Preparatory

Safety & Wellness Infectious diseases Stress Scene Safety Immunizations Universal Precautions Hand Washing Procedures in Dept if Exposed Stress Signs of stress Strategies for reducing stress Proper diet, Exercise, Hobbies, Rest CISD when indicated Scene Safety Hazardous/ Violent

Safety and Wellness Lifting and Moving Patients Proper Body Mechanics Proper Equipment Personnel

Illness Disease Prevention Know your family medical history Get Regular Health screenings Smoking (don’t start or Quit) Adjust lifestyle to prevent hereditary diseases

Medical Legal Issues

Consent Expressed Consent Informed Consent Implied Consent Person wants help and asks for it Informed Consent Procedures explained to patient and they agree to treatment Implied Consent Unconscious patient or minor without guardian present Also called emergency doctrine

Consent Involuntary Consent Mentally Ill, psychological crisis, impaired, or developmentally delayed. May be court ordered May have to involve courts, law enforcement and medical command In life threatening situations fall back on implied consent or the emergency doctrine.

Restraining Patients Necessary if risk to self and others Consult Medical command Request assistance from law enforcement Soft restraints should be used to prevent injury Document all reasons for restraints and do not leave pt unattended Document assessment post restraints ie: PMS

Patient Refusals Adults that are conscious, alert and have decision making capacity Risks and Benefits of treatment should be explained. Document assessment, refusal, attempts to convince patient to accept treatment, alternative ways of seeking TX, witness to events with signatures of parties involved When in doubt consult medical command.

Confidentiality HIPAA Health Insurance portability and Accountability act of 1996 One section of act deals with PHI or protected health information Health info and identity info are considered PHI Can be shared among those caring for patient Can be used for QI and training providing all identifying info is removed.

Advanced Directives A legal document outlining treatment wishes should patient be unable to make decisions DNR do not resuscitate Must list medical problems Signature of patient or guardian Physician signature Must be current not expired. Medical power of attorney Is only activated in cases of incapacity If patient is conscious, alert and has capacity even if they have a MPOA the patient makes the desicions

Legal Terms Duty to Act – responsibility to provide care Negligence – failure to provide same care that a similarly trained person would provide Abandonment – terminating patient care without patient consent or providing for continuation of care. Assault – placing someone in fear of bodily harm Battery – touching someone without consent Kidnapping – seizing, confining, or taking someone away by force. (false imprisonment) Defamation – damaging someone’s reputation Libel written defamation Slander verbal defamation

Reportable incidents Child abuse Elder abuse At Risk adult abuse Crimes resulting in injuries Childbirth Dog bites Domestic violence Rapes Communicable diseases