Transcript Chapter 24 Poisoning and Overdose

Introduction to Emergency
Medical Care
1
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Chapter 3
Medical, Legal,
and Ethical Issues
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National EMS Education
Standard Competencies (1 of 3)
Preparatory
Applies fundamental knowledge of the
emergency medical services (EMS) system,
safety/well-being of the emergency medical
technician (EMT), medical/legal, and ethical
issues to the provision of emergency care.
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National EMS Education
Standard Competencies (2 of 3)
Medical/Legal and Ethics
• Consent/refusal of care
• Confidentiality
• Advanced directives
• Tort and criminal actions
• Evidence preservation
• Statutory responsibilities
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National EMS Education
Standard Competencies (3 of 3)
Medical/Legal and Ethics (cont’d):
• Mandatory reporting
• Ethical principles/moral obligations
• End-of-life issues
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OBJECTIVES
4.1
4.2
4.3
4.4
Define key terms introduced in this chapter. Slides
11–12, 14, 16–22, 24, 26–32, 34–35, 39
Describe your scope of practice as an EMT. Slides
11–12
Differentiate between scope of practice and
standard of care. Slide 12
Given a variety of scenarios, determine which type
of patient consent applies. Slides 16–19
continued
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OBJECTIVES
4.5
4.6
4.7
Given a variety of ethical dilemmas, discuss the
issues that must be considered in each situation.
Slides 13, 30
Explain legal and ethical considerations in situations
where patients refuse care. Slides 20–23
Discuss the EMT’s obligations with respect to
advance directives, including do not resuscitate
orders. Slide 24
continued
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OBJECTIVES
4.8
4.9
4.10
Given a variety of scenarios, identify circumstances
that may allow a claim of negligence to be
established. Slides 27–30
Explain the purpose of Good Samaritan laws. Slide
30
Identify situations that would constitute a breach of
patient confidentiality. Slide 32
continued
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Objectives
OBJECTIVES
4.11
4.12
4.13
Identify situations that would constitute libel or
slander. Slide 32
Recognize medical identification devices and organ
donor status. Slides 33–34
List items that may be considered evidence at a
crime scene. Slide 39
continued
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OBJECTIVES
4.14
4.15
4.16
Describe ways in which you can minimize your
impact on evidence while meeting your obligations
to care for your patient. Slides 36, 38
Recognize situations that may legally require
reporting to authorities. Slide 39
Given a scenario involving an ethical challenge,
decide the most appropriate response for an EMT.
Slides 22, 45–46
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MULTIMEDIA
• Slide 14
Legal Issues in Healthcare Video
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CORE CONCEPTS
• The scope of practice of an EMT
• How a patient may consent to or refuse
emergency care
• The legal concepts of negligence, torts,
and abandonment
• What it means to have a duty to act
• The responsibilities of an EMT at a crime
scene
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Topics
• Scope of Practice
• Patient Consent and Refusal
• Other Legal Issues
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Introduction (1 of 2)
• A basic principle of emergency care is to
do no further harm.
• A health care provider usually avoids
legal exposure if he or she acts:
– In good faith
– According to an appropriate standard of care
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Introduction (2 of 2)
• The EMT is often the first link in the chain
of prehospital care.
• Litigation against EMS will increase due
to wider availability and more complex
care.
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Scope of Practice
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Scope of Practice
• Regulations and ethical considerations
that define extent or limits of job duties
• May include skills and procedures
• Determined by national, state, local laws,
statutes, and protocols
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Standard of Care
• Care expected from EMT with similar
training for patient in a similar situation
• Meeting standard of care reduces risk of
legal action
• Scope of practice: what you can do
• Standard of care: how you should do it
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Ethics
•
•
•
•
•
Morals or standards governing actions
Not always required by law
“Golden Rule” standard
Very important in EMS
Good ethical behavior—what you do when
no one is looking
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Legal Issues
in Health Care Video
Click here to view a video on the topic of legal issues in health care.
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Patient Consent and Refusal
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Patient Consent
• Permission from patient to assess, treat,
and transport
• Expressed consent
– Must be informed
• Implied consent
– Assumed consent
– Follow local laws and protocols
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Consent for Children
• Minors not permitted to provide consent
for treatment
• Obtain from parent or legal guardian
• Possible exceptions (check local law)
– In loco parentis
– Emancipated minors
– Life-threatening illness or injury
– Minors who have children
– Minors serving in armed forces
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Consent for
Mentally Incompetent Adults
• Adult patients incapable of informed
decisions about care
• State and local laws and protocols permit
transport of such patients under implied
consent
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Expressed Consent
• Patient acknowledges he or she wants
you to provide care or transport.
