1. introduction and medico-legal aspects for paramedics

8/15/2019 1. Introduction and Medico-Legal Aspects for Paramedics

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PHLEBOTOM YPRACTICE,DEFINITION,AND DUTY


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Phlebotomy the incision of vein for blood letting

Phlebotomist blood collector; the individual who

performs phlebotomy


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Primary function of aphlebotomist:

to assist the healthcare team in theaccurate, safe and reliable collection and

transportation of specimens for clinical

laboratory analyses.


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Three important clinical

purposes for laboratoryanalyses of specimens:

1. Dianostic Testin:to figure out what is wrong with the

patient. (tests that detect abnormalities)


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!. Therapeutic "ssessments:to develop appropriate therapy or

treatment of the medical condition. (tests

that predict the most effective treatment

or the drug of choice)

#. Monitorin:

to make sure the therapy or treatment is

working to alleviate the disease or illness.(tests to confirm that the abnormality has

returned to normal or that the drug is

reaching its effective dosage)


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CLINICALDUTIES OF

THEPHLEBOTO


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I!en"i#$"hepa"ien"

correc"l$


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Assess"hepa"ien"

prior"o

%loo!collec"ion


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Prepare"he

pa"ien"correc"l$


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Per#or&"hepunc"ure


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Assess"he

!e*reeo#%lee!in*

an! pain


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Assess

"hepa"ien"a#"er

"hephle%o"o

&$proce!ure


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Technical $uties

• Manipulate small objects, tubes and needles

• elect and use appropriate e!uipment

• "erform !uality control functions• #ransport the specimens correctly

• "repare$process the samples for

testing$analysis• %ssist in the laboratory testing procedure,

washing glassware and cleaning e!uipment


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%lerical $uties

"rint$collate$distribute laboratory

re!uisitions and reports

%nswer the telephone

%nswer all !ueries as appropriate

&emonstrate courtesy in all patient

encounters

'espect privacy and confidentiality


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ETHICALSTANDARD

S


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Do &O H"'M toanyone

intentionally.


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Perform accor$in to

(O)&D TE%H&*%"L"B*L*TY an$ +OOD

,)D+ME&T.


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'E(PE%T pa"ien"+s ri*h"s

-con$entiality/ pri0acy/the riht to no2 about

their treatment/ an$ theriht to refuse treatment3


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EDICO-

LE.ALASPECTS


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La2s societal rules or regulations that are

advisable or obligatory to serve.

Ethics moral standards of behavior orconduct that govern an individuals action.

Bioethics moral issues or problems thathave resulted because of modern medicine,

clinical research, and $or technology.


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*n the Philippines e0eryone is consi$ere$

*&&O%E&T untilP'O4E& +)*LTY

in a

court of la25


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%onstitutional La2*ased on "hilippine +onstitution

"$ministrati0e La2aw governing administrative agencies (government)

(tatutory La2-ritten aw/; enacted by legislative body

%ommon -6%ase73 La2

*ased on court decisions, doctrines, and customs 0 usage

Types of La2


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%riminal La2+onduct offensive to society as a whole

%ct prohibited by statutory or common lawcalled a crime

"unishment1 2mprisonment 0 3ines

%i0il La2egal rights and responsibilities (duties) of

private citi4ens

"unishment1 2mprisonment 0 3ines

%lassication of La2


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“Legal or civil wrong committed by one

person against the person or

property of another person”

T2o Types Intentional

Negligence

Leal Torts


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"laintiff must establish that the defendant

intended to commit the specific wrong thathas been alleged.

Must be conscious performance of act toaccomplish specific result, or where a

reasonable person would have known the

results of a particular act. Deliberate action

Conscious action

"laintiff must show intent

*ntentional Tort of Miscon$uct


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"ssault 8 Battery %ssault 5 threatening to touch in a harmful way

*attery 5 touching in a harmful way

9alse *mprisonment +onscious restraint of freedom of another without

proper authori4ation, privilege, or consent

2n the healthcare setting, it must be limited to, andin proportion with the procedure being performed.

