Chapter 3

Abandonment

Unilateral termination of care by the EMT without the patient’s consent and without making provisions for transferring care to another medical professional with the skills and training necessary to meet the needs of the patient

Advance directive

Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also called a living will or health care directive

Algor mortis

Cooling of the body after death until it matches the ambient temperature

Applied ethics

The manner in which principles of ethics are incorporated into professional conduct.

Assault

Unlawfully placing a patient in fear of bodily harm

Battery

Unlawfully touching a patient or providing emergency care without consent.

Bioethics

The study of ethics related to issues that arise in healthcare.

Compensatory damages

Damages awarded in a civil lawsuit that are intended to restore the plaintiff to the same condition that he or she was in prior to the incident.

Contributory negligence

A legal defense that may be raised when the defendant thinks that the conduct of the plaintiff somehow contributed to any injuries or damages that were sustained by the plaintiff.

Defamation

The communication of false information about a person that is damaging to that person’s reputation or standing in the community.

Dependent lividity

Blood settling to the lowest point of the body, causing discoloration of the skin; a definitive sign of death.

Depositions

Oral questions asked of parties and witnesses under oath.

Discovery

The phase of a civil lawsuit where the plaintiff and defense obtain information from each other that will enable the attorneys to have a better understanding of the case and which will assist in negotiating a possible settlement or in preparing for trial. Discovery includes depositions, interrogatories, and demands for production of records.

durable power of attorney for health care

A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf, in the event that the person making the appointment loses decision-making capacity

Duty to act

A medicolegal term relating to certain personnel who either by statute or by function have a responsibility to provide care.

Emergency doctorine

The principle of law that permits a health care provider to treat a patient in an emergency situation when the patient is incapable of granting consent because of an altered level of consciousness, disability, the effects of drugs or alcohol,or the patient’s age

Ethics

The philosophy of right and wrong, of moral duties, and of ideal professional behavior

Good Samaritan laws

Statutory provisions enacted by many states to protect citizens from liability for errors and omissions in giving good-faith emergency medical care, unless there is wanton,gross, or willful negligence.

Government immunity

Legal doctrine that can protect an EMS provider from being sued or that may limit the amount of the monetary judgment that the plaintiff may recover; generally applies only to EMS systems that are operated by municipalities or other governmental entities

Gross negligence

Conduct that constitutes a willful or reckless disregard for a duty or standard of care.

Health care directive

A written document that specifies medical treatment for a competent patient, should he or she become unable to make decisions. Also known as an advance directive or a living will.

Health care proxy

A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf in the event that the person making the appointment loses decision-making capacity. Also known as a durable power of attorney for health care

Informed consent

Permission for treatment given by a competent patient after the potential risks, benefits, and alternatives to treatment have been explained.

In loco parentis

Refers to the legal responsibility of a person or organization to take on some of the functions and responsibilities of a parent

interrogatories

Written questions that the defense and plaintiff send to one another.

Libel

False and damaging information about a person that is communicated in writing.

medicolegal

A term relating to medical jurisprudence (law) or forensic medicine

negligence per se

A theory that may be used when the conduct of the person being sued is alleged to have occurred in clear violation of a statute.

protected health information (PHI)

Any information about health status, provision of health care, or payment for health care that can be linked to an individual. This is interpreted rather broadly and includes any part of a patient’s medical record or payment history.

proximate causation

When a person who has a duty abuses it, and causes harm to another individual, the EMT, the agency, and/or the medical director may be sued for negligence.

punitive damages

Damages that are sometimes awarded in a civil lawsuit when the conduct of the defendant was intentional or constituted a reckless disregard for the safety of the public.

putrefaction

Decomposition of body tissues; a definitive sign of death.

res ipsa loquitur

When the EMT or an EMS system is held liable even when the plaintiff is unable to clearly demonstrate how an injury occurred

slander

False and damaging information about a person that is communicated by spoken word

statute of limitations

The time within which a case must be commenced.

torts

Wrongful acts that give rise to a civil lawsuit.

You arrive at the scene of an older woman complaining of chest pain. In assessing her, she holds her arm out for you to take her blood pressure. This is an example of:

A.implied consent.

B.informed consent.

C.expressed consent.

D.emergency consent.

C

Which of the following is an example of abandonment?

A. An EMT leaves the scene after a competent adult has refused care.

B. An EMT transfers care of a patient to an emergency department nurse.

C. An AEMT transfers care of a patient to a paramedic.

D. An AEMT transfers care of a patient to an EMR.

D

The unauthorized confinement of a person is called:

A.assault.

B.battery.

C.false imprisonment.

D.slander.

C

Failure of the EMT to provide the same care as another EMT with the same training is called:

A.libel.

B.slander.

C.negligence.

D.abandonment.

C

An 8-year-old boy was struck by a car, is unconscious, and is bleeding from the mouth. A police officer tells you that he is unable to contact the child’s parents. You should:

A.continue to treat the child and transport as soon as possible.

B.cease all treatment until the child’s parents can be contacted.

C.continue with treatment only if authorized by medical control.

D.provide airway management only until the parents are contacted.

A

An advance directive is:

A.a set of specific guidelines that clearly defines the different types of consent.

B.a formal list that defines by state law whether a patient has decision-making capacity.

C.a written document that specifies the care you should provide if the patient is unable to make decisions.

D.a verbal order given to you by a dying patient's family regarding whether treatment should be provided.

C

Which of the following patients is competent and can legally refuse EMS care?

A. A confused young female who states that she is the president

B. A man who is staggering and states that he drank only three beers

C. A conscious and alert woman who is in severe pain from a broken leg

D. A diabetic patient who has slurred speech and is not aware of the date

C

You are treating a patient with an apparent emotional crisis. After the patient refuses treatment, you tell him that you will call the police and have him restrained if he does not give you consent. Your actions in this case are an example of:

A.assault.

B.battery.

C.negligence.

D.abandonment.

A

The EMT has a legal duty to act if he or
she is:

A. off duty and witnesses a major car accident.

B. a volunteer, is on duty, and is dispatched on a call.

C. paid for his or her services, but is not on duty.

D. out of his or her jurisdiction and sees a man choking.

B

Which of the following statements about records and reports is FALSE?

A. Legally, if it was not documented, it was not performed.

B. A complete, accurate report is an important safeguard against legal problems.

C. An incomplete or untidy patient care report is evidence of incomplete or inexpert emergency medical care.

D. Your patient care report does not become a part of the patient’s hospital record because your treatment was provided outside the hospital.

D

How to manage pediatric patients in emergencies when parents or guardians are not immediately available

If parents or guardians are unreachable, EMS is able to provide care to a minor in emergency situations. If a teacher is available, they can act in loco parentis.

When is it necessary to forcibly restrain a patient?

If a patient is combative or presents a risk to themselves or others and is in need to emergency care. It may be necessary to get legal authority before you restrain a patient otherwise there can be penalties.

When can patient information legally be released?

• If that person poses an imminent threat to themselves or others, their information may be released to the police.

• If the patient is a victim of abuse some patient information may be released.

• For treatment, payment, or health care operations

• If the patient says its okay

• Public benefit (health reasons)

What are the key components required to prove negligence in the context of EMS care?

1. You did not act within a standard of care

2. You did not act at all

3. You caused damages to the patient

4. The damages only would’ve happened if you were there to cause them

What is the duty to act?

The EMT has an obligation to provide care and to do so in a manner that is consistent with the standard of care established by training and local protocols

What is the breach of duty?

There is a breach of duty when the EMT does not act within an expected and reasonable standard of care