1. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley CHAPTER Legal and Ethical Principles of Emergency Care 2

2. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 1.Define the following terms: a.Abandonment b.Advance directive c.Battery d.Breach of duty e.Civil law (tort) f.Competence Objectives (continued)

3. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 1.Define the following terms g.Competent h.Confidentiality i.Consent j.Criminal law k.Duty l.Duty to act Objectives (continued)

4. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 1.Define the following terms m.Emancipated minor n.Ethics o.Expressed consent p.Good Samaritan law q.Health Insurance Portability Accountability Act (HIPAA) Objectives (continued)

5. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 1.Define the following terms r.Implied consent s.Informed consent t.Mandated reporter u.Negligence v.Standard of care w.Unresponsive x.Values Objectives (continued)

6. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 2.Explain the concepts of “duty” and “breach of duty” as they relate to the Emergency Medical Responder. 3.Explain the term ethics and how it relates to the Emergency Medical Responder. 4.Explain the term Good Samaritan law and how these laws relate to the Emergency Medical Responder. 5.Explain the term mandated reporter and how it relates to the Emergency Medical Responder. Objectives (continued)

7. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 6.Differentiate the terms scope of practice and standard of care. 7.Compare and contrast the various types of consent utilized by the Emergency Medical Responder. 8.Explain the role of the Emergency Medical Responder for patients who refuse care. 9.Differentiate civil and criminal litigation. 10.Explain the common elements of an advance directive. Objectives (continued)

8. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 11.Explain the role of the Emergency Medical Responder when confronted with an advance directive. 12.Explain the role of the Emergency Medical Responder with regards to patient confidentiality. 13.Explain the role of the Emergency Medical Responder with respect to evidence preservation when working in or around an actual or potential crime scene. Objectives (continued)

9. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 14.Consistently model ethical behavior in all aspects of Emergency Medical Responder training and job performance. 15.Demonstrate compassion and empathy toward all classmates, coworkers, and simulated patients. 16.Participate willingly as a team member in all class/training activities. Objectives (continued)

10. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 17.Value the importance of maintaining patient confidentiality. 18.Demonstrate a desire to always do what is right for the patient. Objectives

11. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Topics Legal Duties Consent Advance Directives Negligence Abandonment Confidentiality Reportable Events Special Situations

12. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley LEGAL DUTIES

13. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Legal Duties “Good Samaritan laws” minimize exposure to liability; encourage bystanders to provide emergency care. – Requires individual providing care to do so without compensation and to remain within scope of practice. Duty: legal term that one is morally or legally obligated to provide care.

14. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Legal Duties Scope of Practice – What is legally permitted to be done by individuals trained or licensed at a particular level – Does not define what must be done for patient or in a particular situation – Based on EMS education standards

15. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Legal Duties Standard of Care – Varies county to county, state to state, region to region – Based on what is expected of someone with training and experience working under similar conditions – Expected to follow approved standing orders/protocols for your EMS system

16. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Different emergency personnel may be assisting during an emergency, including police, firefighters, and EMTs. Each must practice the standard of care expected of his own level of training. (© Mark C. Ide)

17. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Legal Duties Ethical Responsibilities – Ethics: study of principles that define behavior as right, good, and proper. – Patient's needs before own, so long as safe to do so. – Patient receives appropriate medical care. – Maintain open mind. (continued)

18. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Legal Duties Ethical Responsibilities – Develop understanding of differences. – Treat all people equally. – Provide highest standard of care. – Maintain and practice skills and knowledge. – Attend continuing education. (continued)

19. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Legal Duties Ethical Responsibilities – Be honest in reporting care provided. – Errors should be reported immediately. – Values are core beliefs that you hold to be true. (continued)

20. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Legal Duties Ethical Responsibilities – EMS values  Integrity  Compassion  Accountability  Respect  Empathy

21. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It How can understanding legal/ethical issues help the EMR make better decisions? How does scope of practice and standard of care differ? How can embracing ethical values help the EMR serve as a better patient advocate?

22. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley CONSENT

23. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Legal term to give formal permission for something to happen EMRs must receive permission from patients before legally providing care

24. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Competence – Being adequately or well qualified to make decisions both physically and intellectually

25. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Patient may not be competent to make medical decisions  Being a minor  Intoxication  Drug ingestion  Serious injury  Mental illness

26. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Expressed Consent – Competent adult's informed decision to accept emergency care provided by an EMR (informed consent). – By law, only parent or guardian of child may give consent or refuse care. (continued)

27. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Expressed Consent – Advise patient of following:  Tour level of training  Why you think care may be necessary  What care you plan to provide  Any consequences related to refusing care

28. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Implied Consent – Legal position assumes that unresponsive or incompetent adult patient would consent to receiving emergency care if he/she could. – Law assumes parents would want care to be provided for their child.

29. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Use implied consent to provide care to a minor when a parent or guardian is not available.

30. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Emancipated Minor – Legally allowed to make their own decisions regarding medical care.  Married  Pregnant  Parent  Member of armed forces  Financially independent; living away from home

31. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Refusal of Care – Alert and competent adults have the right to refuse care. – Restraining or threatening to restrain patient against his/her wishes could result in violation of criminal law. – Parent/legal guardian can refuse to let you care for a child. (continued)

32. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Consent Refusal of Care – When care is refused:  Stay calm and professional.  Inform patient of potential dangers of refusal.  Use aid of someone patient trusts.  Carefully document refusal of care.

33. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It What must the EMR receive from a patient in order to provide care? How can the EMR determine competence of a patient to refuse care? EMRs must not leave a patient refusing care until someone with higher training assumes care.

34. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley ADVANCE DIRECTIVES

35. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Advance Directives Document that allows a patient to define in advance what his/her wishes are should he/she become incapacitated due to medical illness or severe injury.

36. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Advance Directives Designation of agent to make decisions on your behalf Do Not Resuscitate (DNR) order Choice to prolong or not prolong life Pain relief options Donation of organs

37. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Advance Directives Do Not Resuscitate (DNR) Orders – Written legal document, signed by patient and physician. – States patient has terminal illness and does not wish to prolong life through resuscitative efforts. – Does not mean “do not care.”

38. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It What is the benefit of having an Advance Directive? EMRs must be familiar with their state's regulations and forms in use. You respond to a nursing home where an elderly female is having difficulty breathing. She has a valid DNR. Is it acceptable to withhold oxygen?

39. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley NEGLIGENCE

40. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Negligence Failure to provide expected standard of care. Four elements to determine if negligent: – Duty to act – Breach of duty – Damages – Causation

41. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Negligence EMRs have a legal duty to act. – A legal duty to act has been established if care is offered and accepted by patient. – Provide care according to agency's standard operating procedures. – Laws vary from state to state.

42. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Negligence General rule: advise patient to accept treatment by EMTs. State “Good Samaritan” laws may offer protection from civil liability; be familiar with your own state's laws.

43. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It What are the four elements required to prove negligence? By what standard will the EMR be judged?

44. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley ABANDONMENT

45. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Abandonment To leave sick or injured patient before equal or more highly trained personnel can assume responsibility for care. Could include failure to provide patient information during transfer to more highly trained personnel. Inform provider accepting care of facts gathered, assessment made, and care rendered.

46. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It You are on scene with an adult who has fallen and is complaining of only ankle pain. The ambulance has not arrived yet. A “child not breathing” call is dispatched in your immediate vicinity but the other EMR unit responding is across town. What do you do?

47. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley CONFIDENTIALITY

48. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Confidentiality Treatment of information that individual has disclosed in relationship of trust and with expectation that it will not be divulged to others. Protect patient's right to privacy. Information only released if patient has authorized to do so in writing.

49. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Confidentiality Authorization not required for you to pass on patient information to other health-care providers. Health Insurance Portability and Accountability Act (HIPAA) gives patients more control over their healthcare information and limits ways that information is stored and shared.

50. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley During transfer, sharing of information with those involved in the care of the patient is a necessary and important part of good patient care.

51. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It How might an EMR unwittingly reveal confidential information? You respond to a duplex where a 30- year-old male appears to have over- dosed. The EMTs arrive on scene and assume care. The patient's parents who live next door enter the room and ask you what happened. What do you tell them?

52. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley REPORTABLE EVENTS

53. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Reportable Events All 50 states have laws that define mandatory reporters and what types of events they must report. May include: – Exposures to infectious diseases – Suspicious burns – Vehicle crashes – Drug-related injuries

54. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Reportable Events May include: – Crimes that result in knife or gunshot wounds – Child and elder abuse – Domestic violence – Rape

55. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It Understand the reporting requirements for your state. Keep report forms and phone numbers needed in a readily available location. Do not assume someone else on scene will handle the report.

56. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley SPECIAL SITUATIONS

57. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Special Situations Organ Donors – Patient completed legal document that allows for donation of organs and tissues in event of death. – Care must not differ in any way from care of patient who is not a donor. – Oxygen delivered to body cells by CPR will help preserve the organs.

58. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Special Situations Medical Identification Devices – Necklace, arm/ankle bracelet, or card meant to alert EMS personnel that patient has particular medical condition (heart problem, allergies, diabetes, epilepsy). – May provide important medical information. (continued)

59. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Special Situations Medical Identification Devices – Some areas use “Vial of Life” program. – Special vial where important medical information is stored. – Window sticker alerts EMS to vial kept in patient's refrigerator.

60. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley The Medic Alert bracelet is one example of a medical identification device (front shown).

61. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley The Medic Alert bracelet is one example of a medical identification device (back shown).

62. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Special Situations Crime Scenes – Location where crime has been committed or place where evidence relating to crime may be found. – Do not enter scene until instructed to do so by law enforcement. – Make as little impact on scene as possible to preserve evidence.

63. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It Organ donors receive the same care as those who are not donors. True or False? Aside from medical alert tags, where else might you find health information? Minimize impact on crime scenes (e.g., touch/move little, don't cut through holes in clothing from GSW or stabbing).

64. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley SUMMARY

65. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Summary Legal duty to provide care and must do so within scope of practice. Must maintain high degree of integrity as well as ethical and moral standards when caring for patients. Have a responsibility to keep both knowledge and skills up-to-date.

66. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Summary Must obtain consent from every victim and be able to apply principles of expressed and implied consent. Properly manage and document all patients who refuse care and enlist law enforcement when necessary.

67. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Summary Could be accused of negligence if you do not provide acceptable level of care or if you abandon patient. Must respect privacy and confidentiality of all patients and refrain from sharing information about patients unless legally allowed or required to do so.

68. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley REVIEW QUESTIONS

69. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 1.Explain the concepts of: a.duty to act b.breach of duty c.ethics 2.What is the difference between scope of practice and standard of care? 3.How does the Good Samaritan law in your area relate to the EMR? 4.What is the difference between civil and criminal litigation? Review Questions

70. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 5.What are the different types of consent? 6.Explain the role of the EMR with regard to: a.Refusal of care b.Advance directives c.Patient confidentiality d.Mandated reporting e.Crime scene preservation Review Questions

71. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Please visit www.bradybooks.com and follow the Resource Central links to access content for this text. www.bradybooks.com