Why Emergency Medical Technicians ask for consent!
Have you ever wondered why an EMT or Paramedic always asks for consent? Why do they always explain what they are doing? Maybe we don't want an episode like this.
There are five types of consent that an EMT, Paramedic, or Firefighter can obtain. They are an expressed consent, informed, implied, minor and involuntary consent. An informed consent consist of procedures being expressed to the patient and explicit permission is given before the medic proceeds.
Expressed consent is just like an informed consent. The patient has given the EMS personnel the right to proceed after he/she has been informed of the assessment, procedures and any related risks that might come from said procedures.
Implied consent is also known as an Emergency Doctrine. An Emergency Medical Technician assumes that a patient that is unresponsive or incompetent would consent to emergency care if he/she could.
Minor consent is obtained by the parent or legal guardian. There may be cases when a parent or legal guardian is unavailable. An EMT would then assume that an implied consent or Emergency Doctrine is assumed.
Last but not least is the involuntary consent. This is consent from a mentally incompetent adult or an individual in custody of law enforcement or the court. EMS personnel will need a third party, legal guardian, LEO, or officer of the court to deem the patient unable to make such a decision or take care of themselves.
Personally this last one can be a little tricky. For others, it might be smooth sailing on scene. Where I'm employed we have several clients who are part of the mental health department or on the verge of being quite senile. At times I wonder if an involuntary consent would come into play. Perhaps something I might need to bring up at work. Thankfully, those three famous questions come into play. "What is the date? What's your name? and Who is our current President always comes into play." If patients are unable to answer these questions there is a high degree of likeliness that they may not be able to express consent for treatment.
The important thing is that consent must be obtained due to the fact that it's policy, the client might be a minor, or there might be a "Do Not Resuscitate" or directive filed with the Pt. In the next blog post, I'll discuss the different types of directives that an EMT, Paramedic, or Firefighter might have to deal with.