EMT Emergency Care 14th Edition Chapter 4

abandonment

leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training

slander

false, injurious information stated verbally

confidentiality

the obligation not to reveal information obtained about a patient except to other health care professionals involved in the patient's care, or under subpoena, or in a court of law, or when the patient has signed a release of confidentiality

consent

permission from the patient for care or other action by the EMT

safe haven law

a law that permits a person to drop off an infant or child off at a police, fire, or EMS station or to deliver the infant or child to any available public safety personnel

do not resuscitate (DNR) order

a legal document, usually signed by the patient and physician which states that the patient has a terminal illness and does not wish to prolong life through resuscitation efforts

duty to act

an obligation to provide care to a patient

expressed consent

consent given by adults who are of legal age and mentally competent to make rational decision with regard to their well-being

good Samaritan laws

a series of laws, varying by state, designed to provide limited legal protection for citizens and some health care personnel when they are administering emergency care

HIPAA

the Health Insurance Portability and Accountability Act, a federal law protecting the privacy of patient-specific health care information and providing the patient with control over how this information is used and distributed

implied consent

the consent that is presumed a patient or patient's parent or guardian would give if they could, such as for an unconscious patient or a child whose parents cannot be contacted when care is needed

liability

being held legally responsible

negligence

a finding that there was failure to act properly in a situation in which there was a duty to act that needed care as would reasonably be expected of the EMT was not provided, and that harm was caused to the patient as a result

organ doner

a person who has completed a legal document that allows for donation of organs and tissues in the event of death

scope for practice

a set of regulations that defend the scope, or extent and limits, of the EMT's job

POLST

physician orders that state not only the patient's wishes regarding resuscitation attempts but also the patient's wishes regarding artificial feeding, antibiotics, and other life-sustaining care if the person is unable to state the person's desires later

in loco parentis

literally "in place of a parent," indicating a person who may give consent for care of a child when the parents are not present or able to give consent

assault

placing a person in fear of bodily harm

battery

causing bodily harm or restraining a person

tort

a civil, not a criminal, offense; an action or injury cause by negligence from which a lawsuit may arise

Res ipsa loquitur

a Latin term meaning "the thing speaks for itself"

moral

regarding personnel standards or principles of right and wrong

ethical

regarding a social system or social or professional expectations for applying principles of right and wrong

libel

false, injurious information in written form

Advance directive

a DNR order; instructions written in advance of an event

crime scene

the location where a crime has been committed or any place where evidence relating to a crime may be found

standard of care

for an EMT providing care for a specific patient in a specific situation, the care that would be expected to be provided by an EMT with similar training when caring for a patient in a similar situating

the collective set of regulations governing the EMT is called the EMT's:

scope of practice

laws that govern the skills and treatments that an EMT may perform are:

different from state to state

when the EMT advocates for the physical/emotional needs for a patient, this is considered a(n) ________ for the EMT

ethical responsibility

which of the following is not a type of consent required for any treatment or action by an EMT

a. child and mentally incompetent adult

b. implied

c. applied

d. expressed

applied

when you inform the adult patient of a procedure you are about to perform and its associated risks, you are asking for the patient's

expressed consent

you are assessing a 28-year old male patient who was found unconscious at the bottom of a stairwell. consent that is based on the assumption that this patient would approve your life-saving care is called

implied

you are treating a 22-year-old female who decides that she does not want a cervical collar and definitely does not want to be transported to the hospital. the record of her refusal of medical care and/or transport should include all of the following except:

a. informing the patient of the risks and consequences of refusal

b. documenting the steps you took

c. signing of the form by the Medical Director

d. obtaining a release form with the patient's witnessed signature​

signing of the form by the Medical Director

it is clear that your 24-year-old competent male patient does not want to go to the hospital. forcing him to go to the hospital against his will may result in _________ charges against the EMT

assault

which of the following is an action the EMT should not take if a 36-year-old female refuses care?

a. leave phone stickers with emergency number should she change her mind

b. recommend that a relative call the family physician to report the incident

c. tell the patient to call her family physician if the problem recurs

d. call a relative or neighbor who can stay with her

tell the patient to call her family physician if the problem recurs

you are at the home of a very sick patient who has a terminal illness. her daughter states that she has DNR paperwork. another name for a DNR order is a(n)

advance directive

There may be varying degrees of DNR orders in your state, which may be expressed through a variety of detailed instructions that may be part of the order such as:

A. allowing CPR only if cardiac or respiratory arrest was observed

B. allowing comfort-care measures such as endotracheal intubation

c. disallowing the use of long-term life-support measures

d. specifying that only 5 minutes of artificial respiration will be attempted

allowing CPR only if cardiac or respiratory arrest was observed

in a hospital, long-term life-support and comfort-care measures would consist of intravenous feeding and:

the use of a respirator

If an EMT with a duty to act fails to provide the standard of care, and if this failure causes harm or injury to the patient, the EMT may be accused of:

negligence

Leaving your 82-year-old male patient on a hallway stretcher in a busy ED and leaving without giving a report to a health care professional is an example of

abandonment

The EMT should not discuss information about a patient except to relay pertinent information to the physician at the emergency department. Information considered confidential includes ?

a. patient history gained through interview

b. assessment findings

c. treatment rendered

d. all of these

all of these

the EMT should not release confidential patient information. the exception to this rule would be to

inform other health care professionals who need to know information to continue care

a medical identification device worn to indicate serious medical conditions is available in each of the following formats except

a. bracelets

b. necklaces

c. cards

d. patches

patches

You respond to a high-speed collision involving a motorcycle and an automobile. The 22-year-old female cyclist has severe head injuries and is not likely to live until morning. When treating this woman, who happens to have an organ donor card, the EMT should:

treat the patient the same as any other patient and inform the ED physician

You are at the scene of a home invasion where the 55-year-old male homeowner was shot in the head multiple times by the perpetrators. the police have called you to determine whether there are any signs of life. At this crime scene, you should:

avoid disturbing any evidence at the scene unless emergency care requires.

you mention to your partners, out of view of the patient, that once you get to the emergency department and turn over the patient, there will be some reports to file. commonly required reporting situations in most states include all of the following except:

a. child and elder abuse

b. crimes in public places

c. sexual assault

d. suspected human trafficking

crimes in public places

the extent of limits of an EMT's occupation is referred to as the:

scope of practice

you were called to a bar fight where a 28-year old male was knocked unconscious. on your arrival, he is awake and has a broken nose but no life threats. he admits to drinking "half a dozen beers" in the last 90 minutes. he wants to refuse medical attention. why should you discourage the patient from refusing medical care and transport?

he may not be mentally competent at this time

The federal law designed to protect the patient's private medical information is called

HIPPA

you are on the scene where a 40-year-old male barricaded himself and his wife in their home and threatened to do harm. after 2 hours, the wife escaped through the bathroom window, and the police rushed in and restrained the husband. it is your responsibility to transport him to the local ED. what should be your highest priority?

monitoring the patient's mental status and vital signs

The police are concerned about the presence of microscopic evidence at the scene of a violent assault. Your crew was asked to be careful and limit their involvement in the scene to essential patient care. What are examples of microscopic evidence?

a. the position in which the patient was initially found

b. any dirt and carpet fibers

c. fingerprints that were found at the scene

d. the condition of the scene

any dirt and carpet fibers

you are on the scene where a 46-year-old female who is refusing to go to the hospital. after arguing for 20 minutes you decide to just restrain her and remove to the ED as her family wishes so they can get a break from her complaining. if the patient is of sound mind you could be charged with

battery

the concept used in ________ law is "res ipsa loquitur" which is a Latin term for:

tort: "the thing speaks for itself"

when conducting a physical exam of an unconscious adult patient with a suspected medical problem, you remember that there was a "Vital of Life" sticker on the front door of the residence. this is important because it may:

reveal that additional medical identification is in the refrigerator

list four conditions that must be fulfilled for a patient to refuse care or transport

1. patient must be legally able to consent

2. patient must be awake and oriented

3. patient must be fully informed

4. patients will be asked to sign a release form

Finding of negligence or failure to act properly, requires that all of the following circumstances be proven

- the EMT had a duty to the patient

- the EMT did not provide the standard of care (committed a breach of duty)

- there was proximate causation (the concept that the damages to the patient were the result of action or inaction by the EMT)

four medical conditions that may be listed on a medical identification device (such as a necklace, bracelet, or card) are

1. heart conditions

2. allergies

3. diabetes

4. epilepsy

describe the purpose of the typical state "safe haven" law and how it may affect your EMS agency

most states have implemented some sort of "safe have" law. under such law, a person may drop an infant or child off at any police, fire, or EMS station or deliver the child to any public safety personnel

if you are on off-duty EMT, you are legally required to stop and offer assistance?

no, unless your state law requires you to stop. if you do stop you should not leave the patient except in the hands of another EMT or advanced EMT. leaving a patient is abandonment which is an example of gross negligence

are you protected from a lawsuit? explain

yes and no. anyone can be sued. most states do have a Good Samaritan law or some law dealing specifically with EMS personnel that have limited protections in this situation as long as your treatment is not grossly negligence

are you protected from a liability suit provided that your treatment is appropriate?

yes in most states