Can EMTs administer medications while not on shift?

Slushster

Slushster

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Im a relatively new EMT now working in PA on a BLS 911 ambulance at my university. A few weeks ago my friend found an .3mg EpiPen at his fraternity after a party and tried to find the person who had lost it. After finding no success, he gave it to me and I tried to find the rightful owner. At this point, there is little hope the Pen will be claimed. My question is whether or not an off duty EMT can administer drugs such as Narcan and Epi during a spotted medical emergency. Please let me know where the line is drawn!
Thanks!!!
 
luke_31 said:
Don't do it. Pushing medications off duty is practicing medicine without a license. You don't want to get into that kind of trouble.
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Got it. So in order to actually practice medicine you have to be working with an agency?
 
You have to be working with an agency and licensed and accredited to perform the procedure. Essentially what you are looking for is that it is in your protocols to perform the procedure or administer the medication. Also that your company carries the medications that you can administer or you are allowed to use the patient's medications.
 
That will be a legal disaster. Maybe just maybe if you say your untrained, and use an epi pen. But don't announce everything personally I just wouldent do it. But that's because I'm excessively cautious with laws
 
How about this: If anyone is in anaphylaxis Ill call an ambulance! :D
This seems like the best approach.
Thanks for all the responses guys!
 
Slushster said:
How about this: If anyone is in anaphylaxis Ill call an ambulance! :D
This seems like the best approach.
Thanks for all the responses guys!
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If its a true emergency i become an idiot that "can only read directions", i have NO outside knowledge of anything i would be doing. Example epi-pen "pull cap, hold hand around barrel, put in leg" nothing else, i dont check anything after i dont do any of that.
 
Slushster said:
My question is whether or not an off duty EMT can administer drugs such as Narcan and Epi during a spotted medical emergency.
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Generally speaking, if you're not on-duty, you have no duty to act. However, you are subject to the Good Samaritan law of your state (again, in general - PA does have one). I can't speak to medications, frankly.

NysEms2117 said:
If its a true emergency i become an idiot that "can only read directions", i have NO outside knowledge of anything i would be doing. Example epi-pen "pull cap, hold hand around barrel, put in leg" nothing else, i dont check anything after i dont do any of that.
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This is an interesting line of argumentation - an EpiPen (for example), is pretty easy to use, and its use is commonly taught in first aid courses. Assisting with or administering a prescribed EpiPen is, of course, different from administering one that is not the "patient's"...
 
EpiEMS said:
This is an interesting line of argumentation - an EpiPen (for example), is pretty easy to use, and its use is commonly taught in first aid courses. Assisting with or administering a prescribed EpiPen is, of course, different from administering one that is not the "patient's"...
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I personally am always on the SUPER CAUTIOUS side of the law, whenever it comes to a gray area, now that people sue each other for fun. 10 years ago, if i was my current age, i would help somebody because i know they will see the "good intentions" side of it.
 
NysEms2117 said:
I personally am always on the SUPER CAUTIOUS side of the law, whenever it comes to a gray area, now that people sue each other for fun. 10 years ago, if i was my current age, i would help somebody because i know they will see the "good intentions" side of it.
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No disagreement - I used to be much more gung ho, but I am concerned that I'm overly cautious these days.

With respect to EpiPens, here's a good little read. A list of state laws concerning naloxone can be found here.
 
NysEms2117 said:
in respect to NY, there are conflicting laws, but they are so buried i dont think anybody even realizes it lol
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Yeah, I have no clue about NYS requirements, myself. I would note NYS Public Health Law Section 3013(4): "A certified first responder, emergency medical technician or advanced emergency medical technician, whether or not he or she is acting on behalf of an ambulance service, or advanced life support first response service, who voluntarily and without the expectation of monetary compensation renders medical assistance in an emergency to a person who is unconscious, ill or injured shall not be liable for damages alleged to have been sustained by such person or for damages for the death of such person alleged to have occurred by reason of an act or omission in the rendering of such medical assistance in an emergency unless it is established that such injuries were or such death was caused by gross negligence on the part of such certified first responder, emergency medical technician or advanced emergency medical technician." (Underlining and bolding are mine.)
 
If it is a publicly owned (emergency cache of some sort), or the patient's own medication and needs assistance with it, usually a Good Samaritan style law offers reasonable protection provided you act in good faith and do not display a gross negligence.

However, if you have "stuff" in your personal jump bag, that usually flies about as well as a 12ga out of a .22 barrel. Places get persnickety with "Practicing Medicine Without A License" and establishing how people acquired, dispensed, and used medications.

Personally, being from PA, I'd just keep the EpiPen around for house parties next to the salted peanuts or find out a friend who needed to replace theirs...
 
dutemplar said:
If it is a publicly owned (emergency cache of some sort), or the patient's own medication and needs assistance with it, usually a Good Samaritan style law offers reasonable protection provided you act in good faith and do not display a gross negligence.