• To be valid, patient must provide informed
consent.
– You have explained treatment, risks, and
benefits to patient.
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Consent: Expressed
Patient of legal age and rational
Must be informed consent
Must be obtained from conscious,
competent adults before treatment
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Implied Consent (1 of 2)
• Applies to patients who are
– Unconscious
– Otherwise incapable of making informed
decision
Source: © Dan Myers
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Implied Consent (2 of 2)
• Should never be used unless there is a
threat to life or limb.
• Principle of implied consent is known as
the emergency doctrine.
• Good to get consent from a spouse or
relative.
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Consent: Implied
Consent implied for unconscious patient
Based on the assumption the patient
would consent if conscious
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Consent: Children and
Incompetent Adults
Consent required from
parent/guardian
Consent implied in life-threatening
emergency
State regulations vary for age and
emancipation
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Involuntary Consent
• Applies to patients who are:
– Mentally ill
– In behavioral crisis
– Developmentally delayed
• Obtain consent from guardian
– Not always possible, so understand local
provisions
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Involuntary Transportation
• Patient considered threat to self or others
• Court order
• Usually requires decision by mental health
professional or police officer
• If patient restrained, must not risk legal
liability
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The Right to Refuse Treatment
(1 of 2)
• Conscious, alert adults with decisionmaking capacity:
– Have the right to refuse treatment
– Can withdraw from treatment at any time
– Even if the result is death or serious injury
• Places burden on EMT to clarify need for
treatment
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The Right to Refuse Treatment
(2 of 2)
• Before you leave a scene where a
patient, parent, or caregiver has refused
care:
– Encourage them again to allow care.
– Ask them to sign a refusal of care form.
– Document all refusals.
– A witness is valuable in these situations.
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Refusal of Care
• Patient may refuse care or transport
– Legally able to consent
– Mentally competent and oriented
– Fully informed of risks
– Sign release form
• Despite all precautions, EMT may still be
held liable
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If in Doubt About Refusal
•
•
•
•
•
•
Discuss decision with patient
Ensure patient understands risks
Consult medical direction
Ask to contact family member
Contact law enforcement
Listen to patient to determine why refusing
care
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Patient Refusal
When in doubt, err in favor of providing
care!
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Think About It
• What are the risks of beginning treatment
and/or transport without getting consent
from the patient?
• What if the patient refuses to sign the
refusal of care form?
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Things to
Consider During Refusal
• Have witnesses to refusal
• Inform patient that if changes mind, can
call back
• If possible have friend or relative remain
with patient
• Document, document, document
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Advance Directives:
DNR Orders
Patient has the right to refuse
resuscitative efforts.
Usually requires written physician order
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Advance Directives
• Legal document expressing patient’s
wishes if patient unable to speak for self
• Do not resuscitate order (DNR)
• Living will
• Health care proxy
• Does not prevent EMT from providing
comfort measures
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Other Legal Issues
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Duty to Act
• Obligation to provide care
• While on duty, EMT obligated to provide
care if no threat to safety
• Duty to act not always clear
– Off duty
– On duty, out of jurisdiction
• Follow local laws and protocols
• Follow own conscience
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Duty to Act
• Individual’s responsibility to provide
patient care
• Duty to act applies:
– Once your ambulance responds to a call
– Treatment is begun
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Negligence (1 of 2)
• Failure to provide same care that person
with similar training would provide in
same or similar situation.
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Negligence (2 of 2)
• All four of the following elements must be
present for negligence to apply:
– Duty
– Breach of duty
– Damages
– Causation
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Negligence
• Something was not done, or was done
incorrectly
• Must prove:
– EMT had duty to act
– Breach of duty—EMT failed to provide
standard of care expected or failed to act
– Proximate causation—patient suffered harm
because of EMT action or inaction
continued
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Negligence
• Negligent EMT may be required to pay
damages
• Res ipsa loquitur (the thing speaks for
itself): legal concept important in
negligence cases
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Abandonment
• Once care initiated, may not be
discontinued until transferred to medical
personnel of equal or greater training
• Failure to do so may constitute
abandonment
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Physical Signs of Death (1 of 4)
• A physician determines cause of death.
