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PROP 7.1 - MULTIPLE CHOICE QUIZ
Question 1 of 10
What is referred as the system of rules and regulations that promotes justice and monitors the
violation of human rights?
Theory
Law
Resolution
Provision
Question 2 of 10
This is known as precedent law, which allows the development of the law:
Common law
Parliamentary law
Fixed law
All of the above
Next
Question 3 of 10
To ensure that the public is protected from harm brought about by health
professionals by regulating competency and practice standards, there is a need for
a:
Registering body

Union
Regulating body
Both first and third option
Next
Question 4 of 10
A level of professional misconduct, which pertains to knowledge and skills issues
identified to be concerning at the level of expected and required functioning as a
competent healthcare professional:
Unprofessional conduct
Unsatisfactory professional performance
Negligence
None of the above
Next
Question 5 of 10
There is a need to go the Coroner’s Court in the following situations, EXCEPT:
Violent death
Unnatural death
Death of a patient under comfort care approach
Unknown cause of death

Question 6 of 10
If you are a nurse anticipating a Coroner’s case for a patient’s death, what should be
your responsibility?
Remove all interventions like IV lines, catheters and others to facilitate easy
investigation.
The body should be left exactly the same as it was at the time of death.
Provide post-mortem care prior to investigation.
Change the patient’s clothes accessible for possible autopsy.
Next
Question 7 of 10
When suspecting a patient, who presents herself in ED, for the possibility of
involvement in a serious crime, what is your priority?
Call the police
Gather evidence
Interview the client’s history of injury
Provide care for the patient
Next
Question 8 of 10
What is the general rule in gathering evidence?
Ask who did this to the child
Ask the parents
Ask the child

Refer to the appropriate agency
Next
Question 10 of 10
What is a valid consent?
A consent obtained without coercion; the patient must be fully informed and must be
competent to give consent.
A consent obtained with full participation of the nurse and relatives.
A consent offered through acceptance of rewards and incentives.
All of the above.
Next
PROP 7.2 - SHORT ANSWER QUIZ
Question 1 of 44
Describe the difference between criminal law and civil law. Provide an example for
each.
The main difference between civil and criminal law deals with people who committed a
wrong against another person. Criminal law, on the other hand, deals with an individual's
offenses against the state or federal government
Civil laws regulate disputes between private parties. This lesson explains the main
differences between criminal and civil law.
Question 2 of 44
Why does the lack of registration for paramedics create legal problems?
The lack of registration of paramedics creates legal problems as these paramedics
perform high risk interventions and does not have any national standard of training
or any code of conduct owing to the absence of proper registration. Moreover, This
would enable the general public from identifying the genuine ones and protect them
from being treated by the fake ones.
Question 3 of 44

The term ‘paramedic’ also creates concerns for patient safety. What would
protection of the title ‘paramedic’ mean for the general public?
The protection of the title paramedic would prevent the knowing or reckless use of
the title. This would enable the general public from identifying the genuine ones and
protect them from being treated by the fake ones. Moreover, the paramedics would
be recognised properly.
Question 4 of 44
What is meant by the term ‘unsatisfactory professional performance’?
Unsatisfactory professional performance means a level of professional misconduct,
which pertains to knowledge and skills issues identified to be concerning at the level
of expected and required functioning as a competent healthcare professional.
Question 5 of 44
Can a paramedic be charged with ‘professional misconduct’? Why/ Why not?
Yes a paramedic can be charged with professional misconduct so that the
paramedics are not indulged into reckless and negligent activities. The paramedics
are required to conduct their duties responsibly.
Question 6 of 44
If a paramedic was seen to have failed to provide the care, or worked outside of their
scope of clinical practice (unauthorised), what action may be taken against the
paramedic?
If a paramedic was seen to have failed to provide the care, or worked outside of their
scope of clinical practice, the aggrieved person can bring a court action against the
paramedic under the Civil Liability Act. the complaint can be brought to the relevant
state or territory complaint authority.
Question 7 of 44
How could your position as a paramedic be involved in the Coroner’s court?
When a body is required to be investigated in the coroner’s court, the paramedic is
required to prepare the body for examination by the coroner’s court. Moreover, if
required the paramedic is also required to appear in the coroner’s court, the
paramedic needs to act accordingly.
CONFIDENTIALITY & PRIVACY:
Question 8 of 44

