief
Denial, Isolation Anger Bargaining Depression Acceptance
How to respond to PTSD
Notify supervisor, seek out help from internal or external counseling Share emotions in confidence with one’s co-workers Processing can take an indefinite period of time
Legal/ Ethical
Scope of Practice
Determined by state in which licensed
Legal/ Ethical Standard of Care
Determined by state in which licensed
Legal/ Ethical Duty to Act
Anytime an EMT is ON DUTY (as a prehospital medical provider) s/he must act on any ill or injured patient s/he is dispatched to
Legal/ Ethical Patient Consent
Competent individuals have the right to permit or refuse any treatment In a conflict, patient’s right of refusal will trump what is viewed to be recommended or reasonable
Legal/ Ethical Expressed Consent
Verbal consent given by a competent patient
Legal/ Ethical Implied Consent
Consent automatically inferred from a patient who is unconscious or inebriated
Legal/ Ethical
Competency
(Not seriously intoxicated)
No magical standard indicates “too intoxicated”
EMT must determine on scene and determine the level of medical care
Minors are not considered competent, parents make decisions
Legal/ Ethical Litigation
Know defenses against being sued by patients based on duties
Legal/ Ethical
Good Samaritan Law
Immunity against liability for someone who performs an emergency medical procedure for which s/he is is trained/ certified for UNLESS it is done in a way that is grossly negligent
Legal/ Ethical
Confidentiality (2 exceptions)
HIPAA
(Health Insurance Portability and Accountability Act)
Keep all medical information private. Interview/ examine patient in as private a setting as possible.
Discuss only with (1) person to whom you transfer care of patient or (2) compelled by legal order
Legal/ Ethical
Crime Scenes
Disturb as little as possible
Document patient care, disturbances required for patient care
Mandated reporter for child abuse
Some states require notification for: 1. sudden death, 2. gunshot wounds, 3. spousal/ elder abuse, 4. animal bites
Legal/ Ethical
Medical Direction (Chain)
State Protocols, then:
Medical Control (on-line medical control/ off-line medical control)
On-line: Consulting with an emergency department physician– transfers patient care to physician (EMT is eyes and ears)
Off-line: Follow written orders from physician without on-line contact
