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3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
3)Medico Legal And Ethical Issues
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3)Medico Legal And Ethical Issues

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  • 1. Medical/Legal and Ethical Issues
  • 2. Confidentiality
    • Confidential information
      • Pt. history
      • Assessment findings
      • Treatment rendered
    • Releasing confidential information
      • Written release signed from pt/legal guardian
    • Written release not needed…
      • Receiving facility,Transporting agencies
      • Continuation of care
      • 3 rd party billing info
      • Continuing education (remove pt ID)
      • Sate law (rape, abuse, GSW)
      • Subpoena
      • 12VAC5-31-950. Disclosure of patient information.
  • 3. Reporting Requirements
    • Vary from state to state
    • Abuse
      • Child
      • Elderly
      • Spouse/family
    • Crime
      • Wounds form violent crime
      • Sexual assault
    • Infectious disease exposure
    • Pt. restraint laws
    • Mentally incompetent
      • Intoxicated with injuries
  • 4. Scope of Practice What You Do…
    • “ Range of activities & limitations of a given medical provider”
    • Defined by state legislation
    • References national curricula
    • May be enhanced by
      • Medical direction
      • Protocols
      • Standing orders
    • Va OEMS Scope of Practce
  • 5. Standard of Care What You Know…
    • “ Body of knowledge, laws, policies, common practices, standards, and guidelines that provide the basis for prehospital care”
    • Defined by protocols and sate certification
  • 6. Negligence
    • “ Deviation from standard of care that results in HARM to the pt.”
    • 4 Elements of Negligence
      • Duty to act
      • Breach of duty
      • Damage
      • Causal connection
    • ALL 4 must be proven
  • 7. Components of Negligence
    • Duty to Act
      • “ Legal requirement to assess and treat a pt”
      • Est. pt-provider relationship
      • Implied
        • Pt calls for ambulance and one is sent
        • Treatment is started
      • Formal
        • Contracts
      • Off duty EMT has NONE
  • 8. Components of Negligence
    • Breach of Duty
      • “ Negligent action/omission that has violated the standards of care expected for an EMT under the circumstances”
        • Ex. Perform a procedure incorrectly
          • Failing to act in a timely/appropriate manner
          • Failing to act in the circumstances required
          • Performing other skills deemed negligent
  • 9. Components of Negligence
    • Damage
      • Physical
      • Psychological
    • No damage= No case
  • 10. Components of Negligence
    • Causal Connection
      • Clear connection from injury to EMT actions
  • 11. Abandonment
    • “ Termination of pt care without assuring the continuation of care at the same level or higher”
  • 12. Good Samaritan Laws
    • Protects volunteers from litigation
    • Raises bar
      • Negligence
      • Gross negligence
        • “ Willful & wanton recklessness that would be so careless as to be dangerous”
      • Va Good Samaritan Law
  • 13. Consent
    • MUST be obtained before treatment
    • Types
      • Expressed
      • Implied
  • 14. Expressed Consent
    • Verbal or other gesture
    • Characteristics
      • Informed of risks/benefits
      • Legal age
      • Rational decisions
      • Conscious
      • Mentally competent
  • 15. Implied Consent
    • “ Consent assumed from the unconscious pt requiring aid”
    • Assumes a reasonable person would expect emergency care in the situation
  • 16. Consent Special Cases
    • Children/Mentally incompetent people
      • Consent from legal guardian/parent
      • Treat as implied if none found
    • Emancipation
      • 16 years old and:
        • Married
        • In armed forces
        • Lives independently of parents
          • Financially self supporting
        • Is/was a parent
        • Code of Va § 16.1-331 - 334
  • 17. Refusals
    • Pt has right to
      • Refuse Care
      • Withdraw consent at any time
    • Pt must be
      • Mentally competent
      • Informed of risks/consequences
      • Sing “release of liability” form
        • Get a witness
    • Complete PPCR
      • Narrative
      • Advice given
      • Planned treatments
  • 18.  
  • 19. Complications of Refusals
    • False imprisonment
      • Transport pt against will
    • Assault
      • Creating fear of injury
    • Battery
      • Touching someone without their permission
  • 20. Do No Resuscitate (DNR)
    • DNR
      • Legal order signed by doctor
      • Withholds lifesaving measures in event of resp/cardiac arrest
      • HAVE TO SEE ORIGINAL
        • OTHERWISE
      • Treat the pt
      • MUST TRANSPORT WITH PT
    • Types
      • DNR Form
      • DNR jewelry
      • “ Other DRN”
        • Written order by doctor
    • Providers
      • Cannot recognize DNR from other states
      • Va Durable DNR Fact Sheet
  • 21. Advanced Directives
    • Advance Directive
      • Withhold certain care but not others
      • Specific to the pt.
    • Healthcare Proxy/POA
      • Legally empowered person other than pt
      • Makes medical decisions for pt
      • Mentally incompetent pt.
  • 22. Special Situations
    • Donor/Organ Harvesting
      • EMT role
        • ID pt as possible donor
        • Est. communication with medical direction
        • Provide care to maintain viable organs
      • Documentation
        • Donor card
        • Back of drivers license
  • 23. Special Situations
    • Medical ID insignia
      • Bracelets
      • Earrings
      • Charms/Pendants
      • Cufflinks
      • Ring
    • ID pt with medical problems
      • Allergies
      • Epilepsy
      • Diabetes
      • DNR status
      • Etc…
  • 24. Special Situations
    • Crime Scenes
      • Ensure personal/personnel/pt safety
      • Notify police via dispatch if 1 st responding
      • Don’t disturb items
      • Don’t cut through holes/stabs in clothing
      • Preserve chain of evidence
      • DOCUMENT!!!!!!
  • 25. Risk Management
    • SAFETY
    • Act according to Standard of Care
    • DOCUMENT!
    • Act in interest of the pt.
  • 26. Take a beak!

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