If you are required to attend court in regards to case you attended, are you able to
provide confidential patient information?
The paramedics are allowed to provide confidential patient information, when they
are required to assist the court or police for the investigation of a crime.
Question 9 of 44
Reading the case (Jackson v Lithgow City Council) provided under ‘Paramedics: pre-
hospital trauma teams and evidence’ what point does this case make?
In this case “Mr Jackson started from his house in Lithgow at around 3.30am, taking with
him his two dogs. He was found at the bottom of a drain at about 6.57am, with multiple,
serious injuries. An ambulance was called. The paramedic’s case notes recorded a history of
“? Fall from 1.5 metres onto concrete”. According to French CJ, Heydon and Bell JJ “He
then decided that in view of the (unproved) expense involved in calling the ambulance
officers and the (unproved) unlikelihood that they could remember anything useful, “it was
not unreasonable” to admit the impugned representation”. However in the opinion of the
Court of Appeal Basten J, “I n my view the cost of obtaining evidence from the ambulance
officers, bearing in mind the size of the claim, the limited likelihood of the officers having
any independent or refreshed recollection of detail which would assist the Court, combine to
demonstrate that, in a practical sense, it was not unreasonable to rely upon the
contemporaneous document.” This case makes the point that accurate recording of the
notes of events and findings from the case by the medical professionals are
important in the investigation of a case in future.
Question 10 of 44
In regards to reporting of offences against children, are paramedics mandated to
report suspected child abuse or neglect?
The paramedics are mandated to report suspected child abuse or neglect and a
failure in doing the same is an offence.
Question 11 of 44
What would constitute as a breach of confidentiality?
The breach of confidentiality implies a disclosure of any records related to the
healthcare of a person without availing his permission. These information are
disclosed by the patients to these healthcare professionals with an implied condition
of non-disclosure. These disclosure can be effected either verbally, in a written form
or any other form.
Question 12 of 44
What could a breach of confidentiality lead to for a paramedic?
The breach of confidentiality by a paramedic is a breach of common law duty. This
gives the aggrieved party a right to prosecute the paramedic and also claim
damages from him. Such a breach may also attract disciplinary charge.
Question 13 of 44
There are situations where exceptions are made for breaches of confidentiality, what
are they?
The situations where exceptions are made for breaches of confidentiality are when
the patient agrees to it, in case of child abuse, while reporting infectious diseases
and while assisting the court or the police in investigating a crime.

Question 14 of 44
What is the difference between confidentiality, and privacy?
Confidentiality implies a condition of non-disclosure of the personal information
provided by the patient in availing treatment. On the other hand, privacy is the
handling of the personal information provided by the patient during the treatment
and afterwards ensuring the protection of the same from being leaked.
Question 15 of 44
How does ‘privacy’ come to play part of your work as a paramedic?
A paramedic is required to maintain the health information of the patients in a fair
and responsible manner in order maintain the privacy of the information and to
protect those information.
CONSENT & CAPACITY:
Question 16 of 44
What are the elements of a valid consent for treatment?
The elements of a valid consent for treatment are it must be free from coercion, the
person giving the consent must be informed about the treatment they are provided
with and the patient must have the competence to consent for the treatment.
Question 17 of 44
Describe ‘competence’
Competence indicates the capability of the patient to give consent to the treatment
or refuse to treatment. A person over the age of 18 years is regarded as competent
to consent. The paramedic would assess whether a patient has the decision-making
capacity for a matter by following three steps, whether the patient can take in, hold
and understand the information of the treatment.
Question 18 of 44
A person is presumed to have capacity to make decisions regarding health care.
How would a paramedic assess whether a patient has the decision-making capacity
for a matter?
The paramedic would assess whether a patient has the decision-making capacity for
a matter by following three steps, whether the patient can take in, hold and
understand the information of the treatment.
Question 19 of 44
Describe the ways in which a paramedic may be charged with assault.
The paramedic may be charged with assault by prosecution and by claiming of
damages. They may also be subjected to disciplinary actions in such a case.
Question 20 of 44
What is meant by the ‘Doctrine of necessity’?
Doctrine of necessity is a situation of life and death where the patient is unable to
give consent owing to unconsciousness or absence of a guardian and the paramedic
is required to treat the person without any consent. This does not incur the liability
to the paramedic.

Question 21 of 44
Do patients have the right to refuse treatment from a paramedic? Explain.
Under the common law, the patients have the right to refuse treatment from a
paramedic. It is the right of the patient to either consent to the treatment from a
paramedic or refuse it.
Question 22 of 44
What is a ‘material risk’?
Material risk indicates the risk that a reasonable person placed in the place of the
patient would identify as a risk or the paramedic is identifying as a risk pertaining to
a particular treatment.
Question 23 of 44
You need to gain IV access to a patient due to his low blood pressure, what will you
advise the patient?
I will advise him to observe a treatment for the low blood pressure.
Question 24 of 44
If he refuses stating he can’t take needles, what do you do?
I would be required to stop the treatment as by saying this the patient has refused to
consent to the treatment.
Question 25 of 44
If he rolls up his sleeve and provides his arm to you – what do you do, why?
If he rolls up his sleeve and provides his arm to you, I will give him the treatment
because this will signify the consent of the patient to the treatment.
Question 26 of 44
When is consent required for children?
Children under the age of 18 years are not competent to consent for their treatment.
The consent needs to be given by the guardian, even the refusal of the treatment is
also required to be given by the guardian.
Question 27 of 44
State the legislation that provides the terms for consent for children in New South
Wales
The legislation that provides the terms for consent for children in New South Wales is
Children and Young Persons (Care and Protection) Act 1998.
Question 28 of 44
Research the corresponding legislation in your State, if you are in NSW, please
provide a search for another State legislation.
The another legislation is Guardianship Act 1987
Question 29 of 44
Can a child under the age of 18 refuse consent for life-sustaining treatment?

