EMT 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.

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

Touching a patient or providing emergency care without consent.

bioethics

The study of ethics related to issues that arise in health care.

breach of confidentiality

Disclosure of information without proper authorization.

certification

A process in which a person, an institution, or a program is evaluated and recognized as meeting certain predetermined standards to provide safe and ethical care.

compensatory damages

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

competent

Able to make rational decisions about personal well-being.

consent

Permission to render care.

contributary negligence

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

decision-making capacity

Ability to understand and process information and make a choice regarding appropriate medical care.

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.

depositions

Oral questions asked of parties and witnesses under oath.

discovery

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

do not resuscitate (DNR) orders

Written documentation by a physician giving permission to medical personnel to not attempt resuscitation in the event of cardiac arrest.

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.

emancipated minors

A person who is under the legal age in a given state but, because of other circumstances, is legally considered an adult.

emergency

A serious situation, such as injury or illness, that threatens the life or welfare of a person or group of people and requires immediate intervention.

emergency doctrine

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.

emergency medical care

Immediate care or treatment.

ethics

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

expressed consent

A type of consent in which a patient gives express authorization for provision of care or transport.

false imprisonment

The confinement of a person without legal authority or the person's consent.

forcible restraint

The act of physically preventing an individual from initiating any physical action.

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.

governmental immunity

If your service is covered by immunity, it may mean that you cannot be sued or it may limit the amount of the monetary judgment that the plaintiff may recover; generally applies only to EMS services 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 proxies

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.

implied consent

Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment.

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.

informed consent

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

interrogatories

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

kidnapping

The seizing, confining, abducting, or carrying away of a person by force, including transporting a competent adult for medical treatment without his or her consent.

libel

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

licensure

The process whereby a competent authority, usually the state, allows individuals to perform a regulated act.

medicolegal

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

morality

A code of conduct that can be defined by society, religion, or a person, affecting character, conduct, and conscience.

negligence

Failure to provide the same care that a person with similar training would provide.

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.

patient autonomy

The right of a patient to make informed choices regarding his or her health care.

precedence

Basing current action on lessons, rules, or guidelines derived from previous similar experiences.

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 suit when the conduct of the defendant was intentional or constituted a reckless disregard for the safety of the public.

putrefaction

Decomposition of body tissues.

res ipsa loquitor

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

rigor mortis

Stiffening of the body; a definitive sign of death.

scope of practice

Most commonly defined by state law; outlines the care you are able to provide for the patient.

slander

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

standard of care

Written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organizations so that patients are not exposed to unreasonable risk or harm.

statute of limitations

The time within which a case must be commenced.

tort

A wrongful act that gives rise to a civil suit.

A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should:

assess whether or not the patient's mental condition is impared

Acting in such a way as to make another person fear immediate bodily harm is called:

assault

An EMT would most likely be held liable for abandonment if he or she:

did not make provisions for continued care of an injured patient

As an EMT, the performance or your duties will be compared to that of:

another EMT

At the scene of a mass-casualty incident, you identify a patient as an organ donor. When triaging the other patients, you:

may have to assign the donor patient a lower triage priority

During your monthly internal quality(QI) improvement meeting, you review several patient care reports(PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you:

are in violation of HIPPA because you did not remove from the PCR beforhand

If an action or procedure that was performed on a patient is not recorded on the written report:

it was not performed in the eyes of the law

In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor:

is self-supporting and lives by him- or herself

In order for a do not resuscitate(DNR) order to be valid, it must:

clearly state the patient's medical prblem

In the eyes of the court, an incomplete or untidy patient care form indicates:

that inadequate patient care was administered

In which of the following circumstances can the EMT legally release confidential patient information?

the patient is competent and signs a release form

In which of the following situations does the EMT not have a legal duty to act?

a response to a motor vehicle crash while off duty

Maintaining the chain of evidence at the scene of a crime should include:

not cutting through holes in clothing that were caused by weapons

Putrefaction is defined as:

decomposition of the body's tissue

Shortly after loading your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. He is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?

A mentally competent adult can withdraw his or her consent to treat at any time

The EMT's scope of practice within his or her local response area is defined by the:

medical director

The manner in which the EMT must act or behave when caring for a patient is called the:

standard of care

To minimize the risk of litigation, the EMT should always:

provide competent care the meets current standards

Two EMT's witnessed a call in which a coworker gave adequate medical care but ignored the patient's emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with the human immunodeficiency virus(HIV). The EMT's ignored the coworker's treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMT's is considered

legal but unethical

What section of the Health Insurance Portability and Accountability Act(HIPAA) most affects EMS personnel?

protecting patient prvacy

What type of consent is involved when a 39-year-old mentally competent female with a severe headache asks you to take her to the hospital?

expressed

When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of:

negligence

When faced with a situation in which a patient is in cardiac arrest, and a valid living will or DNR order cannot be located you should:

begin resuscitation at once

When performing his or her duties, the EMT is generally expected to:

exercise reasonable care and act prudently

When you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should:

begin two-rescuer CPR and apply the automated external defibrillator(AED) as soon as possible

Where would you must likely find information regarding a patient's wishes to be an organ donor?

driver's license

Which of the following components are needed to prove negligence?

duty to act, breach of duty, injury/damages, and causation

Which of the following general statements regarding consent is most correct?

a patient can consent to transport but can legally refuse to be treated

Which of the following is not considered to be protected health information(PHI)?

location of the call

Which of the following most accurately defines negligence?

deviation from the standard care that may result in further injury

Which of the following scenarios most accurately depicts abandonment?

a paramedic transfers patient care to an EMT

Which of the following scenarios most accurately depicts informed consent?

an EMT advises a patient of the risk of receiving treatment

Which of the following situations requires you to notify the appropriate authorities?

attempted suicide

Which of the following statements regarding the Good Samaritan law is correct?

It will not protect the EMT in cases of gross negligence

Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated?

implied

While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. Your most appropriate action should be to:

continue transporting your patient and notify the dispatcher of the crash

While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should:

contact medical control and notify him or her of the error

You and your partner are the first to arrive at a potential crime scene with a critical injured patient involved. The scene is safe. Your first priority is to:

provide immediate patient care

You and your partner arrive at the scene of a motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, is not breathing, and does not have a palpable carotid pulse. You should:

have your partner check for a pulse to confirm that the patient is deceased

You are dispatched to a middle school for a 16-year-old female experiencing an asthma attack. She is conscious and alert, but in severe respiratory distress. The school nurse informs you that she has tried several times to contact the patient's parents but has not been successful. You should:

provide treatment up to your level of training and transport the child at once

You are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:

quickly move the coffee table so you can access and treat the patient

You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert, but in obvious pain. He tells you that he did not call 911; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should:

ensure that he is aware of the risks of refusing medical care

You are treating a man with a closed head injury following an assault by a burglar. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should:

proceed with treatment and utilize law enforcement if necessary