Medical, Legal, and Ethical Issues in EMS

Question and answer flashcards covering medical legal concepts, consent, advance directives, documentation, HIPAA, and anatomical terminology.

What is defined as an EMT's Scope of Practice?

The actions and care that EMTs are legally allowed to perform by the state in which they are providing emergency medical care.

What is the Standard of Care for an EMT?

The care that is expected to be provided by an EMT with similar training when managing a patient in a similar situation, also referred to as the Reasonable Person Standard.

What does Duty to Act mean for an EMT?

The legal obligation to provide service, whether or not the EMT thinks the patient needs an ambulance, including patient care priorities at crime scenes and duties to self, partner, and equipment.

What legal protection is provided by Good Samaritan Laws?

Protects a person who is not being paid for services from liability for acts performed in good faith unless those acts constitute gross negligence. It does not protect against being sued.

Under what condition does an adult patient have the legal right to accept or refuse emergency medical care?

When the adult patient is conscious, competent, and rational.

What is informed consent (expressed consent)?

Consent given for assessment and treatment by a conscious, rational patient.

What is implied consent and when does it apply?

The legal assumption that care would be accepted if able; applies to patients who are unresponsive, disoriented, or minors without guardian consent, as well as patients who initially refuse care and then become unresponsive.

How must consent be handled when treating a minor under 18 years old?

Minors are not legally competent to accept or refuse care, so consent must be obtained from a parent or legal guardian; if unreachable, care is provided under implied consent.

What conditions qualify a minor as an emancipated minor?

Being married, pregnant, a parent, a member of the armed forces, financially independent, or emancipated by court decree.

When does involuntary consent apply?

When dealing with a mentally incompetent adult or an individual in the custody of law enforcement.

What is a Do Not Resuscitate (DNR) order?

A legal document or order signed by both the patient and physician that governs resuscitation issues (a copy is acceptable).

What is the function of a Durable Power of Attorney in medical care?

Legally empowers a designated person to make health care decisions for the signer if the signer becomes unable to do so.

What should an EMT do if there is a problem or uncertainty regarding an advance directive?

Provide care and treatment until the situation is clarified, and contact medical direction.

What criteria make a patient competent to refuse treatment Against Medical Advice (AMA)?

The patient must be oriented to person, place, time, and event, and not under the influence of drugs or alcohol.

What are the key steps in the AMA (Against Medical Advice) refusal process?

Verify orientation and competence, ensure no drug/alcohol influence, ensure full understanding, explain consequences up to death, advise to re-contact 911 if needed, and obtain the patient's signature on the AMA form.

What four elements are required to establish negligence?

Duty to act, Breach of duty, Damages/Injury, and Cause (Proximate Causation).

How is abandonment defined in EMS?

Failure to transfer care of a patient to another competent professional of equal or higher level of training.

What constitutes assault in emergency medical care?

A willful threat to inflict harm on a patient.

What constitutes battery in emergency medical care?

The act of touching a patient unlawfully without consent.

How is kidnapping defined in an EMS context?

Taking a patient to the hospital against his or her wishes.

What are the recognized obvious signs of death where care does not need to be initiated?

Rigor mortis, decapitation, decomposition, incineration, evisceration of heart or brain, and dependent lividity (note: dependent lividity is not used in SD County).

What are the criteria for placing a person on a 5150 mandatory 72-hour psychiatric detention?

The person must be a danger to self, a danger to others, or gravely disabled (unable to care for oneself).

According to SD protocol, what are the reporting requirements when abuse is suspected?

You must contact the proper authority ASAP and follow up with the proper paperwork within 24 hours.

Which circumstances require mandated reporting by EMS personnel?

Child abuse or neglect, domestic violence, elder abuse, sexual assault, gunshot wounds or other violence, and infectious diseases.

What does HIPAA require regarding patient information?

The Health Insurance Portability & Accountability Act of 1996 requires health care providers to keep all verbal, electronic, and written patient information strictly confidential.

What body position is shown in this picture?

Supine

What body position is shown in this picture?

Prone

What body position is shown in this picture?

Right lateral recumbent

What body position is shown in this picture?

Left lateral recumbent (Recovery position)

Which major organs are located in the Right Upper Quadrant (RUQ) of the abdomen?

Liver, Right kidney, Colon, Pancreas, and Gallbladder.

Which major organs are located in the Left Upper Quadrant (LUQ) of the abdomen?

Liver, Spleen, Left kidney, Stomach, Colon, and Pancreas.

Which organs and structures are located in the Right Lower Quadrant (RLQ) of the abdomen?

Colon, Small intestines, Major artery and vein to the right leg, Ureter, and Appendix.

Which organs and structures are located in the Left Lower Quadrant (LLQ) of the abdomen?

Colon, Small intestines, Major artery and vein to the left leg, and Ureter.

Which anatomical structures lie in the midline area of the abdomen?

Aorta, Pancreas, Small intestines, Bladder, and Spine.

What organs are contained in the Thoracic cavity?

Heart and Lungs.

What organ systems are contained within the Pelvic cavity?

Urinary and Reproductive systems.