No, a child under the age of 18 cannot refuse to consent for life-sustaining
treatment. Irrespective of his consent, the paramedic needs to continue the
treatment.
Question 30 of 44
What is Gillick competency?
Gillick competency indicates whether the child under the age of 16years has the
capacity to consent to treatment or he requires parental permission for the same.
This is an important term in medical science and it has evolved in the United
Kingdom.
Question 31 of 44
When is consent NOT required?
Consent is not required in case of treatment of life-sustaining treatment.
Question 32 of 44
Who may give consent when the patient cannot?
The guardian of the patient can give consent when the patient cannot.
Question 33 of 44
Following the relevant Guardianship Acts in each State (except NT and ACT) – what is
the hierarchy of ‘persons responsible’?
Following the relevant Guardianship Acts in each State (except NT and ACT), the
hierarchy of ‘persons responsible’ are firstly the person’s guardian, secondly the
spouse of the person, thirdly the person who is in charge of care and fourthly a close
relative or friend.
Question 34 of 44
What is an Advanced Care Directive
Advanced Care Directive implies a legal document that a person makes specifying
the actions or the treatment, which they are required to be provided when they will
be unable to consent for themselves owing to their illness.
Question 35 of 44
If there is any doubt of a valid ACD being in place, what should you do for a patient
who requires resuscitation?
If there is any doubt of a valid ACD being in place, a patient who requires
resuscitation needs to be given the same even without the consent.
Question 36 of 44
In regards to the treatment of mentally ill patients, when may a person be detained?
A person having mental illness can be detained when he satisfies the requirements
of having mental illness and he needs to be given a treatment to which he cannot
consent to.
Question 37 of 44
Restraint has become a great issue with increased assaults and violence against
health care professionals. What levels of restraint may be used by a paramedic in
caring for a patient?

The paramedics can restraint a person who is posing threat to themselves or others.
However, the restraint need to be minimum and is only for the purpose of preventing
the patient from harming himself or others.
NEGLIGENCE:
Question 38 of 44
Detail the four elements that contribute to an act of negligence.
The four elements of negligence are a duty of care that the paramedic owes to the patient, that
duty has been breached by the paramedic, a damage has been caused by virtue of that breach
and the damage has a direct relation to the breach. The same can be illustrated with the case
of Donoghue v Stevenson [1932] UKHL 100.According to Boehm (2003), ‘Most jurisdictions
say that there are four elements to a negligence action:
duty: the defendant has a duty to others, including the plaintiff, to exercise reasonable care,
breach: the defendant breaches that duty through an act or culpable omission,
damages: as a result of that act or omission, the plaintiff suffers an injury, and
causation: the injury to the plaintiff is a reasonably foreseeable consequence of the defendant's act
or omission.’
Question 39 of 44
What is a ‘duty of care’ and when is it owed by a paramedic?
The paramedic is incurred with the duty of care while treating a patient and this duty
of care is owed whenever a health practitioner and patient relationship is created.
Question 40 of 44
Do paramedics have a duty of care to patients when they are off duty?
Yes, the paramedics have a duty of care to patients when they are off duty.
Question 41 of 44

How would a ‘breach of duty’ be proved in a paramedic treatment case?
The person who has brought a proceeding against the paramedic for a breach of
duty is required to introduce evidence proving the same.
Question 42 of 44
If you are treating a patient with a drug that you know ‘may’ drop your patient’s
blood pressure, and your patient falls to the floor due to this drop is blood pressure
(stated in drug therapy protocol) causing a head injury to the patient. Would this
be reasonably foreseeable?
Yes, this was reasonably foreseeable as the paramedic knew that the drug ‘may’
drop your patient’s blood pressure and he should have taken precautions for the
same.
Question 43 of 44
What is ‘vicarious liability’? And how does it relate to paramedic practice?
Vicarious liability is a situation where a person being the superior is held liable
legally for the acts or omissions of the other being the inferior. In the paramedic
practice, the employer being the State Health Department is responsible for the
actions of the paramedic.
Question 44 of 44
Could the Ambulance Service be held accountable for the actions of a paramedic if
they followed their protocols in treatment, but through medical consultation provided
a patient with a higher level of medication, resulting in the death (damage) to a
patient?
Yes, in this case the Ambulance Service be held accountable for the actions of a
paramedic, as they are in a position to control the actions of the paramedic.
PROP 7.3 - CASE STUDY QUIZ
Case Study #1
You are working a night shift in the middle of winter when you are called to attend a 67-
yeart-old fitting patient at a rural property. After an extensive drive, you arrive on scene to
be advised the patient has fitted a few times over the past 24hrs, and is currently in a post-fit
state. The owner of the residence is the daughter of the patient, who provides you with
further details about the patient’s condition. The patient has an inoperable brain tumour and is
required to travel to the major hospital facility whenever changes are noted in her condition.
This has increasingly become more and more regular over the past 3 months. The trip takes 2
hours by road, which requires a minimum overnight stay, to then return home within the
following days. The patient was due to take this trip earlier in the day but had refused the
patient transport service who attended, as she wished to stay at home with her family and see
her time out with them rather than in a hospital with strangers.
Question 1 of 4

