Ch. 1 - The Professional Responder

As a responder, you are a key part of the pre-hospital care system, also known as the emergency medical system. The pre-hospital care system is a network of professional responders with an integrated approach to providing care in an emergency situation. Your level of expertise may provide a link between the first actions of bystanders and more advanced medical care. A professional responder is a person who, in a paid or volunteer capacity, is often summoned to provide initial care during an emergency. As the first trained professional on the scene, you perform critical actions and may have a significant effect on the patient’s outcome.

Transcript

1. Ch 1 – Pg 7
2. Welcome! My name is Laura Glenn • Emergency Medical Call Taker with BCEHS • Professional Responder Instructor • Background in • Athletic Therapy • EMR & PCP Tell me about yourselves • Your name • What brought you here or what do you do for work? • What sport would you compete in if you were to go to the Olympics?
3. What is a Professional Responder? Professional responders are made up of a wide variety of individuals who are tasked with providing medical interventions in the course of their duties. They respond to emergencies on a professional basis and have an obligation to respond to emergencies while they are on duty or when called upon. What would this look like for you or your organaization? Ch 1 – Pg 12
4. Primary Responsibilities 1. Ensure your own safety 2. Ensure safety for bystanders 3. Gain access to the patient 4. Determine any threats to the patient’s life 5. Request more advanced medical care as needed 6. Provide the necessary care for the patient 7. Assist more advanced medical personnel Ch 1 – Pg 14
5. Self-Care Given the nature of the work that responders do, they are exposed to vicarious and traumatic stress. Self-care is an important part of staying healthy – both physically and mentally. In a small group, discuss different elements of self-care that work for you. Ch 1 – Pg 15
6. Elements of Self-Care • Healthy diet • Adequate sleep • Regular exercise • Hobbies • Paying attention to your stress level • Understanding how you react to stressful situations and having a self-care plan Ch 1 – Pg 15-16
7. Critical Incident Stress and Post-Traumatic Stress Disorder Any emergency response, regardless of the circumstances, can cause an adverse stress reaction. CIS usually appears soon after, but may not last long. PTSD usually occurs later and can be much more long-lasting. Ch 1 – Pg 16
8. CIS • Confusion • Lowered attention span • Poor concentration • Denial • Guilt • Depression • Anger • Change in interactions with others • Increased/decreased appetite • Uncharacteristic, excessive humour or silence • Unusual behaviour PTSD • Reliving the event • Avoiding reminders of the event • Constant feeling of dread • Difficulty concentrating and/or sleeping • Sudden attacks of dizziness • Rapid heartbeat • Shortness of breath Ch 1 – Pg 17 Critical Incident Stress and Post-Traumatic Stress Disorder
9. The most important thing you can do to minimize the effect that an emergency will have on you is to know your protective factors and have a self-care plan. Be alert to your own mental and emotional states and watch for S&S of distress in your colleagues. Ensure that you are aware of the resources that are available through your organization. Elements of Self-Care Ch 1 – Pg 17
10. Legal and Ethical Issues • Duty to Act • Scope of Practice • Abuse and Neglect • Consent • Negligence • Refusal of Care • Abandonment • Confidentiality • Documentation Ch 1 – Pg 17
11. Duty to Act Either by case law, statute, or job description, most responders have a duty to act at the scene of an emergency Scope of Practice The range of duties and skills you are allowed and expected to perform Legal and Ethical Issues Ch 1 – Pg 17-18
12. Ethical Responsibilities • Carry out duties in a professional manner: • Showing compassion • Communicating sensitively and willingly • Honest in reporting/documenting • Periodically reflect on your professional practice Patient Advocacy • Hearing and representing a patient’s concerns • Respecting their rights • Making every effort to ensure your patient receives effective care in accordance with their wishes • Treating each patient with dignity Legal and Ethical Issues Ch 1 – Pg 18
13. Legal and Ethical Issues Abuse • Any behaviour or action that is used to scare, harm, threaten, control, exploit, or intimidate another person • Physical, emotional, verbal, sexual or financial Neglect • Failure to provide necessary care, aid or guidance to dependent adults or children by those responsible for their care Ch 1 – Pg 18
