5 Components of EMS Systems:
1) Reporting- Call is received from dispatch
2) Dispatch- Notification to emergency personnel
3) First Response- 1st
... [Show More] trained personnel arrival
4) EMS Response- EMS arrive in a medical vehicle
5) Hospital Care- Arrive at a medical facility
Legal Implications:
1) Unauthorized practice of medicine
2) Liability
3) Consent
4) Abandonment
5) Privacy
Unauthorized practice of medicine:
1) it is a misdemeanor to practice without a license in NC
2) In addition to being charged with a misdemeanor, the officer may also be held responsible for any damages when their actions exceed their training.
Liability:
Providing care to the level of your training and to the best of your ability is paramount.
An officer should realize that if sued [after providing emergency medical care]:
the plaintiff must prove gross negligence, wanton conduct, or intentional wrongdoing.
First Aid (Good Samaritan Law):
- There is a reasonable expectation of prompt decisions and action in medical care, AND
- The necessity of immediate medical care or the delay in rendering medical care, would seriously worsen the physical condition or endanger the life of the person.
[Under the Good Samaritan law,] the person shall NOT:
Be liable for any injuries alleged to have been sustained by the person or death of the person alleged to have occurred by an act or omission in the rendering of the treatment UNLESS it is established that the injuries or death was caused by gross negligence, wanton conduct or intentional wrongdoing on the part of the person rendering the treatment.
Types of Consent:
- Actual
- Implied
Actual Consent:
If a person is conscious and the person's judgment appears unimpaired, you should obtain his/her consent before treatment.
If an individual were to refuse treatment and the officer was to provide care, the officer may be considered to have committed an assault upon the individual (and may be held responsible for any damages that resulted from their treatment).
Implied Consent:
If an individual is unconscious or the individual's judgment and ability to respond is impaired, medical care should NOT be delayed for lack of consent because the law presumes that the individual consents to be treated in those circumstances.
However, if anyone present is authorized to give consent, such as next of kin, it may be best practice to act and work with EMS personnel to obtain consent.
Either way, DOCUMENT that consent was given.
Abandonment:
If an officer responds to a medical emergency, the officer should not leave the individual until relieved by someone with equal or greater training.
Leaving beforehand may constitute abandonment and may result in legal action being brought against the officer.
Health Insurance Portability and Accountability Act (HIPAA):
Addresses the prohibitions against the release of individual information by health care providers and similar entities.
Exemptions to HIPPA for when law enforcement may obtain medical information:
1) to report personal health information to a law enforcement official reasonably able to prevent or lessen a serious and imminent threat to the health or safety of an individual or the public
2) to report personal health information that the covered entity in good faith believe to be evidence of a crime that occurred on the premises of the covered entity
3) to alert law enforcement to the death of the individual, when there is a suspicion that death resulted from criminal conduct
4) when responding to an off-site medical emergency, as necessary to alert law enforcement to criminal activity
5) to report personal health information to law enforcement when required by law to do so (such as reporting gun shot or stab wounds)
6) to comply with a court order or court-ordered warrant, a subpoena or summons issues by a judicial officer, or an administrative request from a law enforcement official
7) to respond to a request for personal health information for purposes of identifying or locating a suspect, fugitive, material witness, or missing person, but the info must be limited to basic demographic and health information about the person
8) to respond to a request for personal health information about an adult victim of a crime when the victim agrees (or in limited circumstances if the individual is unable to agree)
Bloodborne Pathogens:
infectious microorganisms in human blood that can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV)
Other potentially infectious materials (OPIMs):
bloodborne pathogens can also be contained in other bodily fluids, which includes semen, vaginal secretions, saliva, amniotic fluid, cerebral-spinal fluid, and any other body fluid or matter with may contain blood.
Occupational Exposure:
reasonably anticipated skin, eye, mucous membrane, or parenteral, contact with blood or other potentially infectious materials that may result from the performance of an employee's duties
Exposure Control (methods of reducing the likelihood of exposure):
1) administrative controls which include providing vaccinations, preventive procedures, and training programs
2) engineering controls are physical barriers to exposure, such as sharp-safe evidence containers and biohazard labels, as well as hand and eye washing stations
3) work practice controls make the administrative and engineering controls effective. work practice controls also involve the use of personal protective equipment (PPE)
Hepatitis B virus (HBV):
cases swelling in the liver, and is not transmitted by casual contact. it is contracted through exposure to infected blood or other potentially infectious materials.