What are the legal issues that arise with respect to consent?
In this case, the patient has refused to consent for the treatment, which would not be valid as
the person was having fits, which is impairing his ability to consent. Moreover, his daughter
was his guardian for this purpose and has the power to consent for the same. As he is
suffering from a life sustaining disease, the consent would not be required.
Question 2 of 4
What are the legal obligations of the care team when it comes to upholding the
patient's decision or not?
The care team should not uphold the patient's decision as the person was having
fits, which is impairing his ability to consent and he is suffering from a life sustaining
disease, the consent would not be required.
Question 3 of 4
Is there the potential for assault to be committed? If so, how?
No, there are no potential for assault to be committed as the patient has been
suffering for a life threatening disease.
Question 4 of 4
What is the final outcome? Does the patient remain at home? Why or why not?

The patient is needed to be taken for treatment as he is suffering from a life
threatening disease and owing to the fits his ability to consent has been impaired.
Weblink qas CPM
PROP 7.4 - SHORT ANSWER QUIZ
Question 1 of 5
What does the QAS state are the requirements for a ‘Valid Consent’?
The requirements for a valid consent are voluntary decision, informed decision,
service specific consent and competency of the patient to make a decision.
Question 2 of 5
For a valid consent – the patient must be informed.
What does the QAS state the patient, or care giver must be advised of?
The care giver and the QAS must inform the patient about the services that they are
extending to the patient in detail.
Question 3 of 5
Capacity - every adult is presumed to have the capacity to make a decision about
health care, unless it can be demonstrated that they don’t.
What are examples of medical conditions where a ‘temporary’ or ‘permanent’
capacity may lack?

The medical conditions where a ‘temporary’ or ‘permanent’ capacity may lack are
mental illness, impairment of ability to consent owing to illness and
unconsciousness.
Next
Question 4 of 5
What are the 3 capabilities a person must have to show capacity?
The 3 capabilities a person must have to show capacity are understanding of the
treatment, processing the information of the treatment and ability to communicate a
decision.
Question 5 of 5
Urgent Healthcare and ambulance service may be provided without consent in
circumstances where the person has impaired capacity for that health matter.
PROP 7.5 - CASE STUDY QUIZ
Case Study #1
Using the QAS CPM as your guide:
You are called to a park where there is a young male patient in his early teenage
years. The patient is breathing but not responding to you voice. There are only
other children around of the same age who advise you the patient had been sniffing
something out of a bottle.
Question 1 of 3
What are your options here in regards to capacity and consent?
I would be required to treat the patient irrespective of the consent to help him gain
consciousness.
SLIDE 2 OF 3
 Back
After a short time, the patient begins to wake and refuses any treatment or transport
from you.
Question 2 of 3
What would you do in this situation?
Being an emergency situation and the guardian being absent, I would require to give
treatment to him irrespective of his refusal.
Question 3 of 3

What if the situation was the same – but the age of the patient was in his early 20’s –
would this change your responses to the questions above?
Yes, being above 18 years of age the patient is competent to consent, but if the
condition he is having impairs his ability to decide the treatment needs to be given.
PROP 7.6 - CASE REVIEW
Question 1 of 2
In Neal v Ambulance Service of NSW (2008), the court found that the paramedics were
negligent because, despite their reasonable attempts to persuade the patient to go to hospital,
they failed to inform a third party (the police, in this instance) of the possible consequences
of their inability to fully examine the plaintiff and that the plaintiff should be taken to hospital
to be medically assessed.
From the topics covered within this section, what are the legal issues raised by this case?
cc

The issue that arises in this case is whether the ambulance services has any duty to treat the
patient irrespective of his refusal. Whether the ambulance services were required to take
assistance from a third party like the police in this situation.
Question 2 of 2
Ambulance Service of New South Wales v Worley:
In this case the treating paramedics were found to be negligent in their management of patient
Worley. What topics of discussion are provided by review of this case?
The topics of discussion are provided by review of this case are the negligence of the
paramedics, the duty of care and the breach of the same.
PROP 7.7 - MULTIPLE CHOICE QUIZ
Question 1 of 8
Vicarious liability compels the employer to accept.
Responsibility for superannuation
Liability for the employees’ wrongful acts
Responsibility for wages
Liability for public safety
Next
Question 2 of 8

Unlawful discrimination means:
Less than favourable treatment of an individual based on race
Less than favourable treatment of an individual based on money
Maleficence
Liability
Question 3 of 8
‘Express terms’ means that they are expressed in:
Words
Conduct
Money
Power
Next
SLIDE 4 OF 9
 Back
Question 4 of 8
Paramedics in remote area should expect to receive:
Extra money
Travel time