14. Child Abuse or Neglect Every adult in Canada has a legal duty to report child abuse or neglect, even if it is not confirmed. If you think a child is being harmed, then a report to child protection and/or police needs to occur. As a follow up, accurately complete an incident report, noting in detail anything you were told and any injuries you noted when you first examined the child. Legal and Ethical Issues Ch 1 – Pg 19 and CRC First Aid & CPR Manual
15. Child Abuse • Unexplained physical trauma in a child < 2y/o • Signs of shaken baby syndrome • Injuries in various stages of healing, especially bruises and burns • Unusual extent or number of injuries • Injuries located to suspect parts of the body • An injury that does not fit the description of what caused it Reporting in BC • Attempt to reassure the child, listen calmly and openly, and do not interrogate or make accusations • Be aware of the referral and reporting systems used by your organization, or… • Call 1-800-663-9122 (Provincial Centralized Screening), or… • Call local non-emergency police line • If a child is in immediate danger call 911 Legal and Ethical Issues Ch 1 – Pg 18-19
16. Legal and Ethical Issues Elder Abuse • Infliction of pain or injury (physical abuse) • Financial or material abuse • Unnecessary confinement • Willful deprivation Reporting in BC • Call local non- emergency police line • Seniors Abuse Information Line (SAIL) 1-866-437-1940 • VictimLink BC 1-800- 563-0808 Ch 1 – Pg 19
17. Consent • An individual has a basic right to decide what can an cannot be done with their body • Not limited to getting permission just once • A person can withdraw consent at any time To obtain consent, you must: 1. Identify yourself 2. State your level of training 3. Explain what you think may be wrong 4. Explain what you plan to do Legal and Ethical Issues Ch 1 – Pg 19
18. Legal and Ethical Issues Age of Consent There is no specific age at which one is old enough to give or reject first aid treatment. You must judge whether the patient is capable of giving or refusing informed consent: • Mature enough to understand the circumstances • Must understand the nature of the treatment • Must understand the consequences of refusal Ch 1 – Pg 19
19. Legal and Ethical Issues Implied Consent A person who is unresponsive, confused, seriously ill, or injured may not be able to grant informed consent. In these cases, the law assumes that the person would grant consent for care if they were able to do so. Ch 1 – Pg 19
20. Legal and Ethical Issues Pediatric Patients and Consent You must gain consent from a young child’s parent or guardian (same for an adult who is under a legal guardian’s care). If a child requires urgent care and a parent or guardian is not available, provide the care. If they refuse, try to explain the consequences: • Use terms they will understand • Don’t argue with them • If necessary, you can request law enforcement for assistance in establishing the legal authority to provide care Ch 1 – Pg 19-20
21. Negligence Failure to follow a reasonable standard of care, thereby causing injury or damage to another Four components must be present for a negligence lawsuit to be successful: 1. The responder had a duty of care 2. That duty was breached 3. Damage was caused 4. This damage resulted from something the responder did or failed to do Legal and Ethical Issues Ch 1 – Pg 20
22. Refusal of Care • Repeat your offer of help at least once • If a patient is not competent, has an altered mental state, or poses a threat, you may need to request law enforcement Refusal of Care or Release from Responsibility Form • Completely explain the patient refusal process and ensure the required number of legal witnesses are present and sign the applicable document Legal and Ethical Issues Ch 1 – Pg 21
23. Abandonment • Once you have started providing care, you are legally obligated to continue until either you transfer the patient to someone with equal or higher qualification or the patient formally refuses additional care Legal and Ethical Issues Ch 1 – Pg 21
24. Confidentiality • Information such as a patient’s previous medical problems, physical problems, and medications is personal to the individual • Never discuss the patient or the care you provided with anyone except law enforcement with a direct interest in the patient, or other personnel caring for the individual Legal and Ethical Issues Ch 1 – Pg 21
25. Documentation • As a patient’s condition may change before he or she arrives at the hospital, delivering a record of the condition immediately after the emergency will provide useful information for healthcare providers Elements of Good Documentation • Completeness and accuracy • Objective • Absence of alteration • Legibility • Timeliness Legal and Ethical Issues Ch 1 – Pg 22-23