However, if you have "stuff" in your personal jump bag, that usually flies about as well as a 12ga out of a .22 barrel. Places get persnickety with "Practicing Medicine Without A License" and establishing how people acquired, dispensed, and used medications.

Personally, being from PA, I'd just keep the EpiPen around for house parties next to the salted peanuts or find out a friend who needed to replace theirs...
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Actually, the government won't dare make such an argument in a court of law. If it does it essentially dismantles BLS, because merely having BLS certification is NOT a license to practice medicine- and as such even while on the job, BLS personnel are still subject to the same legal principles- regardless of whether or not their on the clock.

The law in most states also makes it a crime (usually a felony) for any person to knowingly obstruct an EMT or paramedic in the performance of their duty, while acting in official capacity. The federal circuit courts have held that official capacity does not end merely because you punch your time card. Rather, official capacity rests on credential. Thats like saying a police officer can't make arrests off the clock. It just doesn't work that way.
 
NysEms2117 said:
If its a true emergency i become an idiot that "can only read directions", i have NO outside knowledge of anything i would be doing. Example epi-pen "pull cap, hold hand around barrel, put in leg" nothing else, i dont check anything after i dont do any of that.
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Be careful of this type of thinking as generally you would be expected to act in accordance with your level of training.

Obviously would need to check with your state laws for specifics but even if you are acting in a voluntary manner and covered y a Good Samaritan law would still be expected to act within your training/knowledge level.
 
FLdoc2011 said:
Be careful of this type of thinking as generally you would be expected to act in accordance with your level of training.
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NYS has no mandatory duty to act, so anything i would be doing is as a civilian, not an off duty EMT/paramedic/ whatever healthcare provider you are. In NYS it is ethical, not mandatory. To be completely honest i probably would not even announce myself as an EMT, i would just be "the brave soul" that actually does the action on the future patient. Also if you'd like the protocols(as per state regulations) i think it is Public Health Article 30, section 3000.
 
NysEms2117 said:
NYS has no mandatory duty to act, so anything i would be doing is as a civilian, not an off duty EMT/paramedic/ whatever healthcare provider you are. In NYS it is ethical, not mandatory. To be completely honest i probably would not even announce myself as an EMT, i would just be "the brave soul" that actually does the action on the future patient. Also if you'd like the protocols(as per state regulations) i think it is Public Health Article 30, section 3000.
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It's true you would be covered under that acting in a voluntary manner but it doesn't protect you (or anyone for that matter) if you commit gross negligence, and since we're trained providers we automatically know more than the general public and could theoretically be held for gross negligence if we did something that a lay person may not be. I'm not saying it's a duty to act, it's not, but it's also not an excuse to act like you know nothing at all IF you choose to help. If you come across a car wreck with obvious trauma nd attempt to pull a person out of the car assuming they aren't in imminent peril from staying in the car, then a general lay person may not know not to move them or what precautions to take but you do and would be expected to act that way.
 
Also, just to be clear, I'm also not saying that we would be expected to carry certain equipment or medications to be able to give off-duty.

As a physician IF I choose to stop I would give whatever care I could with what was available which would likely just be notifying EMS and comforting the patient. BUT I certainly would not pretend like I know nothing and not use my medical training/knowledge
 
NysEms2117 said:
NYS has no mandatory duty to act, so anything i would be doing is as a civilian, not an off duty EMT/paramedic/ whatever healthcare provider you are. In NYS it is ethical, not mandatory. To be completely honest i probably would not even announce myself as an EMT, i would just be "the brave soul" that actually does the action on the future patient. Also if you'd like the protocols(as per state regulations) i think it is Public Health Article 30, section 3000.
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Not so much as mandatory duty, its more along the lines of your constructive *right* to act. And even if the state doesn't explicitly have a mandatory duty to act, failure to reasonably act could be seen as criminal negligence. (because even if someone isn't trained at all they must still take the minimum steps that any reasonable person would know to take, such as activating the EMS system, etc.) The flip side is that what is considered "reasonable" under the case law takes into account a persons level of training, and what is available on scene.

Minimally these days CPR equipment should be on scene in most places. I mean there's about ZERO chance someone's getting CPR from me without a BVM being on hand, unless I know this person well enough to trust that their probably NOT a bio threat. This is why I think that every BLS trained individual should be carrying a pocket BVM. They're surprisingly small enough, yet will give full functionality as their standard traditional types. (even though the masks on them suck)
 
Well the thing is if I ever was in a situation like that. Unless the person was going to die within the next minute I wouldent do anything aside from call 911. I also think it's a little different being a physician and an EMT. I do understand both of your points though. Although I don't think any of those cases would even stand a remote chance in court
 
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