Professional development
Better accommodation
Next
Question 5 of 8
Good faith:
Has no place in employment law
Has to do with religion
Affects working conditions
Forms the basis of enterprise bargaining
Next
Question 5 of 8
Good faith:
Has no place in employment law
Has to do with religion
Affects working conditions
Forms the basis of enterprise bargaining
Next
Question 6 of 8
Workers compensation is a:
Promotion
Sum of money

Litigation
Illegal
Next
Question 7 of 8
Where may an employee seek redress?
Unlawful discrimination
Only immediately after dismissal
Through a third person
In the first person
Next
uestion 8 of 8
What does the term ‘reasonably practicable’ mean?
Taking into account the characteristics of the public
Taking into account the likelihood of the hazard occurring
Taking into account the money made
Taking into account the security of the premises
Next
PROP 7.8 - SHORT ANSWER QUIZ
Question 1 of 11
An employer announces job cuts and states that only part-time employees will have
their employment contracts terminated.
Could this be a form of discrimination?

This would be a form of discrimination.
Question 2 of 11
Which class of person will be more affected than another?
Inferior class of person will be more affected than the superior ones.
Question 3 of 11
What type of discrimination will this be?
This would be an indirect discrimination.
Question 4 of 11
Where would someone look for information that may be able to assist them?
They can access the official website for information.
Question 5 of 11
What polices should an organisation have in place to ensure discrimination does not
occur?
An organisation should have anti-discriminatory policies in place to ensure
discrimination does not occur.
Question 6 of 11
A member of an ambulance crew witnesses their colleague refiling through the medicine
cabinet of a patient. The paramedic leaves some of the patients’ medicine but takes other
items and places them in their pocket. The paramedic who witnesses this confronts their
colleague about this, as they believe the medicines have been taken for the paramedics own
use. The paramedic who takes the medicine remonstrates with their colleague and threatens
them saying that, if they say anything to anyone, they will ‘do them in’.
Identify the legislation that exists to protect the paramedic who witnesses this, possibly,
suspicious act.

The legislation that exists to protect the paramedic who witnesses this, possibly, suspicious
act is the Witness Protection Act 2000.
Question 7 of 11
A paramedic driving an ambulance under emergency conditions (lights and sirens) claims a
red light as an exemption and treats the junction as a give way. They advanced through the
intersection at 15km/h. As they do so, a car collides with the ambulance. The crew isn’t
injured but the driver of the other vehicle is trapped with a fractured femur and requires
freeing from the vehicle by the fire service.
Is the driver of the ambulance liable for the injuries sustained by the driver of the other
vehicle?
And, if not – under what principal?
The driver of the ambulance will not be liable for the injuries sustained by the driver of the
other vehicle by virtue of the doctrine of necessity.
Question 8 of 11
A member of a paramedic crew is continually belittled by their colleague stating such
things as that they are not ‘up to the job’, they couldn’t ‘cannulate a barn door in a
breeze’ and they ‘flap more than a frogman’s flipper’ even at commonplace
incidents. The offended paramedic remonstrates with their colleague appropriately
as to the harm these constant comments cause them. The offending officer
dismisses the complaints and states that – in fact – they were being supportive by
‘building character’
Is the stated defence of ‘building character’ acceptable applied to this set of facts?
And Why?
The defence of ‘building character’ is not acceptable applied to this set of facts as
this is indirect discrimination.
Question 9 of 11

What improvements could be made in the workplace to ensure this behaviour is
removed from the service?
A 64-year-old paramedic, who has given excellent service to their ambulance service, arrives
back at the station at the end of shift. The paramedic is met by the Area Manager to be told
that the service is restructuring and creating positions for a ‘new breed of super paramedics’
and told not to return tomorrow. They are also told they have done nothing wrong, ‘it’s just
the way things are’. The paramedic is thanked for their service, handed a letter with the
words Termination of Contract in bold letters at the top and told they will be offered some
compensation but it has still to be worked out. They ‘should still get paid for a while’, the
paramedic is told. The paramedic accepts the letter and is escorted from the premises.
Is this lawful or unlawful dismissal?
This is lawful dismissal as the employer has given proper compensation and notice of the
same. The paramedic is thanked for their service, handed a letter with the words Termination
of Contract in bold letters at the top and told he was also offered some compensation but it
has still to be worked out. They ‘should still get paid for a while’, the paramedic is told. The
paramedic accepts the letter and is escorted from the premises.
Question 11 of 11
Search and Identify the section of the Fair Work Act 2009 that deals with termination
of contract in this case (i.e. Unfair Dismissal)
Look up on net
AMBULANCE SERVICE OF NSW CODE OF CONDUCT Document Number SOP2007-012
Ambulance Service of NSW Code of Conduct
File No. C04/21-02