• Presumptive signs of death:
– Unresponsiveness to painful stimuli
– Lack of a carotid pulse or heartbeat
– Absence of breath sounds
– No deep tendon or corneal reflexes
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Physical Signs of Death (2 of 4)
• Presumptive signs of death (cont’d):
– Absence of eye movement
– No systolic blood pressure
– Profound cyanosis
– Lowered or decreased body temperature
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Physical Signs of Death (3 of 4)
• Definitive signs of death:
– A body in parts (decapitation)
– Dependent lividity (blood settling)
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Physical Signs of Death (4 of 4)
• Definitive signs of death (cont’d):
– Rigor mortis (stiffening)
– Putrefaction (decomposition)
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Medical Examiner Cases (1 of 2)
• Involvement depends on nature/scene of
death.
• Examiner notified in cases of:
– Dead on arrival (DOA)/dead on scene (DOS)
– Death without previous medical care
– Suicide
– Violent death
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Medical Examiner Cases (2 of 2)
• Examiner notified in cases of (cont’d):
– Poisoning, known or suspected
– Death from accidents
– Suspicion of a criminal act
Source: © Corbis
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Good Samaritan Laws
• Grant immunity from liability if person acts
in good faith within level of training
• Rarely applies to on-duty personnel
• May not cover EMTs in some situations
• Does not protect persons from gross
negligence or violations of law
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Good Samaritan Laws and
Immunity (1 of 2)
• If you reasonably help another person,
you will not be held liable for
error/omission
• Good Samaritan actions to be met:
– Good faith
– Without expectation of compensation
– Within scope of training
– Did not act in grossly negligent manner
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Good Samaritan Laws and
Immunity (2 of 2)
• Gross negligence is conduct that
constitutes willful or reckless disregard.
• There is another group of laws that grants
immunity from liability to official providers.
– Laws vary; always consult with the medical
director.
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Think About It
• You arrive on the scene of a patient in
cardiac arrest. The family says she has a
DNR, but don’t know where it is. How
should you handle this?
• You are off duty and arrive on the scene of
a vehicle crash. Police and EMS have not
yet arrived. Are you legally obligated to
stop and render aid?
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Confidentiality
• Information on patient’s history, condition,
treatment considered confidential
• Can be shared with other health care
personnel as part of patient’s continuing
care
• Otherwise must be obtained through
subpoena
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Confidential Information
Patient history
Assessment findings
Treatment rendered
Written release required to release
information
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Confidential Information
Exceptions to written release:
Subpoena
Other health care personnel treating
patient
Mandatory reporting (rape, abuse)
Insurance
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HIPAA
Health Insurance Portability and
Accountability Act mandates increased
privacy of patient-specific medical
information and their:
Record keeping
Storage
Access
Discussion
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Medical Identification Devices
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Organ Donor
• Person with completed legal document
allowing donation of organs and tissues in
event of death
• May be identified by family members,
donor card, driver’s license
• Receiving hospital and/or medical
direction should be advised per protocol
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Safe Haven Laws
• Allow person to drop an infant or child at
any fire, police, or EMS station
• States have different guidelines for ages of
children included
• Protect children who may otherwise be
abandoned or harmed by parents unwilling
or unable to care for them
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Crime Scenes
• Location where crime
was committed or
anywhere evidence may
be found
• Once police have made
scene safe, EMT’s
priority is patient care
• Know what evidence is
• Take steps to preserve
evidence
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Examples of Evidence
•
•
•
•
Condition of scene
Patient
Fingerprints and footprints
Microscopic evidence
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Evidence Preservation
•
•
•
•
Remember what you touch
Minimize impact on scene
Work with police
If patient transported on your stretcher,
stretcher sheet may be valuable source of
evidence
• Document thoroughly
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Mandatory
Reporting Guidelines
•
•
•
•
•
Child, elderly, or domestic abuse
Sexual assault
Stab/gunshot wounds
Animal attacks
Check local laws and protocols
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Chapter Review
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Chapter Review
• Medical, legal, ethical issues part of every
EMS call.
• Morals are how a person expresses
beliefs of right and wrong.
• Consent may be expressed or implied
continued
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Chapter Review
• If a competent patient refuses care or
transport, you should make every effort to
persuade him, but you cannot force him to
accept care or go to the hospital.
• Negligence is failing to act properly when
you have a duty to act.
continued
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Chapter Review
• Abandonment is leaving a patient after you
have initiated care and before you have
transferred the patient to a person with
equal or higher training.
