Transcript Unit 3

Unit 3
Legal Responsibilities
of the EMT
Overview
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Knowledge of standard care
Patient’s rights
Collaborating with law enforcement
Common allegations against an EMS
Protection against lawsuits
Introduction
• EMT has many legal responsibilities
• Legal duty to provide care in same
manner as other EMTs
• EMT must be familiar with pertinent
laws
The Legal Responsibilities of
an EMT
• Medical protocols
– Set of written regulations detailing proper
procedure for caring for patient
• Knowledge of standard of care
– EMTs must act within specific guidelines
• Legal duty to act
– Failure to treat patient within standard of
care may constitute patient abandonment
The Legal Responsibilities of
an EMT (cont’d.)
• Patient’s bill of rights
• Respect for patient’s rights
– Patient information must not be disclosed
without patient’s permission
– Failure to maintain confidential patient
information is breach of confidentiality
The Legal Responsibilities of
an EMT (cont’d.)
• Health insurance portability and
accountability act (HIPAA)
– Allows insurance portability and continuity
– Standardization of administrative and
financial data exchange
– Protection of privacy, confidentiality, and
security of health care information
The Legal Responsibilities of
an EMT (cont’d.)
• Obtaining patient consent
– Types of consent
• Informed consent
• Express consent
• Implied consent
– Children and adolescents
• In loco parentis: allows adult sibling or close
relative to give consent
The Legal Responsibilities of
an EMT (cont’d.)
• Obtaining patient consent (cont’d.)
– Prisoners, mentally disturbed persons, and
consent
• Emergency doctrine
• Courts may authorize specific treatments
• Preplanning can prevent legal problems later
The Legal Responsibilities of
an EMT (cont’d.)
• Right to refuse care
– AMA vs. RMA
• A refusal of medical assistance (AMA)
– Low priority or nonemergency situation
• Refusal against medical advice (RMA)
– Life threatening situation
– Advance directives
• Living will or do not resuscitate order (DNR)
• Health care proxy
The Legal Responsibilities of
an EMT (cont’d.)
The Legal Responsibilities of
an EMT (cont’d.)
• Documentation
– EMT’s report will become part of patient’s
medical record
– Accuracy and completeness are essential
• Initiating resuscitation
– Absence of pulse and breathing requires
start of CPR unless DNR order or
unambiguous signs of death are present
The Legal Responsibilities of
an EMT (cont’d.)
Collaborating with Law
Enforcement
• Challenges
– Treating patient who may
be participant in crime
– Trying not to disturb
evidence
– Knowing when a scene is a
crime scene
– Patient care takes priority
over evidence collection
Collaborating with Law
Enforcement (cont’d.)
• Motor vehicle collisions
–EMT should be evidence conscious
• May be asked to testify
• Consider as potential crime scene
• Carefully document observations
Collaborating with Law
Enforcement (cont’d.)
• Threat of violence on the scene
– Personal safety is first priority
– Never enter unsafe scene without police
• Physical restraint of combative patients
– EMT may use physical restraint to prevent
harm to patient or others
Reporting of Abuse
• Child abuse
– Special role in detecting and reporting child
abuse
• Mandated reporter
• Domestic violence
– Must be nonjudgmental and empathetic
• Elder abuse and neglect
– Social services referral system
Common Allegations
Against EMS
• Ambulance collisions and liability
– Operator responsible for damages or
injuries incurred due to lack of due regard
• Negligence
– Malpractice is damage to patient
– Tort law involves civil wrongs against
another
– Negligence is care given below standard
Common Allegations
Against EMS (cont’d.)
• Four elements of negligence
– Duty to act
– Breach of duty to act
– Causation of Injury
– Damages
Common Allegations
Against EMS (cont’d.)
• Patient abandonment
– Duty to continue care until relieved
– EMT can be held responsible for injuries
resulting from abandonment
• Assault and battery
– Transport of patient without consent may
result in charges of assault, battery, and
false imprisonment
Common Allegations
Against EMS (cont’d.)
• Breach of confidentiality
– The emergency medical treatment and
active labor act (EMTALA)
• Part of Consolidated Omnibus Budget
Reconciliation Act (COBRA)
• Known as “antidumping” law
• Protects patients whom hospitals might refuse
to care for
Protection Against Lawsuits
• Good Samaritan laws
– Encourages health care professionals to
help others in public situations
• Immunity statutes
– Protects health care providers from paying
damages for acts performed at work
• Best practices
– Follows protocols and use compassion
Conclusion
• Specific legal responsibilities vary from
state to state
• Advice of an attorney can be invaluable
• EMTs must protect themselves from
threat of legal action
• Best protection is good patient care and
conscientiousness