Date issued 25 May 2007
Author Branch Professional Standards and Conduct Unit
Branch contact 9320 7785
Division Professional Standards and Conduct Unit
Summary The Code of Conduct has been developed to clearly define the standards of behaviour
expected of all staff and to assist staff by providing a framework for day to day decisions and actions.
Applies to
All staff working in any permanent, temporary, casual, termed appointment or honorary capacity
within the Ambulance Service of NSW
Review date 10 August 2008
Previous reference N/A
Status Active
Approved by Chief Executive
Compliance with this policy directive is mandatory.
PROP 7.9 - SHORT ANSWER QUIZ
The Code of Conduct states that the reputation of the Ambulance Service is built on certain
principals that must be incorporated in to the decision, actions and behaviours of all staff.
The Code of Conduct sets the Ethics and Legal foundations of the organisation.
Question 1 of 5

What are these principals?
These principals are promotion of positive work place culture, inculcation of the core value
of openness, collaboration, empowerment and respect.
Question 2 of 5
What must an employee of the Ambulance Service report in regards to ‘conflicts of interest’
and who, and how must this be reported?
An employee of the Ambulance Service report in regards to ‘conflicts of interest’ must
inform his supervisor about the conflict of interest and avoid the conflict of interest. This
must be reported immediately without any delay.
Question 3 of 5
State the 3 types of Conflicts of Interest and provide a basic summary for each.
The 3 types of Conflicts of Interest are Bribes, gifts and benefits. Bribe is a monetary
benefit provided, gift signifies token or other items as a gesture and benefits are any
services.
Question 4 of 5
For breaches of the Ambulance Service Code of Conduct – who and when should staff
report to?

The staff needs to report to their immediate supervisor immediately for breaches of
the Ambulance Service Code of Conduct.
Question 5 of 5
What are the Occupational Health & Safety requirements set out under the Code of
Conduct?
The employees are required to ensure the health and safety of the fellow employees
or other people concerned by keeping the workplace safe and healthy.
Newspaper Article, "“Paramedic refused to
carry dying girl over safety fears”
Read the Article from the Telegraph Newspaper, “Paramedic refused to carry dying
girl over safety fears”, regarding a young girl Shannon Powell, and answer the
following quiz. Please consider the ethical and legal definitions in your answers
Paramedic refused to carry dying girl over safety fears
Shannon Powell, a paramedic, refused to carry a dying 14-year-old girl from a crosscountry race
course because of health and safety fears for herself, a coroner heard.
Shannon had collapsed in the mud during a cross-country run Photo: INS news
1:50PM GMT 08 Dec 2011

The life-saver declined to take part in the "chaotic" rescue mission to save Shannon Powell, saying
she was worried about her own back, a witness told the inquest.
Shannon had collapsed in the mud and was foaming at the mouth in a violent fit during a
crosscountry run but, due to a series of gaffes, life-savers only reached her almost an hour later, the
coroner heard.
Catherine Sheppard, a marshal, told the hearing that the response was so infuriating she almost
attacked the rescue worker.
She said: "The response of the London Ambulance Service (LAS) attendant was that it was her health
and safety and her back that was the issue.
"I believe that I walked away at that point. I really was very close to being either verbally or
physically abusive to the LAS attendant.
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"At that point I remember Shannon being taken away on the trolley bed."
The helper, who is also a history teacher, told how she saw the teenage girl fall wide-eyed and rigid,
to the floor.
However, rather than call 999 the assistant said she followed athletics' club policy and told an
organiser who sent a first-aider to the scene.
It was only on their arrival, five minutes later, that she said she called ambulance personnel trained
to keep Shannon alive.
However, paramedics only arrived at 12.50pm, almost an hour after Shannon collapsed, she
believed.
The inquest in Barnet heard how gates at the park were locked and organisers assumed paramedics
would have the keys.
There was also confusion about where the park was, which entrance they should use and where the
teenager was lying freezing on the muddy track with Mrs Sheppard's fleece over her, coroner
Andrew Walker said.
Marshals, who were not first-aid trained, were not told to call 999 in the event of a serious
emergency and one organiser assumed paramedics would have the keys to the park gates.
Maps of the Middlesex Cross Country Championships' course contained errors delaying medical help
as it was rushed to the scene where the talented youngster collapsed in a fit in Trent Parl, Enfield,
north London.
Mr Walker said: "A person who has collapsed and has a fit is a hugely, potentially serious issue.
"No-one at that stage will know why the person has collapsed in that way and it needs medical
attention urgently.
"So first of all you need someone who can get there within four minutes to begin resuscitation and
second of all to have the LAS on their way."

