nbleak21
Adventurer
Not sure if they've stopped issuing to all units, but I know we are no longer issued them in our First aid pouches nor CLS bags for that very reason.
I'm becoming obsessed with First Aid
- Thread starter ThomD
- Start date
Not sure if they've stopped issuing to all units, but I know we are no longer issued them in our First aid pouches nor CLS bags for that very reason.
Now there is a scary thought. Happily I'm too old to start a new career that takes so much education. My next career will be at REI.
SunTzuNephew
Explorer
I disagree. They're called UNIVERSAL PRECAUTIONS for a reason.
Back in 1983 (way before I went to medical school) I was just an EMT/SAR guy. Returning home from a training exercise I was first on scene of a pretty bad traffic accident, and as part of my attempts to render aid I crawled through blood covered broken glass and got cut up.
A few months later, I had Hepatitis-C (back then we called it Non-A/Non-B). I may need a liver transplant (if I can get one) at some point in the future. Universal precautions, and the mind-set they created, were barely being taught then, if at ll. I think everyone who thinks they may administer first aid should start out with a box of gloves, a CPR shield and maybe eye protection.
Not really. This came up as a question from one of my medics (I'm an EMS Medical Director). To be sued, you'd have to be knowledgeable that they had a DNR, that a reasonable person in your position with your training would have acted differently, and that you did something wrong.
Since people don't usually carry DNR orders around, and a medic-alert bracelet is not adequate notification (DNR's specify the nature of a persons illness and the degree of care they want or don't want, you can't fit it on a line - or as one person I saw, a tattoo on the chest) field personnel, unless TOLD by competent medical personnel, are pretty much immune. Even if they did have the orders with them, odds are they hadn't specified whatever accident they were in.
Well, we were going to fly up to Ryan airstrip today but the weather is craptacular so this is kind of long...
Not even close. You don't have licenses for CPR, lifeguard, whatever. I have a license from several states to practice medicine. Some states license prehospital personnel (some don't) but specify fairly strictly what the limits of that license is (scope of practice). In most cases for advanced EMT's they can do what I say they can do but its on MY MEDICAL license....and for anyone but an EMT-basic, they must be on duty in most cases, or they only have -basic scopes of practice.
Volunteer first aiders/lifeguards have is a 'certificate' that certifies on a particular date you met a standard of performance after completing a standard course of instruction. Do it wrong? Oh, well. As long as 'doing it wrong' doesn't involve practicing medicine, there's not much you can get into trouble for. If I do it wrong, aside from civil liability (my malpractice insurance) I can lose my license to practice, and conceivably be sentenced to jail for manslaughter or murder.
Here's what one of my CPR cards says:
Not even a certificate.
As far as the various Good Samaritan laws go, each state is different and some don't have any at all. But it's safe to say that as long as you perform at your level of training (and not in excess of it) and do what a reasonable person with the same level of training would have done, you're OK. And I've been admitted as an expert witness in a few states in suits against medics.
There is more of a risk, IMHO, that if you identify yourself as a whatever, and don't perform then you're liable. A tort (a civil lawsuit seeking monetary recompense for a harm that was done to you) requires 4 elements be proven: Each element has to be present for the suit to go against you.
- There has to be a Duty to Act...There is an expectation that you will perform....Put a bunch of EMS stickers on your car and it's at least possible that a lawsuit can go against you, although I don't think it's ever been done yet;
- Having a duty to act (expectation of care) you have not provided that attempt (you can fail, but you have to try) If you fail, thats another issue (malpractice). This is called a Breech of Duty
- That breach of duty was the cause, or close to being the cause in the law, of someone being harmed, (Proximate or near proximate cause);
- Someone actually was harmed because of your breech.
Now, issue #1 is why medical abandonment is such an issue. You create an expectation that you're going to handle something, and a more qualified individual passes by, or someone doesn't call for more help. For example, say you see a kid in a stream having trouble. You jump up and say "I'll take care of it" and the pros don't get called? Better get him, quickly, without hurting him. You have created an EXPECTATION that you will help and are competent to do so...thats #1 and #2. That same action applies to a professional dumping a patient. Not a good thing to do.
