MLE1
Term that describes the legal obligation to provide care according to an established standard?
Duty to act
The ability of a patient to understand the information you are providing coupled with the ability to process that information and make an informed choice regarding medical care.
Decision-making capacity.
True or false. A patient who has attempted suicide or who has suicidal ideation cannot refuse transport.
True.
A patient who has attempted or has suicidal ideations should not be regarded as having a normal mental capacity.
In many states, death is defined as:
Absence of circulatory, and respiratory function.
Blood settling to the lowest point of the body, causing discoloration of the skin.
Dependent lividity.
The unauthorized confinement of a person that lasts for an appreciable amount of time:
False imprisonment
Type of consent that is generally obtained when a competent adult clearly agrees to receive EMS treatment?
Expressed consent
The right of a patient to make decisions concerning his or her health is known as:
Patient autonomy.
Disclosure of information other than to those providers directly involved in the care of the patient without proper authorization may result in liability for:
Breach of confidentiality.
In the absence of a DNR the general rule is if the the body is still intact, and there are no definitive signs of death you should:
Withhold resuscitation.
Or
Initiate Emergency medical care.
Initiate Emergency medical care.
The stiffening of body muscles caused by chemical changes within the muscle tissue.
Rigor mortis
The communication of false information that damages the reputation of a person:
Defamation
Implied consent may apply when an unconscious patient requires emergency treatment and cannot communicate a decision. True or false?
True
(Implied consent can apply in an emergency when an incapacitated patient cannot provide consent and a reasonable person would generally want necessary emergency treatment.)
The type of consent given when the patient specifically acknowledges that he or she wants you to provide care or transport.
Expressed consent.
What does HIPAA stand for?
Health Insurance Portability and Accountability act of 1996.
A general cooling of the body in which the internal body temperature becomes abnormally low.
Hypothermia
Refers to the cooling of the body until it matches, the ambient temperature.
Algor mortis
Defamation in writing is called:
Libel
An EMT arrives at a patient's home and the patient says, “I don't want to go to the hospital.” What should the EMT do first if the patient appears capable of making decisions?
Determine whether the patient has decision-making capacity
(The EMT should assess whether the patient understands the situation and can make an informed decision before accepting the refusal.)
You explain the nature of the treatment being offered along with the potential risk, benefits, and alternatives to treatment as well as potential consequences of refusing treatment. This is called:
Informed consent.
HIPAA considers all patient information that you obtain in the course of provided medical treatment to a patient to be:
Protected health information
Hypothermic patient should not be considered dead until:
They are warm and dead.
Decomposition of the body tissues:
Putrefaction
Defamation that is spoken is called:
Slander
Which findings are important when determining whether a patient has decision-making capacity during a refusal? Select every correct answer.
A. The patient can communicate a choice.
B. The patient can appreciate the consequences of the decision.
C. The patient agrees with the EMT's recommendation.
D. The patient can understand information about the situation.
A. The patient can communicate a choice
(Being able to communicate a consistent choice is an important component of capacity.)
B. The patient can appreciate the consequences of the decision
(Recognizing how the decision may affect the patient is an important component of capacity.)
C. The patient can understand information about the situation
(Understanding the relevant information is an important component of decision-making capacity.)
True or false. A patient gives you consent to treat them so that means you can treat them in any way that you see fit.
False. A patient may agree to certain types of emergency medical care, but not to others.
Name ways to safeguard PHI. 3 different ways from chapter. At least 3 for double points.
Never leave electronic devices they have patient information on them unattended
Do not share passwords or login information.
Dispose of documents or reports that contain PHI.
Do not inadvertently disclose PHI to others who may be on scene.
Do not use your personal electronic device to capture photos or images of a patient or vehicle.
Do not post on social media.
Definitive signs of death:
Decapitation
Dependent lividity
Rigor mortis
Algor mortis
PutrefactionTrue or false.
You off of duty and come upon a scene of a medical emergency. You have no duty to act under any circumstances.
False
(If you are off duty, you are generally a private citizen. You can choose to pass by. But if you stop, identify yourself, or begin treating a patient, you are locked into a legal duty to act until a formal handoff occurs.)
Common law principal that when tut reasonably help another person, you should not be liable for errors and omissions that are made in giving good-faith emergency care.
Good Sam in law
An EMT begins treating a competent adult without first obtaining consent, and there is no emergency preventing communication. Which legal concept is most directly implicated?
Battery
(Battery can involve unauthorized physical contact or treatment without the patient's consent.)
True or false.
There are situations in which you must disclose a patient’s PHI.
True.
