UNDERSTAND Medical Legal for EMTs

Summary

This educational video script covers key concepts for emergency medical technicians (EMTs) and paramedics, emphasizing the importance of adhering to scope of practice, protocols, and standing orders. It delves into negligence, detailing types like malfeasance, misfeasance, and nonfeasance, and stresses the significance of proper patient care transfer to avoid abandonment. The script also discusses consent, including express, informed, and implied consent, and the legal aspects of Good Samaritan laws and immunity for first responders. It addresses the handling of minors, DNR orders, and advanced directives. Finally, it provides guidance on recognizing signs of death, including rigor mortis and lividity, and offers resources for EMT and paramedic students.

Takeaways

• 📚 Scope of Practice: Understand the boundaries of your care as defined by state laws and protocols.
• 📖 Protocols: Adhere to written or digital guidelines that detail actions for each provider level in treating patients.
• 🏥 Standing Orders: Know what actions you can take without contacting medical control, such as dosing medications.
• 🛡 Standard of Care: Be aware of the expected actions of an EMT or paramedic in various scenarios and document deviations.
• ❌ Negligence: Recognize the difference between simple negligence, gross negligence, and its subtypes like malfeasance, misfeasance, and nonfeasance.
• 🚑 Abandonment: Ensure proper transfer of care to a higher level of training before leaving a patient, to avoid abandonment.
• 👨‍⚕️ Good Samaritan Laws: Familiarize yourself with state-specific laws that may protect you when providing off-duty aid.
• 📝 Documentation: Maintain thorough records of patient care, especially when transferring or in unusual circumstances.
• 🚫 Consent: Understand the types of consent, including express, informed, and implied, and how they apply to different patient situations.
• 🔒 Restraints: Use physical or chemical restraints only as per protocols and when necessary for patient safety.
• 💀 Recognize Death: Learn to identify signs of death, such as rigor mortis, lividity, and decomposition, to determine when EMS care is futile.

Q & A

What does 'scope of practice' refer to in the context of EMS?

Scope of practice refers to the boundary that EMS providers should not cross within their care, which can be defined by state laws or professional guidelines.

How are 'protocols' different from 'standing orders' in EMS?

Protocols are written or digital guidelines that outline what EMS providers can and cannot do at each provider level, while standing orders specify the actions that can be taken without consulting medical control.

What is the significance of 'standard of care' in EMS?

Standard of care pertains to the actions that another EMS provider would typically take in a given scenario, which can be evaluated at a local or state level.

What is considered 'gross negligence' in the context of EMS?

Gross negligence is a complete and total disregard for the standard of care, involving reckless or willful disregard for the duty and care of the patient.

Define 'malfeasance' in the context of EMS negligence.

Malfeasance is permitting an action outside of one's scope of practice, meaning it's not authorized by protocols or standing orders.

What is 'misfeasance' and how does it differ from 'malfeasance'?

Misfeasance is performing an action that is within one's protocols but doing it in the wrong manner, as opposed to malfeasance, which involves actions outside the scope of practice.

How is 'nonfeasance' distinguished from other types of negligence?

Nonfeasance is the failure to act when expected to, such as not providing CPR when it is indicated, unlike malfeasance or misfeasance which involve improper actions.

Why is 'abandonment' crucial in EMS and what scenarios does it involve?

Abandonment in EMS refers to discontinuing care without proper transfer to a healthcare provider of equal or higher training level, such as leaving a patient without transferring care at a hospital.

What protection does a 'Good Samaritan law' provide for EMS providers?

Good Samaritan laws protect individuals, including EMS providers, who assist others in emergency situations, although the specifics vary by state.

How is 'consent' obtained in EMS when responding to a 9-1-1 call?

Consent can be obtained through express consent, where the patient asks for help, or informed consent, where the patient agrees to treatment after understanding the situation and proposed care.

What is 'implied consent' and when is it applicable in EMS?

Implied consent is when EMS providers assume that any normal person in a given emergency situation would want care, such as when a patient is unresponsive or has an altered mental status.