MICP - Medico-legal aspects fo CCT, IFT, and SCT

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***** DRAFT***** ****PLEASE COMMENT< SUGGESTONS NEEDED**** Focus Statement: This Module will introduce the participant to EMTALA, COBRA, medical direction, advance directives, and scope of practice issues particular to the transport environment.

Health & Medicine Economy & Finance

Medical Legal Considerations in IFT, CCT, and SCT Mobile Intensive Care Paramedic Series

Focus Statement ,[object Object],[object Object]

Presentation Information ,[object Object],[object Object],[object Object],[object Object]

Laws/Regulation Affecting Critical Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

4 Basic Concerns To Most Legal And Ethical Dilemmas ,[object Object],[object Object],[object Object],[object Object]

Scope of Practice? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

State Law ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Medical Director ,[object Object],[object Object],[object Object],[object Object],[object Object]

COBRA and EMTALA ,[object Object],[object Object],[object Object],[object Object],[object Object]

EMTALA: “Coming to the Emergency Department” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EMTALA and Medical Control ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EMTALA and “Appropriate Transfer” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Principals of EMTALA ,[object Object],[object Object]

EMTLA and Qualified Personnel ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EMTALA and OB transfers ,[object Object],[object Object]

What do I need for the Transfer? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EMTALA and “Diversion” ,[object Object],[object Object],[object Object]

EMTALA and “parking” ,[object Object],[object Object],[object Object]

Advanced Directives ,[object Object],[object Object],[object Object],[object Object]

ADA Issues ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],WHAT IS IN THE PATIENT’S BEST INTEREST?

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Chapter 11: Risk Management in Selected High-Risk Hospital Depts High Risk Depts. in Hospitals All clinical depts. in hospitals have potential for risk, but some are greater than others: Emergency Room Obstetrics and Neonatology Surgery and Anesthesia Diagnostic Imaging Treat highly vulnerable patients in often chaotic settings where the results of errors can be catastrophic and costly Emergency Medicine Which Definition? AMA – any condition clinically determined to require immediate medical care Federal Legislation – condition manifested by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to an individual’s health, serious impairment to bodily functions or serious dysfunction of any body organ or part Clinicians –view emergencies as life-threatening situations The mere existence of an ER implies a duty to treat any patient who arrives Emergency Medicine Issues Emergency Medical Treatment and Active Labor Act (EMTALA) Pre-hospital services Dept Capabilities and Staffing Triage Process Emergency Medicine Issues Medical Records Documentation and Consent Support Services Departures, Discharges and Transfers Risk Management Obstetrics and Neonatology Lawsuits in this category are usually the most expensive Advanced technology has improved survival rates for infants but led to increased risks for facilities Ethical Dilemmas Standards and Guidelines Levels of Care Level 1 – least intensive and designed to treat low-risk mothers and babies Level 2 – must be able to manage high-risk mothers, high-risk fetuses and small, sick neonates Level 3 – must be able to monitor and maintain critical functions of mothers and neonates the nurse to patient ratio is more intensive as well Obstetrics and Neonatology Obstetrics and Neonatology Prenatal and Perinatal Care Intrapartum Period Delivery Neonatal Resuscitation and Management Maternal Exam Post Delivery Family Attendance Issues Obstetrics and Neonatology Medical Record Documentation Neonatal Services Infant Transport Infant Abduction Surgery and Anesthesia Surgery and Anesthesia claims are usually co-dependent Increased number of surgeries performed in outpatient or ambulatory settings with decrease in number of claims Paid malpractice claims are higher in the outpatient setting Handout Case Study 10 Surgery and Anesthesia Negligence and Malpractice Surgical Services Staff Preoperative Assessment and Treatment Intraoperative Risks Postoperative Recovery Documentation Handout Case Study 11 Surgery and Anesthesia Intraoperative Risks Sedation and Anesthesia Wrong Site, Wrong Procedure, Wrong Person Implants Retained Foreign Bodies Patient Burns and Pressure Injuries Surgical Fires Handout Case Study 12 Diagnostic Imaging Creating images of the human body utilizing various methods: X-rays Computed tomography (CT) Interventional radiography Ultrasound Magnetic resonance imagine (MR ...

