Off-Duty CPR

[AtlantaEMT]

I've looked around and haven't quite seen the answer and the answers I have seen or been told have always been kind of gray.

I remember an instructor telling me that one of the worst things a new EMT or any EMS provider can do is buy a jump bag becuase you can end up working without medical control and also not be protected under the good samaritan act. And also that the most you can really do is CPR.

But here is my question.
When providing CPR I'm assuming it is okay to use a one way mask but could you use an OPA/NPA along with a BVM?

I doubt I'll run into anybody who needs it but this is more of a curiosity question.

 

[lightsandsirens5]

The way I look at it is this. The majority of time I am off duty, I don't do anything different than I would have before I got into EMS. I have always carried a small faceshield, you know those small ones that you can fit into your wallet or clip onto your key ring. I would have used that before I became an EMT, so I still wold now. However, I would never carry around and use either an OPA or a BVM, so why should I now?

Also, if I ever have to do CPR off duty, I would only identify myself as someone who knows CPR. Ie. I see person doing CPR on the floor in the Safeway. I go over ans say, "Hey I know CPR, can I help?" Not, "Hey, I'm an EMT. I have everything in my car. Keep doing CPR and I'll be right back with all my equipment."

 

[emt seeking first job]

And in most cases, there is an EMS system in place, the role of the off-duty tech or medic should also be to call 911 and direct the responders to the patient.

The phone call and directing the responders seems basic, but, most bystanders these days can not hack doing that.....

 

[medicRob]

I will carry a mask, BVM, BP Cuff, steth, OPA's, and a few bottles of water in the car. That is about it. You will not see me starting an IV or giving a med when I am off duty. I can just see it now, "NS mobile to the rescue!"

 

[Shishkabob]

It really depends on your local laws if you are able to use a BVM/OPAs as a lay person.

I'm pretty sure BVMs are 100% ok, as lifeguards, who do not have med control, have BVMs. However, just be safe and get a pocket mask.


As far as OPAs, just do a jaw-thrust / headtilt/chinlift.

 

[firecoins]

When a code occurs off duty, I am unlikely to have access to anything but a face mask. Really how many of will carry a BVM with an airway kit and O2 in you pocket. I am not on call 24/7.

 

[zmedic]

I'm pretty sure BVMs are 100% ok, as lifeguards, who do not have med control, have BVMs. However, just be safe and get a pocket mask.

But organizations that have lifeguards have set medical policies, insurance, etc that covers them on duty. I don't think lifeguards are supposed to use BVMs or OPAs off duty. I'd say you shouldn't be carrying anything that you don't feel 100% comfortable standing in front of your medical director, a lawyer and a reporter and explaining why you are sure that you are allowed to do X.

It's one of those if you have to ask if you are allowed to do it, you probably shouldn't.

 

[AtlantaEMT]

Also, if I ever have to do CPR off duty, I would only identify myself as someone who knows CPR. Ie. I see person doing CPR on the floor in the Safeway. I go over ans say, "Hey I know CPR, can I help?" Not, "Hey, I'm an EMT..."

Sounds logical. And I would for sure not identify myself as an EMT. Maybe Dr Nohbdy if anything (to justify a possible stethoscope).

I do a lot of camping, hiking, kayaking, rafting, etc and have thought about carrying a jump bag with more advanced stuff that would be exclusively for my very close friends, family, and I. Random people get the basic becuase I'm not screwing my career for a complete stranger who is going to sue me for saving their life. I'll go to jail for family and friends if it'll save their life.

One thing that has bugged me about being an EMT is that despite I've built up these skills and worked hard for this knowledge that I have in my head, it does not belong to me and is not controlled by me.

 

[usalsfyre]

Stick with basic first aid/CPR and you should do fine. I carry a small (very small) bag in my trunk with a CAT, an abd pad, a few 4x4s, an occlusive dressing, coban and some tape. This is enough to take care of 99% of things that will kill you prior to EMS arrival.

 

[AtlantaEMT]

Oh, here is something I just thought of. Doing a review booklet it had a situation where you are transporting a patient out of state and on your way back you are flagged down by a woman who points you in the direction of some guy lying on the lawn in cardiac arrest. You begin resucitation including defibrillation and IV therapy. I know IV therapy could be out of line but would the AED be included in there? I mean you see those AED devices all around so I don't see why that wouldn't be okay to do off-duty if any Joe Blow can do it.

 

[somePerson]

I carry a cell phone wth me, it helps me call people that have all the equipment neccesary. If im not on duty, I'll be happy to call 911, find an AED if someone coded in a public place and one is available, and maybe do compressions without ventilating.

 

[zmedic]

Sounds logical. And I would for sure not identify myself as an EMT. Maybe Dr Nohbdy if anything (to justify a possible stethoscope).

Wait, are you saying that you wouldn't identify yourself as an EMT which you are, but you would pretend to be a doctor? If you are an EMT and doing go crazy you're fine, if you impersonate a physician you are hosed.

Tell me I'm misreading what you are saying.

 

[Phlipper]

I carry a kit with hemostatic agents, a chest seal, and an NPA when shooting with a group or in competition since were often way out in the boonies. A kit big enough to cover just about anything an EMT-B can do under the ABCs, and I'd use every bit of it in a heartbeat.

But I don't throw it in the trunk and drive around with it. If I came upon a situation on the road or in the office I'm calling 911, if they're not already on the way. Maybe initiate compressions or use an AED in an extreme case. But when I'm not on duty as an EMT I'm not playing Rickey Rescue.

