The Roles and Responsibilities of the EMT-Basic

1. The Roles and Responsibilities of the EMT-Basic

2. How are the roles defined?The �Standard of Care� Standards imposed by law that are established by State and Federal government agencies, such as the DOT and the BEMS. Standards imposed by the local Medical Society and the Medical Director or Advisor. Professional or institutional standards such as departmental policy and procedure. Roles can be defined by level of certification, circumstances, or events.

3. Medical Directionestablishes �Scope of Practice� Your legal right to function as an EMT-Basic is contingent upon approval by the Medical Director. On-line Medical Control is direct contact with a physician by radio or telephone. Off-line Medical Control is written orders or standing orders, such as the �Medical Protocol and Standing Orders.� On-going Medical Control is the practice of case review and follow-up by reviewing individual performance and practice as part of quality assurance and quality improvement.

4. The Goals of Emergency Care To properly prepare yourself as an EMT so that you can provide care and avoid errors. �Do No Harm.� It is as important to know what not to do as it is to know what to do or what needs to be done. Provide immediate care for life-threatening conditions. Make every attempt to minimize further injury, complications, or infection. Make to patient as comfortable as possible to conserve strength and reduce the possibility of shock. Arrange transport of the patient to the appropriate medical facility in such a fashion as to not complicate the injury or subject the patient to unnecessary pain or discomfort.

5. Your Roles and Responsibilities The safety of yourself, your patient, your crew, and the public you serve. Assessment of injury or illness and the prompt application of care and treatment. The safe handling, lifting, and moving of our patients. Safe transport of the patient and the transfer of care to other medical professionals. Patient advocacy.

6. Your Ethical Responsibilities and Professional Attributes Dedicate yourself to public service with respect for human dignity. Maintain knowledge and skill mastery and demonstrate respect for the competence of others while keeping abreast of changing professional standards. Review your performance as a self-improvement tool. Value honesty and integrity and maintain patient confidentiality. Support your crew and your service and work harmoniously with others with a positive attitude. Live your life in such a way that you earn the trust and respect of the people you serve.

7. Legal Duties Duty to Act. The legal obligation to provide care when on duty or subject to call. If not on duty, rendering aid falls under the �Good Samaritan Law� which states: �A private citizen or emergency worker cannot be held liable for his/her action as long as he/she does not do anything that can be defined as gross negligence or willful misconduct.

8. Negligence In order to prove negligence, the plaintiff or court must prove: That an injury occurred or that the patient was injured. That the injury was caused by the actions or the lack of action by the emergency responder. The emergency responder had a duty to act. The actions taken were in some way unusual, unreasonable, or imprudent (Proximate Cause).

9. Nonfeasance: The failure to perform your duty. Misfeasance: The failure to perform your duty properly. Malfeasance: Performing your duty without the consent of the patient. Negligence continued:

10. Abandonment Legally and ethically the most serious act that an emergency responder can commit. To avoid accusations of abandonment: Follow through with all necessary and appropriate care. Continue to provide care until the responsibility for patient care is transferred to another medical professional of equal or higher training, or until the patient has been released to a registered nurse at the receiving facility.

11. Consent is granting permission to treat. Informed consent: actual consent given by the patient giving the responder permission to treat. Implied consent: an emergency situation when death, disability, or deterioration of condition prevents the patient from giving consent. The law assumes that any reasonable person would want to be treated. Minor�s consent: for dependent children under the age of 18 where the right to give consent is the decision of the parent or primary caregiver. Consent of the mentally ill: similar to that of a minor; if patients or primary caregivers are not available, you must assume that they would want treatment.

12. The Right to Refuse Treatment or Transport Everyone who is mentally competent and not under the influence of drugs or alcohol that may impair their ability to make the decision for what is in their best interest, has the right to refuse treatment or transport. Ill or injured patients who refuse treatment or transport present the EMT with a dilemma: Caring for patients against their will may constitute battery. Not providing care and the patient�s condition worsening may subject the EMT to allegations of negligence or abandonment.

13. When in Doubt . . . Try to determine if their mental status is impaired. Make every effort to understand the extenuating circumstances. Require a signature on a refusal form. It is always best to assume that there is a mental impairment and to proceed with treatment. When compared to the decision to abandon a patient and having the patient�s condition worsen, the decision to provide treatment is defensible from both the legal and medical point of view. In most cases, the problem of refusing treatment can best be resolved by the persuasive skills of the EMT in the field.

14. Advanced Directives DNR. Do not resuscitate orders are typically signed documents that order no resuscitation efforts be undertaken if the patient goes into cardio-respiratory arrest. Advanced Directives and Living Wills are instructions agreed upon and signed by the patient or their DPOA (durable power of attorney, a health care proxy) that give direction for actions to take should the patient be rendered unable to make their wishes known to healthcare providers.

15. Other legal reporting requirements: Child abuse; suspected or confirmed An injury that occurred during the commission of a felony. Drug-related injuries such as an overdose. Childbirth Attempted suicides Dog bites Rape or Assault Some communicable disease

16. The EMT Oath Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patient and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel. Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law. I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly and continuously in order to help make a better world for all mankind. While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot. So help me God.