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1. What was the reasoning for enacting the EMTALA? 2. Should medical advice be dispensed on the telephone? Explain your opinion. 3. Discuss why you think the prescribing, control, administration, and monitoring of medications has become a major area of legal concern for health care professionals. 4. Describe the difference between the certification and licensing of a health care professional. 1. Describe the organization, responsibilities, duties, and legal risks of a governing body. 2. List some of the major provisions of SOX 3. Describe the meaning of the legal doctrine respondeat superior. 4. Describe the term corporate negligence. 5. Why is the Darling case described as a benchmark case? 6. Does the legal doctrine respondeat superior apply to an independent contractor? Explain your answer. Chapter 11 Hospital Departments & Allied Health Professionals LEARNING OBJECTIVESDescribe a variety of negligent errors by allied health professionals.Discuss the purpose of certification, licensure, and reasons for revocation of licenses.Describe helpful advice for caregivers. PROFESSIONAL ETHICS Standards or codes of conduct by specific profession. Created in response to actual or anticipated ethical conflicts.ExamplesFalsifying recordsSexual improprietiesSharing confidential patient information ChiropractorStandard of care requireddegree of care, judgment, & skill exercised by other reasonable chiropractors under like or similar circumstances. Emergency DepartmentObjectives of Emergency Caretreatment must begin as rapidly as possiblefunction is to be maintained or restoredscarring & deformity are to be minimizedtreatment regardless of ability to pay. Jury Returns Largest Medical Malpractice Verdict A man arrived at the ER with severe neck pain and numbness in his arms and legs. A doctor diagnosed his condition as neck strain and released the man from the hospital. A few hours later, the man became completely paralyzed from the chest down… The jury awarded the plaintiff $15 million; $10 million of which was for non-economic damages. −Mark Bello, The Legal Examiner, December 30, 2012 No Duty to Patient Who Left ED UntreatedIn a wrongful death medical malpractice action alleging negligence, the trial court properly granted summary judgment because under Ohio law, an emergency room nurse had no duty to interfere with an individual who left the ED without telling anyone and who refused treatment. −Griffith v. University Hospitals of Cleveland Failure to AdmitPhysician was found negligent in failing to hospitalize the patient or failing to inform her of the serious nature of her illness. The trial court found that had the patient been hospitalized on her first visit, her chances of survival would have been increased. −Roy v. Gupta Documentation Sparse & ContradictoryED physician failed to evaluate the patient & to initiate care within first few minutes of patient's entry into the emergency facility. The e ...

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SOC-400 Research Proposal Outline Sociology students should know how to organize their writing to present a research proposal. This assignment will help you learn this skill. Complete the sections below as directed, citing scholarly sources where needed. Assignment Directions: Use this outline below to complete this assignment. Fill in the missing portions needed to write a research proposal based on your research question and selected type of research: Write your research question here: Type of Research: After reviewing the five types of research presented in this course, describe the type of research (method) you would use for your study. Why did you decide on using this type of research? (50-75 words) (You will be summarizing this aspect in Part III below but in this section, explain why you plan to use this method. Why did you reject the other possible methods?) I. Title: Social Problem/Issue Describe the social problem/issue. II. Introduction: List the sections that will be included in your introduction: (Note: The literature review is not a section of your introduction in this assignment. Also, there is no determined number of sections in the introduction, but use the list provided below as needed) a. b. c. III. Literature Review: Explain the results of your exploration of what has already been studied and what gaps exist in the research that has already been done about the problem or issue you have identified. IV. Methods: Description of research method(s) you plan to use for your proposed research. V. Data Analysis: Include any specific hypotheses you plan to test, what variables you will measure, and how you will measure them. If you are going to use any statistical tests, which ones do you plan to use and what software will this require? VI. Implications: Why is this research important? Will it be used to change some policies, or to improve some social condition? Will it give us a better basic understanding of some type of human behavior? VII. Timeline: This section includes planned dates for the research, especially the data collection and analysis. a. VIII. Budget: What is it going to cost to carry out this research proposal and where will you get the funds to do this? a. References: © 2017. Grand Canyon University. All Rights Reserved. Running head: EMTALA RULE 1 EMTALA RULE 6 Scenario Analysis: The Emergency Medical Treatment and the EMTALA Rule Student’s Name Institutional Affiliation Scenario Analysis: The Emergency Medical Treatment and the EMTALA Rule Ethical challenges are among some of the strongest and most consistent trends in modern-day medicine. Ethical problems arise in the daily practice of medicine, educational practices, and in the conducting of research. As a result, it is dire that physicians to understand the role of relevance ethics in their professional lives (Bitterman, 2006). One particular area of ethics that continue.

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Accession Number: AD0427998 Title: CLINICAL SHOCK; A STUDY OF THE BIOCHEMICAL RESPONSE TO INJURY IN MAN Descriptive Note: Annual progress rept. 1 Jan-31 Dec 1963 Corporate Author: MARYLAND UNIV BALTIMORE SCHOOL OF MEDICINE Personal Author(s): Crowley, R. A. Report Date: 1963-12-31 Pagination or Media Count: 226.0 Abstract: Traumatic shock is associated usually with severe injury and characterized principally by inability to maintain an adequate circulation. This study focuses on the total problem - the reaction of the body to injury, maintenance of life, and repair of injury. Studies currently in progress and those proposed are aimed primarily to understanding the biochemical response to injury in man. Provisions have been made for careful metabolic studies in the shocked patient without interfering with obvious life saving measures. Such extensive studies have required the assembly of a considerable staff - professional and technical - to support a C.S.U. on a 24-hour basis. Experimental problems relevant to establishment of such a unit evolved from two major factors 1 original nature of the study a scientific study of shock in man and 2 an unprecedented design of this study. Solutions to these problems are described. Since inception of the contract January, 1962, some 200 patients have been studied as they have undergone resuscitation measures. Final organization of the unit now permits more complex studies into the physio-biochemical response to injury in man. Descriptors: *ENDOTOXIC SHOCK BACTERIA ENZYMES METABOLISM AMMONIA THERAPY HYPOXIA PHYSIOLOGY WOUNDS AND INJURIES IMMUNOLOGY CARDIOVASCULAR SYSTEM HYPOTHERMIA TOXINS AND ANTITOXINS HEMORRHAGE BLOOD COAGULATION Subject Categories: Stress Physiology Distribution Statement: APPROVED FOR PUBLIC RELEASE

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