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Remember
• EMTs must use good judgment and
decision-making skills when dealing with
patient consent and refusal.
• Avoiding negligence implies using good
judgment; critical thinking is an essential
component for avoiding liability.
continued
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Remember
• EMTs hold responsibility for patients’
protected health information; exercising
care when dealing with this information is
a legal and ethical obligation.
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Questions to Consider
• Define scope of practice, negligence, duty
to act, abandonment, and confidentiality.
• What steps must you take when a patient
refuses care or transportation?
• What types of evidence may be found at a
crime scene? How should you act to
preserve evidence?
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Critical Thinking
• You respond to a motor vehicle crash and
find a seriously injured patient. He has no
pulse and you are about to begin CPR
when someone says, “Don’t do that! He’s
got cancer and a DNR!” No one has the
DNR at the scene. Do you start CPR and
transport the patient?
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Summary (1 of 8)
• Consent is generally required from a
conscious adult before care can be
started.
• Never withhold lifesaving care unless a
valid DNR order is present.
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Summary (2 of 8)
• A parent or legal guardian must give
consent for treatment or transport of a
minor.
• Conscious, alert adults have the right to
refuse treatment or withdraw from
treatment.
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Summary (3 of 8)
• Patient communication is confidential.
• Advance directives, living wills, or health
care directives are often used when a
patient becomes comatose.
• There are both definitive and presumptive
signs of death.
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Summary (4 of 8)
• A donor card or driver’s license indicates
consent to organ donation.
• Standard of care is established in many
ways.
• When your ambulance responds to a call
or treatment is begun, you have a legal
duty to act.
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Summary (5 of 8)
• Negligence is based on duty, breach of
duty, damages, and causation.
• Abandonment is termination of care
without the patient’s consent or
provisions for transfer of care.
• Assault is unlawfully placing a person in
fear of immediate bodily harm.
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Summary (6 of 8)
• Battery is unlawfully touching a person,
which includes providing emergency care
without consent.
• Good Samaritan laws protect persons
who stop to render aid.
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Summary (7 of 8)
• Records and reports are important,
particularly if a case goes to court.
• You should know the special reporting
requirements for abuse of children, the
elderly, and others; injuries related to
crimes; drug-related injuries; and
childbirth.
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Summary (8 of 8)
• You must meet legal and ethical
responsibilities while caring for the
patient’s physical and emotional needs.
• As an EMT, a number of situations might
cause you to end up in court.
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Review
1. You arrive at the scene of an elderly lady
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.
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Review
Answer: C
Rationale: Expressed consent (also called
actual consent) is when the patient
authorizes you to provide treatment and
transport, either verbally or nonverbally. For
example, a patient who holds out his or her
arm to allow you take a blood pressure is
nonverbally giving you expressed consent.
Emergency Care, Twelfth Edition
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Review (1 of 2)
1. You arrive at the scene of an elderly lady 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.
Rationale: Implied consent is limited to life-threatening
emergencies and is appropriate when a person is
unconscious and/or delusional.
B. informed consent.
Rationale: Informed consent is when the patient has
been told of the specific risks, benefits, and alternative
treatments.
Emergency Care, Twelfth Edition
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Review (2 of 2)
1. You arrive at the scene of an elderly lady complaining of
chest pain. In assessing her, she holds her arm out for
you to take her blood pressure. This is an example of:
C. expressed consent.
Rationale: Correct answer. It is also known as actual
consent.
D. emergency consent.
Rationale: This does not exist as a form of consent.
Emergency Care, Twelfth Edition
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Review
2. 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 EMR is transferred patient care from an
AEMT.
Emergency Care, Twelfth Edition
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Answer: D
Rationale: Abandonment occurs when
patient care is terminated without the
patient’s consent or when care is
transferred to a provider of lesser training
and level of certification.
Emergency Care, Twelfth Edition
Limmer • O’Keefe • Dickinson
Copyright ©2012 by Pearson Education, Inc.
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Review (1 of 2)
2. Which of the following is an example of abandonment?
A. An EMT leaves the scene after a competent adult has
refused care.
Rationale: Mentally competent adults have the right to
refuse treatment or withdraw from treatment at any time.
B. An EMT transfers care of a patient to an emergency
department nurse.
Rationale: An EMT can transfer care to someone of
equal or higher medical authority.
