Transcript Preparatory
Preparatory EMS System Safety & Wellness • Infectious diseases – Immunizations – Universal Precautions – Hand Washing – Infection Control Exposure Plan • 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 – 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 Cont. • 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 Always restrain a patient in the supine position Request assistance from law enforcement Soft restraints should be used to prevent injury Document all reasons for restraints and do not leave patient unattended • Document assessment post restraint (i.e. 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 treatment, possible outcome of refusing treatment, and 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 QA/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 decisions 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 • Continuation of Care – releasing a patient to a healthcare provider of equal or greater training. • Battery – touching someone without consent • Kidnapping – seizing, confining, or taking someone away by force. (false imprisonment) • Defamation – damaging someone’s reputation – Libel is written defamation – Slander is verbal defamation Reportable Incidents • • • • • • • • • Child abuse Elder abuse At Risk adult abuse Crimes resulting in injuries Childbirth Dog bites Domestic violence Rapes Communicable diseases