(In the case of child abuse or when you receive a subpoena, you may be legally mandated to report your findings.)
True or false.
It is OK to share PHI with your colleagues, face-to-face.
False.
(Any sharing of private or protected information whether it’s directly sharing images or recordings or verbally relaying information, is a serious violation of HIPAA and ethical principles, even when done privately.)
You arrive on the scene where a patient is an organ donor. You should:
Determine that he is dead.
Recognize that someone else needs those organs.
Withhold all efforts of resuscitation.
Attempt to save the patient’s life in absence of a DNR by all means necessary.
Attempt to save the patient’s life in absence of a DNR by all means necessary.
Failure to provide the same care that a person with similar training would provide in the same or similar situation.
Negligence.
In order to be protected by the Good Samaritan law you must:
4 total
Act in good faith rendering care.
Render care without expectation of compensation.
Act within the scope of your training.
Do not act in a grossly negligent matter.
An EMT posts on social media, “Crazy overdose call today,” and includes a patient's photograph and enough details for coworkers to identify the patient. What is the primary concern?
Violation of patient confidentiality
(Sharing identifiable patient information or images without appropriate authorization can violate confidentiality and privacy requirements.)
Patients who are intoxicated by drugs or alcohol, mentally impaired, or suffer from certain conditions, such as head injury can be treated against their will using:
Implied consent.
True or false.
(HIPAA laws restrict public from taking pictures or recording private patient encounters in a public area.)
False
(There is no expectation of privacy in a public place. Privacy has to be created.)
You arrive on scene of unknown medical. The patient is unresponsive and unable to talk. How can you obtain medical information from this patient?
Look for bracelets, necklaces, or keychain or cards that identify history information
When the EMT does not act within an expected and reasonable standard of care.
Breach of duty
True or false.
If an action you performed was not recorded on a written report it was not done.
True.
(Doesn’t matter if you physically did it or not. If it isn’t documented it didn’t happen.)
An EMT documents that a patient's blood pressure was 120/80 even though the EMT never obtained a blood pressure. What legal problem is most directly created?
A. Negligence
B. Falsification of documentation
C. There is no legal problem created.
D. Battery
Falsification of documentation.
Your patient has a life-threatening injury. A family member is on the way and they tell you do not take the patient to the hospital. You should:
Wait on a family member to arrive.
Treat and transport without their permission under implied consent.
Leave the patient and come back when the relatives arrive.
You don’t do anything.
Treat and transport without their permission under implied consent.
True or false.
An EMT uses an agency supplied equipment to record or distribute information for records or distribute information while in the course of his or her duties. The agency likely owns the images and information.
True.
(Because the agency bought and provided the equipment, they own the digital space inside it.)
Commonly defined by state law, outlines the care you are legally able to provide for the patient:
Scope of practice
The causes and effect relationship between breach of duty and the damages suffered by the patient.
Causation
True or false.
You can have a an untidy report and provide quality medical care.
False.
An (incomplete or untidy report is evidence of incomplete or inexpert emergency medical care.)
An EMT responds to a motor-vehicle collision involving an injured coworker. The EMT is off duty and has no assigned EMS responsibility at the scene. Which statement is most accurate?
A. The EMT must transport the coworker personally.
B. The EMT's obligations depend on the circumstances and applicable law.
C. Being an EMT automatically eliminates all legal responsibilities.
D. The EMT always has the same legal duty to act as an on-duty EMT
The EMT's obligations depend on the circumstances and applicable law.
(Whether a duty exists depends on factors such as jurisdiction, circumstances, employment status, and whether responsibility has been assumed.)
The patient you were transported in the previous question wakes up suddenly and is alert and oriented. He says he does not want to be treated or transported. You should:
Take him against his will.
Take him using implied consent.
Physically restraining him and call the police.
Let him out of the ambulance after explaining the risks and benefits and making sure he has decision making capacity.
Ways to avoid serious ethical or legal issues while using personal social media. There were 4 ways mentioned. Name at least 2 for double.
Avoid logo, uniforms, vehicles, or other markings that associate you with your agency while off duty.
Conduct yourself online with the same professionalism that you do while on duty.
Respect your patients, their friends, family, bystanders, colleagues, and the organization for which you work both in person and online.
Recognized that free speech does not mean every person has a right to say anything under any circumstances without repercussions.
Your _____ further defines the scope of practice by developing protocols and standing orders.
Medical director
A theory that may be used when the conduct of the person being sued is alleged to have occurred a clear violation of a statue.
Negligence Per se
The philosophy of right and wrong, of moral principals, and professional behavior.