Emergency Care, Twelfth Edition
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Review (2 of 2)
2. Which of the following is an example of abandonment?
C. An AEMT transfers care of a patient to a Paramedic.
Rationale: An AEMT can transfer care to someone of
equal or higher medical authority.
D. An EMR is transferred patient care from an AEMT.
Rationale: Correct answer
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review
3. The unauthorized confinement of a
person is called:
A. assault.
B. battery.
C. false imprisonment.
D. slander.
Emergency Care, Twelfth Edition
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Answer: C
Rationale: False imprisonment is defined as
the confinement of a person without legal
authority or the person’s consent.
Emergency Care, Twelfth Edition
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Review (1 of 2)
3. The unauthorized confinement of a
person is called:
A. assault.
Rationale: Assault is unlawfully placing a person in fear of
bodily harm.
B. battery.
Rationale: Battery is touching a person or providing care
without consent.
Emergency Care, Twelfth Edition
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Review (2 of 2)
3. The unauthorized confinement of a
person is called:
C. false imprisonment.
Rationale: Correct answer.
D. slander.
Rationale: Slander is false and damaging information about
a person that is communicated by the spoken word.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review
4. 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
Emergency Care, Twelfth Edition
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Answer: C
Rationale: An EMT could be held liable for
negligence if he or she fails to provide the
same care as another EMT with the same
training would provide in the same situation.
For example, if an EMT fails to give oxygen
to a patient with shortness of breath (an
intervention that is clearly indicated), he or
she may be held liable for negligence.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review
4. Failure of the EMT to provide the same care as another
EMT with the same training is called:
A. Libel
Rationale: Libel is making a false statement in a written
form that injures a good person’s name.
B. Slander
Rationale: Slander is verbally making a false statement
that injures a good person’s name.
C. Negligence
Rationale: Correct answer
D. Abandonment
Rationale: Abandonment is the abrupt termination of
contact with a patient.
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5. 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. only provide airway management until the parents are
contacted.
Emergency Care, Twelfth Edition
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Answer: A
Rationale: The child in this scenario is
critically-injured and requires immediate
treatment and transport; waiting until his
parents are contacted wastes time and
increases his chance of a negative outcome.
If you are unable to contact a minor’s
parents or legal guardian, you should
proceed with care based on the law of
implied consent.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review (1 of 2)
5. 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.
Rationale: Correct answer
B. cease all treatment until the child’s parents can be
contacted.
Rationale: If a true emergency exists, then
consent is implied.
Emergency Care, Twelfth Edition
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Review (2 of 2)
5. 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:
C. continue with treatment only if authorized by medical
control.
Rationale: If a true emergency exists, then
consent is implied.
D. only provide airway management until the parents are
contacted.
Rationale: If a true emergency exists, then
consent is implied.
Emergency Care, Twelfth Edition
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Review
6. 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
Emergency Care, Twelfth Edition
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Review
Answer: C
Rationale: An advance directive is a written
document signed by the patient and a
witness that specifies the medical care that
should be provided if the patient loses
decision-making capacity (ie, he or she is no
longer deemed competent).
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review (1 of 2)
6. An advance directive is:
A. a set of specific guidelines that clearly defines the
different types of consent.
Rationale: An Advance Directive specifies the specific
care a patient will receive and does not address any
type of consent.
B. a formal list that defines by state law whether a patient
has decision-making capacity.
Rationale: An Advance Directive document has already
determined that a patient was competent to make
decisions when the document was created and signed.
Emergency Care, Twelfth Edition
Limmer • O’Keefe • Dickinson
Copyright ©2012 by Pearson Education, Inc.
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Review (2 of 2)
6. An advance directive is:
C. a written document that specifies the care you should
provide if the patient is unable to make decisions.
Rationale: Correct answer
D. a verbal order given to you by a dying patient's family
regarding whether treatment should be provided.
Rationale: An Advance Directive is a written order that
defines the patient’s medical decisions.
Emergency Care, Twelfth Edition
Limmer • O’Keefe • Dickinson
Copyright ©2012 by Pearson Education, Inc.
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Review
7. 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
only drank 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
Emergency Care, Twelfth Edition
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Review
Answer: C
Rationale: A patient who is of legal age (18
in most states), is conscious, and is alert to
person, place, time, and event, likely has
decision-making capacity and can legally
refuse EMS care. However, patients who are
confused, possibly intoxicated, or delusional
are not capable of making a rationale
decision; therefore, you should provide care
based on the law of implied consent.
