Chapter 3 Legal Responsibilities of the EMT. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 2 Overview Knowledge.

Chapter 3Legal Responsibilities of the EMT

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

2

Overview

Knowledge of Standard of Care Legal Duty to Act Respect for Patients’ Rights Obtaining Patient Consent Documentation


3

Overview

Initiating Resuscitation Collaborating with Law Enforcement Reporting Abuse Common Allegations against EMTs Protection against Lawsuits


4

Knowledge of Standard of Care

The law requires that an EMT act within the guidelines that are recognized as appropriate for others within the same level of training


5

Legal Duty to Act

An EMT is under contractual obligation to respond to calls


6

Respect for Patients’ Rights

Right to confidentiality– As in any medical field we are bound to

confidentiality no matter what the case is; this is a trust between caregiver and patient in all aspects of medicine


7


Health Insurance Portability and Accountability Act (HIPAA)

Sought to allow portability and continuity Standardization of administrative and

financial data exchange The protection of privacy, confidentiality, and

security of health care information


8


Right to refuse care– To refuse care, the patient must be of sound mind – The patient must be an adult.– Base station contact must be made– There must be complete documentation– State and county protocols should be followed


9


Against medical advice– Base station contact is mandatory– The patient should be told the risks of not being

transported and the benefits – A form should be filled out and signed by the

patient and a witness


10


Do not resuscitate orders– An order written by a physician, after consultation

with the patient or family (if the patient is unable to discuss treatment options)

– Check your local protocols for specific documentation rules


11

Stop and Review

State the legal obligations of the EMT. What does duty to act mean? Explain the importance of the patient’s

right to confidentiality.


12

Obtaining Patient Consent

Expressed or informed consent– A patient verbally agrees to treatment


13


Expressed or informed consent– A patient verbally agrees to treatment

Implied consent– The condition where an otherwise competent

person would want to be treated

Children and consent– Children cannot give consent for themselves– Attempt contact with a parent or guardian– Use implied consent to treat the patient


14


Children and consent– Children cannot give consent for themselves– Attempt contact with a parent or guardian– Use implied consent to treat the patient


15


Prisoners and consent– Emergency doctrine: a legal principle that allows

for emergency treatment of prisoners– Law enforcement will likely ride with you


16


Mentally disturbed patients– These patients can be treated under

implied consent– May have to have law enforcement there

to aid in an involuntary commitment– A mental health professional can also

do an involuntary commitment


17

Stop and Review

Can an adolescent consent to care? Are there exceptions?

Who can consent for an adolescent? What if they are unavailable?

What is the difference about consent in the “Consent” case study?

Can an adolescent legally refuse care? Are there exceptions?

What duties does the EMT have for the teenager in the “Consent” case study?


18

Documentation

Be complete with documentation– Be sure you state why you use implied consent– If law enforcement or mental heath is involved,

document the official’s name


19

Initiating Resuscitation

Generally, resuscitation should be done unless:– The patient has a DNR– There are obvious signs of death: decapitation,

lividity, rigor mortis, decomposition

When in doubt resuscitate!


20

Collaborating with Law Enforcement

Some emergency responses are also crime scenes

It is important to know how to respond in these situations and to preserve evidence to the best of one’s ability


21


Motor vehicle collisions – You may be called to testify about scenes

involving drunk drivers; these are crime scenes– Carefully document all of your findings with the

scene and the patient


22


Threat of violence on scene– Your safety is first!– Stage away until you know it is safe– If you are on a scene that becomes unsafe for

you, leave immediately--without the patient if necessary

– Be aware of weapons or objects that may be used as weapons


23


Physical restraint of combative patients– Restraints may be used if the patient is

a threat to himself or others– Refer to local laws – Always restrain face up– Calling law enforcement is advised


24

Reporting Abuse

Child abuse – Any act of physical, sexual,

or psychological maltreatment

Domestic violence – Acts of violence against a spouse,

partner, or family member

Elder abuse – An act of violence toward or neglect

of an elderly person


25

Stop and Review

What is the legal importance of documentation?

Under what circumstances can resuscitation be withheld?

How does EMS collaborate with law enforcement?


26

Common Allegations against EMTs

In a 1999 study published in the Journal of Emergency Medicine – 72% of lawsuits were the result of

motor vehicle accidents involving an emergency vehicle

– 35% of lawsuits were related to medical negligence


27


Ambulance collisions and liability– When driving an emergency vehicle, the EMT

has a responsibility to the crew, patients, other motorists, and pedestrians to operate in a safe manner

– You can be held responsible for collisions in many cases

– Emergency vehicle accident prevention classes are available nationwide


28


Negligence– Duty to act– Breach of duty– Causation of injury– Damages occurred


29


Patient abandonment– Begin care and leave the patient– You must turn the patient over to someone

of equal or higher care


30


Breach of confidentiality– The EMT holds privileged information and is

expected to keep it in the strictest of confidence


31


Assault – A patient is afraid that he or she may be touched

without consent

Battery– The actual act of being touched without consent

Good Samaritan Act– The legislation to protect you in your off duty time

if you render care within your scope of practice; this is also known as immunity statutes


32

Protection against Lawsuits

Good Samaritan Act– The legislation to protect you in your off duty time

if you render care within your scope of practice; this is also known as immunity statutes


33

Protection against Lawsuits

Best practices– The best strategy to avoid litigation is to use

common sense in everyday practice


34

Stop and Review

What is necessary to prove a case of negligence?

What should be included in documentation to avoid a lawsuit claiming negligence?

What laws help protect the EMT against litigation?

Chapter 3 Legal Responsibilities of the EMT. © 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 2 Overview Knowledge.

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