1. Preparatory

2. 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

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

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

5. Medical Legal Issues

6. 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

7. 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.

8. 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

9. 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.

10. 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.

11. 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

12. 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

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