Emergency Care, Twelfth Edition
Limmer • O’Keefe • Dickinson
Copyright ©2012 by Pearson Education, Inc.
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Review (1 of 2)
7. 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
Rationale: You must assess whether this patient’s
mental condition is impaired.
B. A man who is staggering and states that he only drank
three beers
Rationale: You must assess whether this patient’s
mental condition is impaired.
Emergency Care, Twelfth Edition
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Review (2 of 2)
7. Which of the following patients is competent and can
legally refuse EMS care?
C. A conscious and alert woman who is in severe pain from
a broken leg
Rationale: Correct answer
D. A diabetic patient who has slurred speech and is not
aware of the date
Rationale: You must assess whether this patient’s
mental condition is impaired.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review
8. 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.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Answer: A
Rationale: Unlawfully placing a person in
fear of immediate bodily harm (ie, having
him restrained) without his consent
constitutes assault. Unlawfully touching a
person without his or her consent constitutes
battery.
Emergency Care, Twelfth Edition
Limmer • O’Keefe • Dickinson
Copyright ©2012 by Pearson Education, Inc.
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Review (1 of 2)
8. 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.
Rationale: Correct answer
B. battery.
Rationale: Battery is unlawfully touching a
person. This includes care without consent.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review (2 of 2)
8. 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:
C. negligence.
Rationale: Negligence is failure to provide the same
care that a person with similar training would provide.
D. abandonment.
Rationale: Abandonment is the unilateral termination of
care without the patient’s consent.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review
9. 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.
Emergency Care, Twelfth Edition
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Review
Answer: B
Rationale: The EMT—paid or volunteer—
has a legal duty to act if he or she is on duty
and is dispatched on a call, regardless of the
nature of the call. If the EMT is off duty
and/or out of his or her jurisdiction, he or she
has a moral obligation to act, but not
necessarily a legal one.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review
9. The EMT has a legal duty to act if he or she is:
A. off duty and witnesses a major car accident.
Rationale: This is a moral obligation to act and not a
legal one.
B. a volunteer, is on duty, and is dispatched on a call.
Rationale: Correct answer
C. paid for his or her services, but is not on duty.
Rationale: Whether paid or volunteer, the EMT must be
on duty.
D. out of his or her jurisdiction and sees a man choking.
Rationale: This is a moral obligation to act, and not a
legal one.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Review
10. Which of the following statements about
records and reports is FALSE?
A. Legally, if it wasn't 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
Emergency Care, Twelfth Edition
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Review
Answer: D
Rationale: One of your most important safeguards
against legal problems is a complete, accurate report;
if it wasn’t documented, it wasn’t done! Furthermore,
an incomplete or untidy patient care report (PCR)
suggests incomplete or inexpert medical care. The
PCR becomes a part of the patient’s hospital medical
record; even though your treatment was provided
outside the hospital, the PCR ensures continuity of
care in the hospital.
Emergency Care, Twelfth Edition
Limmer • O’Keefe • Dickinson
Copyright ©2012 by Pearson Education, Inc.
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Review (1 of 2)
10. Which of the following statements about records and
reports is FALSE?
A. Legally, if it wasn't documented, it was not performed
Rationale: True. If it was not written, then it was not
performed.
B. A complete, accurate report is an important safeguard
against legal problems
Rationale: True. The most important safeguard against
legal problems is a complete, accurate report.
Emergency Care, Twelfth Edition
Limmer • O’Keefe • Dickinson
Copyright ©2012 by Pearson Education, Inc.
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Review (2 of 2)
10. Which of the following statements about records and
reports is FALSE?
C. An incomplete or untidy patient care report is evidence
of incomplete or inexpert emergency medical care
Rationale: True. An incomplete or untidy report equals
incomplete or inexpert emergency 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
Rationale: Correct answer
Emergency Care, Twelfth Edition
Limmer • O’Keefe • Dickinson
Copyright ©2012 by Pearson Education, Inc.
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Credits
• Chapter Opener: © Steve Hamblin/Alamy
Images
• Background slide image (ambulance): ©
Galina Barskaya/ShutterStock, Inc.
• Background slide images (nonambulance): © Jones & Bartlett Learning.
Courtesy of MIEMSS.
Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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Emergency Care, Twelfth Edition
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Copyright ©2012 by Pearson Education, Inc.
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