Ethics
A 17-year-old patient with a serious injury is conscious and asks the EMT not to tell the parents about the injury. What should the EMT recognize before deciding how to proceed?
A. The EMT can always keep the information secret from the parents.
B. Parental involvement and minor-consent laws can depend on the circumstances and jurisdiction.
C. A minor always has exactly the same consent rights as an adult.
D. The EMT can always ignore the patient's request.
Parental involvement and minor-consent laws can depend on the circumstances and jurisdiction
(Consent and confidentiality rules for minors vary according to the situation and applicable law, including exceptions that may permit or require independent consent.)
You call to the city jail. The staff on scene says the patient needs to be transported for a medical evaluation. The patient refuses treatment and transport. You should.
Listen to the jail staff only.
Listen to the inmate only.
Know the provisions in your area and involve online medical control.
Treat the patient under informed consent.
Know the provisions in your area and involve online medical control.
A_____ patient is able to make rational decisions about his or her well-being.
Competent
Operating outside of your scope of practice is considered:
Negligence.
Civil wrongdoings are also known as:
Torts
The code of conduct that can be defined by society, religion, or a person, affecting character and conscience and the definition of right versus wrong.
Morality
Which elements are commonly required to establish negligence? Select every correct answer.
A. A duty to act existed.
B. The EMT disagreed with the patient's medical decision.
C. The breach caused or contributed to harm.
D. The provider breached the applicable standard of care.
A. A duty to act existed.
(Negligence generally requires that the provider owed the patient a duty.)
B. The breach caused or contributed to harm
(A causal connection between the breach and the patient's injury is generally required.)
D. The provider breached the applicable standard of care
(A departure from the expected standard is a central element of negligence.)
People who, despite being under the legal age in a given state, that can be legally treated as adults based on certain circumstances.
Emancipated minors.
An _____ is a written document that specifies medical treatment for composite patient. Should he or she become unable to make decisions.
Advanced directive
The manner in which you must act or behave as an EMT is called:
Standard of care
The unilateral termination of care by the EMT without the patient’s consent without making any provisions for continuing care by a professional, who is competent to provide care for the patient
Abandonment
The manner in which principals of ethics are incorporated into professional conduct:
Applied ethics.
An EMT arrives at a call and finds an alert adult patient with chest pain. The patient refuses evaluation after the EMT explains the potential risks. The patient then walks away. What is the EMT's most appropriate next step?
A. Physically restrain the patient to force evaluation.
B. Document the assessment, risks explained, refusal, and circumstances according to local policy.
C. Call the police to the scene and force the patient to be transported.
D. Just leave the patient he probably is ok
B. Document the assessment, risks explained, refusal, and circumstances according to local policy
(A thorough refusal process and accurate documentation help demonstrate that the patient was informed and that the EMT appropriately addressed the refusal.)
You arrive on scene and find a child with the child’s mother and grandparents. The grandparents want the child evaluated, but the mother refuses EMS evaluation. What should you do?
A. Transport the child because the grandparents requested evaluation
B. Obtain consent from the grandparents
C. Assess the situation and determine whether the mother has the legal authority to make the decision and whether an emergency or other exception requires treatment
D. Allow the grandparents to physically take the child from the mother
C. Assess the situation and determine whether the mother has the legal authority to make the decision and whether an emergency or other exception requires treatment.
(If the child is not in immediate danger, and the mother is the legal guardian and has decision-making capacity, the grandparents generally cannot override the mother’s decision simply because they want EMS to evaluate the child.)
Valid DNR orders must contain:
Clear statement of the patient’s medical problems.
Signature of the patient or legal guardian.
Signature of one or more physician or other licensed healthcare providers.
Some DNR order contain expiration dates. DNR orders with expiration dates must be dated in the proceeding 12 months to be valid.
Actors you must take into an account as EMT
Scene Safety.
General confusion at the scene.
The needs of other patients.
The type of equipment available.
Unlawfully placing a person in fear of immediate bodily harm
Assault
The time within which a claim must be initiated
Statue of limitations
An EMT is asked by a family member to administer a medication that is not within the EMT's scope of practice. The family member says the medication is prescribed to the patient. What is the EMT's best response?
A. Administer it because it is prescribed.
B. Have the family member administer it while the EMT supervises.
C. Decline the intervention and provide care within scope while seeking appropriate medical direction when indicated.
D. Administer half the prescribed dose.
C. Decline the intervention and provide care within scope while seeking appropriate medical direction when indicated
(EMTs should remain within their legal scope and use appropriate medical direction or higher-level resources when necessary.)