Mrs Sheppard told how even as the two paramedics, one male one female, were led up to Shannon
by another marshal they walked slowly behind the race assistant.
Daryl Proctor, a first-aider who raced to Shannon's aid, described hearing the paramedic's
remarkable health and safety assessment.
He said: "We were frustrated at that point. I didn't say anything to them because it was pointless all
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of us saying it.
"The paramedic at the time was saying 'we can't carry her because its health and safety and we
might fall over'.
"They didn't come up with any solution at all. Because of the time we had been there I think I can
say this for all of us - we all looked at each other as if to say '**** health and safety'."
Robbie Proctor, a first-aider who helped Shannon, told how he heard a male paramedic describe the
call as "low priority."
He said: "One of the stewards made a comment and said 'how come it took you so long?'
"The comment that came out was 'this is a low priority call' or 'a green call'. That was the male
paramedic."
The first-aider described how Shannon was being carried by six people from the course on a trolley
bed when she sat bolt upright screaming.
He said: "The last time I put the trolley bed down - and I'm being very honest with the parents here
because it haunts me - Shannon sat up and screamed 'let me go'."
He told how paramedics believed she was having a fit and gave her the painkiller diazepam when
"everything seemed to go haywire."
Family members cried and one had to leave the room as he told the inquest of the chaos that
descended on the rescue bid when the paramedics called for another ambulance and were asked by
the phone operator if they had the number for a TAXI.
It was only when they said 'no' that a second crew was dispatched during the eight minute
conversation in the bitter winter cold.
Mr Proctor told how in the middle of the chaos he was passed a phone by another helper with
Shannon's terrified mother on the other end of the line.
He said: "A lady called Tracy passed me the phone and it was Shannon's mum and what I remember
is Shannon's mum saying 'is my baby okay'?
"I've never been in this situation and I told her the paramedics were looking after her."
The first-aider, who owns the company, Spectrum, brought in to provide medical help at the event,
said the paramedics questioned his qualifications and began asking bystanders if they knew how to
provide lifesaving CPR.

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Shannon, a member of Ealing, Southall and Middlesex Athletics Club, was a keen swimmer and had
not had a seizure since she was a baby.
She had represented Middlesex County at cross country and track events and attended Northwood
College, in northwest London.
Shannon was taken from Chase Farm Hospital, in Enfield, where she died of sudden death syndrome
on January 18, this year.
Mrs Sheppard said: "I saw Shannon collapse on the hill coming down to where I was just 50 metres
or so away.
"My first reaction was to go there and see what had happened so I saw her and she was obviously in
some distress.
"She wasn't awake. I've never seen someone fitting.
"She appeared to be having a fit. Her eyes seemed very dilated. Her pupils were very wide eyed.
"My main observation was that her body was very rigid."
The inquest continues.
© Copyright of Telegraph Media Group Limited 2012
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PROP 7.10 - SHORT ANSWER QUIZ
SLIDE 1 OF 11
Discuss how can you apply the 4 ethical principals in this case when answering the
questions that follow.
1. Respect for autonomy - the patient has the right to refuse or choose their
treatment.
2. Beneficence - a practitioner should act in the best interest of the patient.
3. Non-maleficence - "first, do no harm"
4. Justice - concerns the distribution of scarce health resources, and the
decision of who gets what treatment

Question 1 of 11
Patients have a “right to” and receive quality medical care. Give examples of quality
or substandard medical care in this case.
In this situation Shannon has not been given a quality medical care, she has been
provided with substandard physical care. This because she was not being attended
by the paramedic instantly, and the treatment, which has been provided to her has
been refused by her.
Next
Question 2 of 11
Beneficence: Did the paramedics act in a manner that was in the patient’s best
interests?
Give examples.
No, the paramedic failed to act in a manner that was in the patient’s best interests, as he
has delayed the treatment of the girl when she collapsed because of the fits.
However, in case of such a fit she was supposed to get immediate medical attention.
Question 3 of 11
Non-Maleficence: was the WHS risk of back injury outweighed by the benefits that
could be obtained for the patient?
Discuss.
No, the WHS risk of back injury was not outweighed by the benefits that could be
obtained for the patient. This is because that girl was dying out of fits.
Question 4 of 11

Justice: Discuss if Sharon Powell received the same quality and standard of care
that would be appropriate for anyone else in his circumstances?
No, Sharon Powell received the same quality and standard of care that would be
appropriate for anyone else in his circumstances as the treatment has been delayed.
Question 5 of 11
Autonomy: Discuss whether the paramedics acted as the patient or her guardian
would have wanted?
The paramedic has failed to provide immediate medical help to the patient and the treatment that
has been given to her was refused by her. Hence, the paramedics has not acted as the
patient or her guardian would have wanted.
Question 6 of 11
List what other legal and ethical issues you think may be raised by this case?
The paramedic has the duty to give treatment to the patient on an immediate basis,
which he fails to provide. He delayed the treatment and as a medical professional he
was required to give immediate medical help to the patient irrespective of the
consent in case of life sustaining disease. This would amount to professional
incompetence and misconduct and the paramedic can be prosecuted for the same.
He may also be charged with disciplinary actions.
Question 7 of 11
Discuss how would the law of consent be applied in this case?
In this case, the girl was suffering from fits, which has been life threatening and in
case of life sustaining diseases, the consent is irrelevant.

