1. Preparatory

2. EMS System

3. 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

4. Safety and Wellness Lifting and Moving Patients –Proper Body Mechanics –Proper Equipment –Personnel

5. Illness Disease Prevention Know your family medical history Get Regular Health screenings Smoking (Don’t start, or Quit) Adjust lifestyle to prevent hereditary diseases

6. Medical Legal Issues

7. 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

8. 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.

9. 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)

10. 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.

11. 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.

12. 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

13. 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

14. Reportable Incidents Child abuse Elder abuse At Risk adult abuse Crimes resulting in injuries Childbirth Dog bites Domestic violence Rapes Communicable diseases