CRITICAL THINKING EXERCISE:

Of course, you want to be the best EMT you can be. The purpose of this exercise will be to consider some
ways to accomplish that goal.

1. What qualities would you like to see in an EMT who is caring for you? How can you come closer to
being this kind of EMT?

2. You are devoting a considerable amount of time to becoming an EMT. How do you plan to refresh
your knowledge and stay current once you are out of the classroom?

Answer:

1. Some of the desirable personal traits that EMTs should strive to exemplify include a pleasant, sincere,
and cooperative attitude around his patients and customers. Being able to step up as a leader and
remain emotionally stable during stressful situations is important. Effective listening and communication
skills are essential if you want to be successful in the health care industry. Because your patients come
from such a diverse population of different cultures and backgrounds—many that may be different from
your own—it is critical that you are open-minded and nonjudgmental of your patients and the people
you care for. You can strive to incorporate these traits into your everyday care by thinking about them
daily and approaching each patient (regardless of the circumstances) with the same approach.

2. You can continually refresh your knowledge and skill performance by taking advantage of
conferences, seminars, lectures, classes, videotapes and DVDs, and demonstrations. Review literature
and study evidence-based research.

Many emergency calls pose dangers to EMS personnel. The purpose of this exercise will be to consider
actions you should take at a dangerous scene.

You are called to an unknown emergency at a tavern. As you approach the scene, you see a man lying
supine in the parking lot, apparently bleeding profusely. Two other men are scuffling, and one seems to
have a gun. What actions must you take?

Answer:

Unless you stay safe yourself, you will not be able to help your patient and you may suffer serious injury
—or die. Retreat to a safe place and call for a response by law enforcement. Approach the patient only
when they inform you that the scene is safe.

Many aspects of EMS require moral or ethical decisions. The purpose of this exercise will be to apply
these considerations to several situations you might encounter.

1. You and your partner are in your ambulance on the way back from a call when you come upon a
motor-vehicle crash. It is in an adjoining ambulance district. Do you have a duty to act? Do you have a
moral or ethical obligation?
2. You are transporting a patient who was seriously injured when he was ejected from his vehicle in a
high-speed collision. You talk to another member of your crew who tells you the patient died the next
day. That crew member is worried about getting sued over the death. Do you think that a lawsuit against
you is likely? Why or why not?

3. You respond to a motor-vehicle crash and find a seriously injured patient. You find he has no pulse
and are about to begin CPR when someone tells you, “He’s got cancer and a DNR. Don’t do that, man!”
No one has the DNR order at the scene. Do you do CPR and transport the patient?

Answer:

1. This may not fit the strict definition of “duty to act” because you were not officially dispatched to this
call, but you still have a moral and ethical obligation to render aid since you are on duty and you are
trained providers. In general, if you follow your conscience and provide care, you will incur less liability
than if you do not act. Always follow your local protocols and laws.

2. Think back about your care of the patient and your actions on the call. Were the actions of your crew
so obviously responsible for the patient’s death that a lawsuit is in order? Does res ipsa loquitur apply? If
not, evaluate your care and actions on the call against the three tests of negligence: (1) Did you have a
duty to act? (2) Did you provide the standard of care or commit a breach of duty? (3) If you failed to
provide the standard of care, did your actions cause harm to the patient (also known as proximate
causation)? In order for negligence to be proven, all three must apply. Remember that proximate
causation cannot be applied to patients who are so seriously injured that they cannot be saved.

3. A critical decision like withholding CPR should not be made based on hearsay; it should be made
based on an actual legal document. Without the actual DNR present, you should continue CPR and
consider making contact with medical direction for further guidance.

Understanding medical terminology and knowing how to use it is important in your practice as an EMT.
The purpose of this exercise will be to consider how you might appropriately use medical terminology in
your radio report about a patient’s injuries.

As an EMT, you are called to respond to a teenage boy who has taken a hard fall from his dirt bike. He
has a deep gash on the outside of his left arm about halfway between the shoulder and the elbow and
another on the inside of his right arm just above the wrist. His left leg is bent at a funny angle about
halfway between hip and knee, and when you cut away his pants leg, you see a bone sticking out of a
wound on the front side. You take the necessary on-scene assessment and care steps and are on the
way to the hospital in the ambulance. How do you describe your patient’s injuries over the radio to the
hospital staff?