Symptoms include:
1) jaundice
2) fatigue
3) mild fever
4) nausea/ vomiting/ diarrhea
5) abdominal and/ or joint pain
Hepatitis C virus (HCV):
the most common chronic bloodborne infection in the US; symptoms are similar to those of HBV, but those who are infected may not show symptoms. There is no vaccine to protect from this.
Human Immunodeficiency Virus (HIV):
The virus which leads to acquired immunodeficiency syndrome (AIDS), which is a condition in which the body is unable to defend itself against infections and mutated cells. It is transmitted by sexual contact, sharing drug needles, and during pregnancy, birth, or breastfeeding.
Symptoms include:
1) night sweats
2) fever
3) chills
4) fatigue
5) swollen lymph nodes
6) sore throat
7) mouth ulcers
Time between exposure to the virus and the body's production of these antibodies may be up to (6) months. The time from that point to the onset of AIDS may be more than (10) years.
5 main methods of transmission of bloodborne pathogens:
- contact
- droplet
- air
- food
- vector
Contact Transmission:
can be subdivided into direct and indirect contact:
1) Direct contact transmission involves the transfer of infectious agents to a susceptible individual through physical contact with an infected individual (e.g. direct skin-to-skin contact)
2) Indirect contact transmission occurs when infectious agents are transferred to a susceptible individual when the individual makes physical contact with contaminated items and surfaces (e.g. door knobs)
Droplet Transmission:
this type of exposure occurs when droplets of blood or OPIMs contaminating pathogens are expelled during coughing, sneezing, talking, etc., and are transferred to the exposed person's mucous membranes (Typically takes place within a distance of up to (6) feet)
Airborne Transmission:
occurs through very small particles or droplets that contain infectious agents and can remain suspended in the air for extended periods. When Inhaled by a susceptible individual, transmission can cause inflection. These droplets can travel long distances and do not require face to face contact with an infected individual.
Law enforcement officers are at risk of exposure through many of the tasks performed daily. Some of those risks are:
1) direct contact with those infected or hosting bloodborne pathogens
2) Indirect contact with surfaces with may be contaminated with blood or OPIMs
3) Droplet and airborne exposure can occur anytime and anywhere the officer is near someone who is infected or hosting a bloodborne pathogen
2 Primary categories of precautions that are recommended by the CDC (centers of disease control):
- Standard Precautions
- Transmission-based Precautions
(- Work-practice Controls)
Standard Precautions:
apply to 1) blood; 2) all body fluids, secretions, and excretions except swear, regardless of whether or not they contain visible blood; 3) non-intact skin; and 4) mucous membranes.
These precautions include the use of:
- Handwashing
- Appropriate personal protective equipment such as gloves, gown, masks, whenever toughing or exposure to patients body fluids is anticipated
Transmission- based Precautions:
these are recommended to provide additional precautions beyond standard precautions
Work Practice Controls:
the procedures which must be followed to maintain safety in the workplace, and include:
-prohibiting smoking, eating, or applying make-up (including lip balm) in an area where contaminated surfaces may be present.
- Food should not be stored in a refrigerator where evidence containing blood or OPIMs is routinely stored.
Personal Protective Equipment (PPE):
Defined by the Occupational Safety and Health Administration (OSHA) as "specialized clothing or equipment worn by an employee for protection against infectious materials."
Disposable ________________ should be worn at any time, there is a risk or if a risk should be reasonably anticipated. These should be worn even if you do not have any areas of non-intact skin.
gloves
_________ should be worn when there is a possibility of splattering or splashing, attending an autopsy, or providing emergency medical care to a victim with massive trauma. It is worn to protect the skin and clothing from blood and OPIMs.
gowns
__________ should be used any time there is a chance of splashing or splattering of blood or OPIMs to protect mucous membranes and nasal passages. These protect your mouth and nose.
masks [Show Less]