ABEM Patient Safety & Ethical Practices 3 — Questions and Answers
Question 1: Which infection control practice is MOST important between patients during needle EMG?
- Disposing of needles in a sharps container and changing gloves between patients (Correct answer)
- Wiping the needle with an alcohol swab and reusing it
- Autoclaving the needle after each patient
- Using the same needle for both sides of the same patient only
Correct answer: Disposing of needles in a sharps container and changing gloves between patients
Single-use needle disposal in sharps containers and fresh gloves between patients are standard precautions that prevent cross-contamination.
Question 2: A patient who does not speak English arrives for electrodiagnostic testing. Which approach to informed consent is MOST appropriate?
- Use a qualified interpreter to explain the procedure before obtaining consent (Correct answer)
- Obtain consent through a family member who speaks both languages
- Proceed without verbal consent since the procedure is minimally invasive
- Reschedule until the patient can bring an English-speaking companion
Correct answer: Use a qualified interpreter to explain the procedure before obtaining consent
A qualified interpreter ensures accurate communication of risks, benefits, and alternatives, satisfying the legal and ethical requirements of informed consent.
Question 3: The principle of nonmaleficence in electrodiagnostic practice is BEST exemplified by:
- Avoiding unnecessary repetitive needle passes that increase patient discomfort without adding diagnostic value (Correct answer)
- Performing a comprehensive study regardless of patient tolerance
- Billing for the maximum number of billable units per session
- Sharing full raw data with all healthcare providers involved
Correct answer: Avoiding unnecessary repetitive needle passes that increase patient discomfort without adding diagnostic value
Nonmaleficence (do no harm) requires limiting needle passes to those that are clinically necessary, minimizing unnecessary discomfort.
Question 4: A needle stick injury occurs during an EMG procedure. The FIRST priority is:
- Wash the wound thoroughly with soap and water and follow institutional exposure protocols (Correct answer)
- Complete the study before addressing the injury
- Immediately test the patient for bloodborne pathogens without their consent
- Discard the used needle and resume the study without reporting
Correct answer: Wash the wound thoroughly with soap and water and follow institutional exposure protocols
Immediate wound care and following established exposure protocols are the first steps after a needlestick to minimize infection risk.
Question 5: Which of the following is an example of a conflict of interest that must be disclosed in electrodiagnostic medicine?
- Financial ownership in a facility to which the physician refers patients for EMG (Correct answer)
- Using equipment from a manufacturer the physician has no financial relationship with
- Performing studies on patients referred by unaffiliated physicians
- Charging the standard fee for electrodiagnostic services
Correct answer: Financial ownership in a facility to which the physician refers patients for EMG
Financial relationships with referral facilities create conflicts of interest that must be disclosed and managed per ethical and legal standards.
Question 6: A patient requests a copy of their electrodiagnostic report. Under HIPAA, the electrodiagnostician should:
- Provide access to the report within the legally required timeframe (Correct answer)
- Deny access because raw medical data may be misinterpreted
- Release the report only to the referring physician
- Require a court order before releasing the record
Correct answer: Provide access to the report within the legally required timeframe
HIPAA grants patients the right to access their own medical records, and the provider must fulfill this request within 30 days.
Question 7: When performing electrodiagnostic studies on a minor, informed consent should be obtained from:
- The parent or legal guardian, with age-appropriate assent from the minor when possible (Correct answer)
- The minor alone if they appear mature enough to understand
- The referring physician on behalf of the family
- No one, as minors cannot provide legally valid consent or assent
Correct answer: The parent or legal guardian, with age-appropriate assent from the minor when possible
Parental or guardian consent is legally required for minors, while age-appropriate assent from the child reflects ethical respect for developing autonomy.
ABEM Patient Safety & Ethical Practices 3
Which infection control practice is MOST important between patients during needle EMG?