POV issues

[omak42]

I am currently a volunteer firefighter/EMT-B in Ariel, WA. My dept covers quite a bit of area and we do really well responding. However, there is one part of the district that I am in quite a bit, that is covered by a station that does not have any medical equipment...just fire. Everyone knows that the most important thing we can do for a patient is to give them oxygen, which is where my question comes in. Since we dont have any medical equipment up at that station, I was going to look into buying an oxygen cylinder to keep in my POV, so that when I am up there I can give oxygen to a patient before the squad or engine gets there. I was wondering if anyone knew where I could find any regulations on transporting oxygen. I just want to make sure that Im not going to be breaking any of them, before I start carrying oxygen with me.....

 

[ffemt8978]

First of all, welcome to EMTLIfe.com from a fellow Washingtonian.

I'm not aware of any state laws that would pertain to transporting a small O2 cylinder. Your MPD may have a different say on the matter, though.

I would recommend that you consider why you think you need to carry O2 in your POV before you go out and purchase the equipment. How often does O2 given on scene really make a difference in patient outcome? The times that O2 would make a difference are generally (not always) times you're bagging/ventilating your patient. Atmospheric oxygen is normally sufficient for the time it takes the appropriate equipment to arrive on scene.

Also, from a liability standpoint you have a whole other can of worms. You become responsible for the care, upkeep, cleaning, and testing of they equipment. If something goes wrong with it, you're on the hook.

I think a better solution would be to put a jump kit with some O2 on one of the rigs at the station (engine, quick response, or what ever).

 

[akflightmedic]

Here is the simple answer and was covered in EMT B class.

Oxygen is a DRUG.

In order to carry or administer DRUGS, you need a physician prescription or medical directors approval.

If this isnt reason enough alone not to carry it in your POV, look at the response above for many other reasons not to.

 

[MMiz]

Emregency Oxygen may not require a prescription.

Emergency Oxygen that administers more than 6LPM for more than 15 minutes, and that is labeled as Emergency Oxygen, may not require a prescription.

I've called and spoken to my local EMS, state EMS, national EMS, local MD, EPA, FDA, and we no one is quite sure who has jurisdiction over the issue. I've called state pharmacy boards and written letters to just about every medical organization/governing body I can think of, and while everyone believes that O2 requires a prescription, they're not sure what legislation makes it so.

I finally gave up, but I'd love to find the answer.

 

[omak42]

thanks for the responses....

I know the neighboring fire district has all of their EMTs carry it in their POV...from what I have seen with this district, and knowing how strict they are, I cant see them carrying it without checking up on anything. I also talked to the training officer at the nearby transportation agency and he said he didnt think it would be an issue of actually carrying it, but rather making sure that it was stored correctly, in your vehicle.

As far as needing a prescription for it, i know that is not true...

 

[medicdan]

I know this: I am a SCUBA Diver (Rescue Diver), but I also have a diving O2 certification (Divers Alert Network, DAN O2 Provider)-- and often go off beach diving with friends. When I go diving, I carry an O2 kit in my car-- a small M9 tank and supplemental O2 delivery devices (NC, NRB, and a Demand Inhalator Valve, essentially a FROVD).
Because I care for other SCUBA equipment, I have no problem caring for my O2 kit-- the care is similar. I have only needed to fill the tank twice, but I havent had a problem-- I explain that I am a diver, and trained in O2, and they understand that it is Emergency O2.
In terms of placardation, I don't think we need a formal placard (for hazmat), until we start carrying a lot more, but I do have a sticker on my window that says "OXYGEN ONBOARD, NO SMOKING".

I just got a new toy for my O2 kit, but I dont carry it around. Its called REMO2-- it is a closed circuit breathing system for when on a boat far from shore with limited O2 on board. Much like a rebreather for SCUBA diving, it scrubs exhaled air and recirculates it with further O2. It seems like it works well-- but there is no use for it when shore diving.

In terms of you carrying O2, I think it depends on what the difference in response times is-- does it take 2 more minutes for the fire trucks to get there or 10, 20 minutes? Oxygen is never a bad idea for well-monitored patients-- but its not a wonder drug.

Hope this helps....

 

[Canoeman]

We get this situation in our area quite a bit. Coverage in many of our rural districts is iffy, especially during the day. We established a criteria based on times and distances for providers in those areas who respond POV.
If response time of an (amabulance) is > 25 minutes to these areas providers can carry O2 and related medical equipment. If <25 mins. first aid kits etc. only.

CM

 

[Guardian]

I am currently a volunteer firefighter/EMT-B in Ariel, WA. My dept covers quite a bit of area and we do really well responding. However, there is one part of the district that I am in quite a bit, that is covered by a station that does not have any medical equipment...just fire. Everyone knows that the most important thing we can do for a patient is to give them oxygen, which is where my question comes in. Since we dont have any medical equipment up at that station, I was going to look into buying an oxygen cylinder to keep in my POV, so that when I am up there I can give oxygen to a patient before the squad or engine gets there. I was wondering if anyone knew where I could find any regulations on transporting oxygen. I just want to make sure that Im not going to be breaking any of them, before I start carrying oxygen with me.....

why not look into getting that station some medical equipment to carry on their fire trucks. In my experience, medical equipment on POVs is almost never a good solution.

 

[akflightmedic]

Here is the simple answer and was covered in EMT B class.

Oxygen is a DRUG.

In order to carry or administer DRUGS, you need a physician prescription or medical directors approval.

If this isnt reason enough alone not to carry it in your POV, look at the response above for many other reasons not to.

Yes drugs need a prescription OR ( I stress the OR in the original post) a medical directors approval. Please note the OR in the above sentence.

I was just reiterating the fact the O2 is a drug as so many people forget that and believe it is totally harmless to handle, transport or administer.

If anyone is going to carry any drug in their POV, they better have medical directors approval and also have a plan in place per OSHA guidelines (if you are OSHA state) on the storage, maintenance and care of such cylinder.

You are also opening yourself up to a whole new area of liabililty. I know this seems like over reaction but you have to consider every scenario.

Are you going to keep a log showing daily how much O2 you have?

What size cylinder are you going to buy?

What are you going to do when you run out of O2 on scene and no unit is there yet? Now you have intiated a higher level of care and are unable to continue that level.

Who is going to pay for your refills? It can get quite expensive as O2 gets used up pretty darn quick.

Are you also going to ensure and pay a company to do testing on your cylinder annually so you have proof that it is not faulty and in good working condition?

All the above questions are a moot point, IF you have medical directors approval AND you let them supply the tanks, therefore absorbing all the costs and liability.

Wouldnt it be easier to try and get the equipment where it truly belongs, and that is on the responding apparatus in that area? Fight to make it right, equip those trucks!