Describes a person in the position or place of a parent that can legally give consent for treatment of the minor if a parent or guardian is not available.
In loco parentis.
A type of advance directive executed by a competent adult that appoints another individual to make medical decisions on his or her behalf. 2 different names. Both for double points.
Durable power of attorney for healthcare. Health care proxy.
A serious situation such as an Andrea Hill that arises suddenly; threatens life, or welfare a person or a group people and requires immediate intervention.
Emergency
Unlawfully touching a person:
Battery
Provides the ability to collect, store, ands share standardized EMS data in the United States:
NEMSIS
A paramedic asks an EMT to perform a procedure that the EMT has never been trained or authorized to perform. The EMT is told, “Just do it this once; I'm taking responsibility.” What is the most legally appropriate response?
A. Perform it because the paramedic assumes responsibility.
B. Perform it if the patient's condition is serious enough.
C. Decline the procedure and remain within the EMT's authorized scope while assisting appropriately.
D. Perform it and document that the paramedic ordered it.
C. Decline the procedure and remain within the EMT's authorized scope while assisting appropriately
(The EMT should not perform an unauthorized procedure and should continue providing appropriate care within training, certification, and scope.)
You encounter a patient with a head injury that you believe needs to be forcibly restrained. You should:
Select all that apply.
A. Refer to local laws.
B. Go ahead and restrain them. It’s for their own well-being.
C. Consult medical control for authorization to restrain and contact law-enforcement.
D.Just leave them they’ll probably be OK.
E. Get back to the station to finish watching your show.
F. Determine if the patient is a risk to themselves or others.
E. Determine decision making capacity.A. Refer to local laws.
C. Consult medical control for authorization to restrain and contact law-enforcement.
F. Determine if the patient is a risk to themselves or others.
E. Determine decision making capacity.
A patient has a DNR order and you are called to the home because they have difficulty breathing. They are not in cardiac arrest.You should:
Withhold treatment due to the DNR order.
Or
Provide supportive care.
Provide supportive care.
An individual’s responsibility to provide patient care.
Duty to act
The seizing, confining, abducting, or carrying away of a person by force/
Kidnapping
A legal defense raised when the defendant thinks that the conduct of the plaintiff somehow contributed to the injuries or damages were sustained by the plaintiff:
Contributory negligence
Regardless of age, a minor can consent to their own medical care if they meet these criteria: There are instances.
They are legally emancipated.
They are married or divorced.
They have a child.
They live apart from their parents and support themselves financially.
You arrive on scene and encounter a patient with a life-threatening injury. The patient is alert and has decision making capacity. They understand all risks.They refuse treatment and transport you should. You should:
Understand that they have the right to refuse treatment or withdraw from treatment at any time, even if doing so may result in death or serious injury.
Contact medical control and document this consultation
Document all pertinent info in the PCR.
Describe what you believe is wrong with the patient. The treatment you believe is necessary, any possible risks of treatment, the availability of alternate treatments and the possible consequences of refusing treatment.
Assess the patient’s ability to make an informed decision.
You get a call to a home with a family, whose loved one had a DNR. The patient is deceased you should:
Select all that apply
A. Attempt to resuscitate the patient anyway.
B. Request the DNR.
C. Question why they would call.
D. Show respect and empathy.
E. Make sure the DNR order hasn’t expired.
F. Make sure it’s sign by physician or other healthcare professional.
B. Request the DNR.
D. Show respect and empathy.
E. Make sure the DNR order hasn’t expired.
F. Make sure it’s sign by physician or other healthcare professional.
Medical examiner cases include:
when a patient is dead on arrival.
Death without previous medical care or when the position is not able to state the cause of death.
Suicide.
Violent death.
Poisoning.
Death resulting from unintentional injuries.
Suspicion of criminal act.
Infant and child death.Makes it possible for EMT or EMS system to be held liable even when the plant is unable to clearly demonstrate how the injury occur under the theory of:
Res ipsa Loquitor
You arrive at a residence for a 14-year-old patient with severe abdominal pain. The patient’s grandmother, who is present, wants you to transport the child to the hospital. The child’s mother, who is also present and is the legal guardian, refuses evaluation and states that the child is fine.
A. Follow the grandmother’s wishes because she is requesting appropriate medical care.
B. Respect the mother’s refusal because she is the child’s parent and legal guardian.
C. Assess the child and determine whether an emergency medical condition exists that may require treatment despite the parent’s refusal.
D. Transport the child immediately because minors cannot legally refuse EMS care.
C. Assess the child and determine whether an emergency medical condition exists that may require treatment despite the parent’s refusal.