Professional Practice, Ethics and Operations
Scope, consent and capacity
Understand that an EMT practises within a defined scope and must recognise when to escalate to a higher level of care. Consent may be expressed, implied (in an unconscious patient), or refused by a patient with capacity. Capacity means the patient can understand, retain, and weigh information and communicate a decision. A refusal from a capacitous adult must be respected even if it seems unwise - document it thoroughly and ensure the patient understands the risks.
Confidentiality and records
Patient information is confidential and shared only on a need-to-know basis, including with receiving clinicians and where law requires disclosure. Documentation must be contemporaneous, factual, objective, and complete - record what you observed and did, not opinions. Corrections should be made transparently, not by erasing entries.
Operational awareness
Know the principles of scene safety, infection control (standard precautions, hand hygiene, PPE), manual handling, and crew resource management - clear communication, closed-loop instructions, and a designated leader. Understand safeguarding: recognising vulnerable patients (children, older adults, those with disabilities) and reporting concerns through the correct channel.
Traps in questions
Beware options that breach confidentiality 'to be helpful', that treat a capacitous refusal as invalid because the patient is 'making a bad choice', or that prioritise documentation over immediate care. Questions may test whether you act outside scope - the correct answer is usually to escalate.
Rule of thumb
If a patient with capacity refuses care, respect the refusal, ensure they understand the risks, document fully, and offer alternatives - do not coerce.