The scope of care (also called the scope of practice) includes the emergency care and skills an Emergency Medical Responder is allowed and expected to perform. These duties are set by state laws and regulations. As an Emergency Medical Responder, you have a legal duty to ensure the well-being of your patients by providing necessary medical care. Your ethical responsibilities include treating all patients with respect and giving each patient the best care you are capable of giving. You must also determine if the patient is competent (that is, if he or she can understand the questions you ask and the results of the decisions the patient makes about his or her care).
A competent patient must give you his or her consent (permission) before you can provide emergency care. Expressed consent is one in which a patient gives specific permission for care and transport to be provided. Expressed consent may be given verbally, in writing, or nonverbally. Implied consent is consent assumed from a patient requiring emergency care who is mentally, physically, or emotionally unable to provide expressed consent. Implied consent is based on the assumption that the patient would consent to lifesaving treatment if he or she were able to do so.
Patients have the right to refuse care and transport. As an Emergency Medical Responder, you must make sure that the patient fully understands your explanation and the consequences of refusing treatment or transport. Call advanced medical personnel to the scene as soon as possible to evaluate the patient. In high-risk situations in which the patient's injuries may not be obvious, you must contact the medical director or call Advanced Life Support personnel to the scene to assess the patient.
An advance directive is a form filled out by the patient. It outlines patients' wishes for care if they are not able to express them. A Do Not Resuscitate (DNR) order is written by a physician and details patients' wishes for care when they are terminally ill.
Assault is considered threatening, attempting, or causing a fear of offensive physical contact with a patient or another person. Battery is the unlawful touching of another person without consent. Because each state has its own definitions of assault and battery, you should check your local protocols concerning these terms. To protect yourself from possible legal action, clearly explain your intentions to your patient and obtain his or her consent before beginning patient care.
Abandonment is terminating patient care without making sure that care will continue at the same level or higher. You can also be charged with abandonment if you stop patient care when the patient still needs and desires additional care.
When a healthcare professional is negligent, he or she fails to act as a reasonable, careful, similarly trained person would act under similar circumstances. Negligence includes the following four elements: (1) the duty to act, (2) a breach of that duty, (3) injury or damages (physical or psychological) that result, and (4) proximate cause (the actions or inactions of the healthcare professional that caused the injury or damages).
A medical identification device is used to alert healthcare personnel to a patient's particular medical condition. This identification device may be in the form of a bracelet, a necklace, or an identification card.
If you are sent to a crime scene, you must wait for law enforcement personnel to declare that the scene is safe to enter. After you are certain the scene is safe and have ensured your safety, your first priority is patient care. You should be alert and document anything unusual on the call.
An organ donor is a person who has signed a legal document to donate his or her organs in the event of his or her death. The patient may have an organ donor card or may have indicated his or her intent to be a donor on his or her driver's license.
A prehospital care report (PCR) is a legal document that is used in a number of ways: (1) for medical uses (to ensure continued patient care), (2) as a legal record, (3) for administrative uses (billing as well as agency/service statistics), (4) for education, and (5) for research (data collection).