*ased on -reasonableness/

Miscon$uct -types3


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Defamation of Character

(lan$er 5 spoken

Libel 5 written Must be written or spoken, and made to a

person other than the plaintiff

Invasion of Privacy "atients medical record (includes 6ray images)

3reedom of 2nformation %ct (pt. can access

records)

Miscon$uct -types3


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-kill and learning commonly possessed

by members of a particular profession./

2n healthcare known as

“Standard of Reasonable Care”

&epends on specifics of situation7pen to interpretation by judge 0 jury

(tan$ar$ of %are


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“Doing something you should not have done”

or

“Not doing something that you should have

done.”

8egligent behavior or actions that cause

harm to another person is known as

6malpractice7.

9ippocratic 7ath1 “Do no harm”!

Tort of &elience


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“A breach from the standard practice that is

the proximate cause of a patient’s injury.”

:lements of proof of negligence in a medicalmalpractice case include a $e0iation, or$eparture from acceptable practice

% negligent act committed by a professional personconstitutes malpractice only if it involves

negligence in the carrying out of his professional

duties

Me$ical &elience Malpractice


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%riminal Malpractice %ssault

*attery

Mercy illing (“Angel of Death”)

%i0il Malpractice "ractice falls below “Standard of Care”

Ethical Malpractice


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=. &uty of responsibility to patient owed>. &uty of responsibility is breached

(broken)

#. Damaes?. "ro6imal (&irect) +ause

Malpractice:

Plainti; mustpro0e


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EDICO-LE.AL

DOCTRINES % rule or principle of law, especially whenestablished by precedent

+an be invoked by either plaintiff or

defendant


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Respondeat

Superior

“Let the master

respond.”


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:mployer is liable for negligent acts of

employees which occur when theemployee is acting as an instrument of

the employer.

:mployee:mployer relationship must

e6ist

&oes not relieve practitioner of negligent

behavior

6*n$emnication7 :mployer can recover awarded damages

from its employee


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The “Borrowed

Servant”#he common law principle that the

employer of a borrowed employee,rather than the employees regular

employer, is liable for the employees

actions that occur while the employeeis under the control of the temporary

employer.


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Res ipsa loquitur

“The thing speasfor itself”


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7ften invoked to cause the defendant to prove his

actions were not negligent

(accused my prove that he is innocent)

#he outcome is so ob0ious that thedamages can only have been caused by the

defendant.

e.g. sponges " instruments left inside patients# surgical

outcomes $esp. plastic surgery% that didn’t turn out right#

&rong medications administered to the patient.


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In#or&e!

Consen" A!rmation by patient to

consent to have procedure performed


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Pa"ien" &us" ha/e0

%ppropriate mental capacity %ccepted elements of consent

'ho can si*n1

Must be over age of majority pouse

:mancipated Minor


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*nforme$

%onsent mustcontain:


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"uthori


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&o uarantee clause

Patient )n$erstan$in %lause 9ad all !uestions answered

:verything e6plained to patient

(inature %lause

Tissue Disposal %lause

"atient signature or mark

itness


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INFORED

CONSENT FORRESEARCHPURPOSES'e=uires a 6consent

$ocument7 that: :6plains the nature of the research and any risks

and benefits to the participant;

&escribes the level of confidentiality of theresearch data;

&escribes the measure that the researcher will

take to ensure that confidentiality is maintained.


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*mplie$%onsent:6ists when immediate action is re!uired

to save a patients life or to prevent

permanent impairment of the patients

health.


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(tatute ofLimitations aw that defines how soon after an injury a

plaintiff must file the lawsuit or be forever

barred from doing so.

"revent the threat of a lawsuit from hangingover a possible defendants head forever and to

force legal action while memories are fresh,

records are available and witnesses are still

living.


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e!icalRecor!s• "ital• #eat$ legible$ a%%urate

• &edi%al malpra%ti%e

• 'illing$ utiliation reie*$qualit+ improement


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> B"(*%

P)'PO(E( :=. %llows continuity of care plan

>."rovides documentation of illness andtreatment

@. &ocuments communication between

physician and health care team

?. "rovides legal document that can be

used by patients and health care team

for legalities


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*f it is &OT ?'*TTE&

$o2n/it 2as &OT DO&E5


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%O&%L)(*O&:#o safeguard against litigation,

the paramedic must be

knowledgeable about legal issues

and the effects they may have.

1. introduction and medico-legal aspects for paramedics

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