Anyway, most volunteers, unpaid (and upaid means you receive NOTHING, not even a free cup of coffee, I'm told there have been attempts to claim that a free meal created a situation where people tried to get Good Sam laws tossed), are OK. And realistically, if you don't have much to lose, you don't have much chance of someone taking it away from you. If you have a lot to lose, malpractice insurance (even for medics) might be a good idea.
SunTzuNephew
Explorer
SunTzuNephew
Explorer
Got combat gauze? It's got quikclot in it...Also part of the standard IFAK/CLS bags according to AMED.
SunTzuNephew
Explorer
There was one or two anecdotal reports of severe burns from the powder. the USUHS did some tests and couldn't duplicate the problems. You know those surgeons, always whining when you don't tell them how great they are. Almost like fighter pilots
As far as having to be surgically removed, no kidding? EVERYTHING in the wound had to be debrided by a surgeon. Some pantywaist navy surgeon (sorry, redundant) complained about having to spend a minute extra cleaning out the wound. Boohoo. Its not like some patient that needed it got it and then had to have surgery BECAUSE of the QC.
The main reason the powder was replaced by the sponge and gauze is because it works better. The powder was a pita to get into the wound in a breeze (and it's always windy in Iraq, I think) and could actually wash out of where it was needed from bloodflow before it was effective. The sponge is much better.
1leglance
2007 Expedition Trophy Champion, Overland Certifie
Great news on the Quickclot gauze vs powder...I will revise what I tell people and might just add some to the kit.
I have seen a few folks flown into our trauma bay with the powder and it was a mess in the wound...and yeah the main folks complaining were the trauma dr's
Personally I am all for direct pressure but I can see when & where a clotting agent would be good to have.
Thanks Sun for the more indepth response than what I wrote, I think the fact that EMS is often under the license of a Dr is often overlooked.
For me it is less about my Duty to Act than it is about how I would feel if I could have helped and didn't.
I have seen a few folks flown into our trauma bay with the powder and it was a mess in the wound...and yeah the main folks complaining were the trauma dr's
Personally I am all for direct pressure but I can see when & where a clotting agent would be good to have.
Thanks Sun for the more indepth response than what I wrote, I think the fact that EMS is often under the license of a Dr is often overlooked.
For me it is less about my Duty to Act than it is about how I would feel if I could have helped and didn't.
Amauri
Explorer
If someone does not show you the proper documentation your ok.
I am an EMT, my first day working I went on a "trouble breathing" call. We show up there's a large man in his late 70's laying on a bed obvious signs of COPD, on oxygen, first thing I do while my partner is checking out the patient is turn up his oxygen. His daughter and wife are there the man and the wife don't speak a lick of English so I had to have the daughter translate, she had a very thick Russian accent and kept claiming the man had a DNR. My partner call me over, there's what appears to be a bone protruding from the guys upper abdomen. Turns out it's an aneurysm that he has had for years. If this guys dies on us we can't perform CPR because he would be dead anyway. We needed to get this guy to the hospital NOW! He starts breathing his breathing slowed and we where having trouble getting a pulse, I'm thinking this guy is dead. All the while his daughter is yelling at us telling us he has a DNR but couldn't find it. She grabs a large file and jumps in the ambulance with us, my partner is driving and I'm taking care of the patient. The daughter is asking us to take to take her dad to a hospital that is 30 min. away running code 3, dispatch sends us to one that is 10 min. She starts nagging. I'm asking the daughter to translate for me and she decides to get on the phone. If you have ever met me you know I am soft spoken and very calm, I rarely loose my cool. But this lady... I yell at her "Ma'am get off the damn phone and answer these questions or your dad is going to die! So she complies. We are almost at the hospital when she finally finds his DNR. I take a look at it basically he just did not want any artificial ventilation(tubes down his throat). I don't say anything to her I just keep doing my thing. We get to the hospital and turn him over. He lived.
Good times.
So, it is official - you are crazy! I'd be 50ish before I could even get into Med school, so that isn't going to happen.
My next challenge is to find a way to reinforce what training I've had. Work is going to run some mass casualty drills later this year, but maybe I need a set of flash cards or something.
SunTzuNephew
Explorer
LOL, I had students in the Caribbean (there are some decent med schools there, classes in English and everything) who were in their late 50's...talk about guts. A few were medical professionals (mid levels, one was a British/Pakistani dentist trying to become an oral surgeon), a few were very brave people. Most did OK.