I have recently been surprised at how many folks in my area carry darn near a duty jump bag around with them all the time and can't wait for the opportunity to use it. These are the guys with all the EMT stickers in the window and even a light bar on their POV. I admire their dedication, I guess. But that's just not me.

 

[fast65]

When I'm off-duty I'm just a citizen, yes I have more medical knowledge than the average person, but still, at that time I am just a citizen and will only do what a CPR trained person would do. I'll give rescue breaths with a pocket mask, do compressions and run an AED if one's required and available, but other than that I'm not going to be playing Rickey Rescue as someone else said.

 

[AtlantaEMT]

Wait, are you saying that you wouldn't identify yourself as an EMT which you are, but you would pretend to be a doctor? If you are an EMT and doing go crazy you're fine, if you impersonate a physician you are hosed.

Tell me I'm misreading what you are saying.

It was a reference to Homer's "The Odyssey". As in I help someone, I save their life, they sue (next logical step in today's times), and when they want to file a suit they want to file one against Nobody. I'd personally stay as vague as possible. I really did stay at a Holiday Inn Express once.

I was more curious than anything. I would help my friends and family and shove a combitube down their throat if needed (and sometimes if not). But that is for the people I care about.

For the general public. I'll do what I can that will keep me protected under the good samaratin law if a situation arrises and prevent the guy with the YMCA CPR card from doing something stupid (like chest compressions on someone with seizures).

 

[Jay]

As a community responder I do have the whole 9 yards in my POV including but in no way limited to O2 Cylinders, Suction Equipment, OB Kit, Trauma Gear, BVM/OPA/NPA, the list goes on and on. There are no stickers on my vehicle and no lightbar either but I am pretty much on call for this program 24/7 when I am in my home area. Being that I have the equipment I would do the following:

• If in my operational area and the severity warrants it I would get on my cell and call it in. I would have medical control and the appropriate resources would be en route. A win-win for everybody.
• If outside of my area, I would keep to HCP BLS protocols but not use the OPA/NPA as they are invasive and in most states require medical control. I would use the BVM but without O2 as oxygen is a drug and requires medical control.

That's pretty much common sense from a liability standpoint because as long as your not doing anything invasive or providing drugs your OK. In a life and death situation where seconds count I am honestly not sure what I would do but hope that I am never in that situation; I came close once when I was involved in a 6 car pile up on a busy highway but was able to get out and see cars spun around into oncoming traffic and two tractor tailors involved, luckily there were no injuries too severe and local EMS was there within minutes. I helped triage and then went to the ER myself to find out that I had a thecal sac tear, herniated two discs, multiple muscle injuries and was dehydrated. I guess my adrenalin was pumping because I didn't feel injured until about two minutes out from the hospital, I was on scene for maybe 30 minutes.

Anyhow, on a lighter note, I was considering putting one sticker on my car, something that lets people know I got O2 in the truck to keep them from riding my @$$.

 

[the_negro_puppy]

If I came across and arrest i'd do compressions, not going mouth to mouth unless friend/family. Probably even help with a defib if there was one. Thats it.

 

[Sassafras]

Oh, here is something I just thought of. Doing a review booklet it had a situation where you are transporting a patient out of state and on your way back you are flagged down by a woman who points you in the direction of some guy lying on the lawn in cardiac arrest. You begin resucitation including defibrillation and IV therapy. I know IV therapy could be out of line but would the AED be included in there? I mean you see those AED devices all around so I don't see why that wouldn't be okay to do off-duty if any Joe Blow can do it.

None of it is appropriate as you are transporting a patient. Your priority is your patient, and to leave that patient even to save the life of another can indicate abandonment if something goes south. Sure most IFT transports are stable, but there's a reason we transport them and it's because they aren't healthy enough to go alone. Call 911 if you are even stopped long enough, but your job is to the patient you are currently transporting.

That being said, I show up as a first responder POV often. I still only keep gloves and a pocket mask in my car, and carry my steth with me. I should bring my bp cuff, but I always forget in that split second between the pager going off and me realizing I have someone to watch the kids and run out the door. I do want to get a SMALL jump bag. Something to keep my gloves from getting dusty in the car and to put a couple airways in. Last time we showed up at an arrest the ambulance didn't show for 15 minutes so we were stuck with no airways and rolling a patient to repeatedly clear fluid from the airway since we had no suction either. I would rather just be prepared for something as clear cut as an arrest if I show up on scene.

 

[firecoins]

Oh, here is something I just thought of. Doing a review booklet it had a situation where you are transporting a patient out of state and on your way back you are flagged down by a woman who points you in the direction of some guy lying on the lawn in cardiac arrest. You begin resucitation including defibrillation and IV therapy. I know IV therapy could be out of line but would the AED be included in there? I mean you see those AED devices all around so I don't see why that wouldn't be okay to do off-duty if any Joe Blow can do it.

He seems to be referring to the return trip where he is patientless.

Nobody should have a problem with an EMS crew using an AED during a cide provided you have shockable rhythms. I usually work in between NJ and NY. I have yet to have an ER ask what state I am from whenI brought a patient in. If your bringing in a code and used an AED on a patient, they should be focused on continuing care.

AED is more important than starting an IV. You can always get on the phone and request medics from 911. Intercept.

IVs

 

[Sassafras]

Woops. Misread that little tidbit.