Question 8 of 11
What policies, protocols and procedures may need to be changed as a result of the
issues in this case (both for the Ambulance Services and the event provider, as they
would be most ‘at fault’)?
As a result of the case the paramedics needs to be trained to act diligently and actively in the
emergency situations and their chief objective should be the benefit of the patient.
Question 9 of 11
Was appropriate help sought when the extent of the patient’s condition was realised
by those first on the scene? What can you do when a patient’s condition is beyond
your scope of your practice?
No, appropriate help was not sought when the extent of the patient’s condition was
realised by those first on the scene. They should have treated the patient
immediately and should have called 999.
Question 10 of 11
What attempts were made to clarify unclear instructions in this case?
What should have been done?
In this case, the paramedic has called the care team as he cannot treat the dying girl. However, being
an emergency situation, the paramedic should have called the 999.
Question 11 of 11
Using the NSW Ambulance service Code of Conduct grievance and complaints
procedure, how would a complaint against the officers be handled?
Would you consider the actions of the Paramedics unethical?
Would you report their actions and to whom?
A complaint against the officer will be made to the NSW Ambulance service. Yes, the paramedic
refused to carry the dying girl, which he has a duty to treat being a paramedic. Yes, it would report
their actions to their superior.

Reading from internet
Risk Management & Quality Improvement Handbook
(ACHS)
EQuIPNational Resource
RISK MANAGEMENT & QUALITY IMPROVEMENT HANDBOOK
Risk Management and Quality Improvement Handbook, July 2013
Produced by the Australian Council on Healthcare Standards (ACHS) Copies available from the ACHS
website: www.achs.org.au/
Copyright © the Australian Council on Healthcare Standards (ACHS) This work is copyright. Apart
from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process
without prior written permission from The Australian Council on Healthcare Standards. Requests
and enquiries concerning reproduction and rights should be addressed to the Chief Executive, The
Australian Council on Healthcare Standards, 5 Macarthur Street, ULTIMO NSW 2007 Australia.
Telephone: [phone] Facsimile: 61 2 9211 9633
Recommended citation: The Australian Council on Healthcare Standards (ACHS), Risk Management
and Quality Improvement Handbook. Sydney Australia; ACHS; 2013.
First edition (EQuIP 4): 2007 Second edition (EQuIP5): 2011 Third edition (EQuIPNational): 2013
This Handbook is only available via the ACHS website and may be revised annually. In this case,

PROP 8.1 - SHORT ANSWER QUIZ
SLIDE 1 OF 4
Question 1 of 4
From the reading, look at the Quality Cycle complete the following sentences:
a. It is therefore an essential part of a continuous improvement program to collect data on
different aspects of the care and services being provided.
b. An assessment of the current situation should be made by analysing the data from the
monitoring phase of the cycle.
c. Actions should be prioritised and then taken according to the assessment
decisions.
Next
Question 2 of 4
What are the important questions to ask in regards to evaluation?

The important questions to ask in regards to evaluation are:
 Did the action achieve the desired result / outcome?
 Is the improvement sustainable over time?
 Is there any more that can be done for this activity / initiative / project? Is it complete?
 Are the best possible care and services being provided?
 Are staff aware of any resulting changes?
Question 3 of 4
State the ways in which monitoring can be undertaken in the workplace.
The ways in which monitoring can be undertaken in the workplace are audits,
surveys, record reviews, observations, extracting data from data bases, etc.
Question 4 of 4
What is the importance of allowing for ‘Feedback’ in the quality improvement
process and who should be involved?
Consumer or patient feedback offers healthcare organisations with insight and
information on their consumer or patients' perspective regarding the services they
provide. The consumers and the patients should be involved.
PROP 8.2 - CASE STUDY QUIZ
Case Study #1
As a patient transport officer, a great deal of your work involves manual handling of patients,
transferring from chairs, beds, stretchers, and so on, all of which takes it's toll at the end of
each shift. You have been researching on-line a new practice of lifting patients. The research
shows a large decrease in both injuries to health care staff, as well as patients (from falls).
The procedure only requires minimal change in equipment, and training for staff in the use of
this equipment.
Question 1 of 4
How would you help to identify the problem in your workplace and voice your concerns of
current work practices?

I would discuss the concerns about the current practices with the manager and explain him
with proper information the importance of the new technique. I would ask the manager to grant
the permission for the improvement in the work practices and in doing so I would inform the
manager with all the benefits that the improvement would provide.
Question 2 of 4
What consultation would you have with your manager in regards to your
improvement in work practices?
I would ask the manager to grant the permission for the improvement in the work practices and in
doing so I would inform the manager with all the benefits that the improvement would provide.
Question 3 of 4
Outline your method of changing the procedure using a continuous quality
improvement model.

The method of changing the procedure using a continuous quality improvement
model would include the identification of the work practices, analyse the present
processes, measuring own performance in the present system, calculate the data
collection, collect and examine the data, identification of variances, comparison of
the present practice with the proposed one, identification, documentation and
implementation of the quality improvement activity and avail feedback.
Question 4 of 4
What type of feedback would you be looking for after implementing the new
procedure
After implementing the new procedure, a positive feedback is expected.

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