Can EMTs administer medications while not on shift?

bakertaylor28 said:
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)
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I think you're crossing over into what a lot of us probably think is that it's ethical to help if you can but that's a different topic. I'm purely talking about what's spelled out in law. Certainly not spelled out that we must carry even basic equipment or stop/help at all.
 
NysEms2117 said:
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
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Vs. withholding the epi and allowing anaphalaxis to progress? are you kidding? Forgoing epi even a short time when dealing with clear symptoms of anaphalaxis is ASKING AND BEGGING for a full arrest- or at least the need for an advanced airway on the most difficult possible terms.

The thing to remember is that anaphalaxis can progress extremely quickly to a full arrest- sometimes in a matter of a few minutes.
 
NysEms2117 said:
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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I agree and that's what I would do as well. And you never want to be a test case. I have seen mention of some case studies and one where a civilian pulled a person from a car possibly aggravating their injuries and was sued, I don't think anything came of it but still, what a hassle.

In basic, use reasonable/common sense based on what you know. No need to play "dumb".
 
bakertaylor28 said:
Vs. withholding the epi and allowing anaphalaxis to progress? are you kidding? Forgoing epi even a short time when dealing with clear symptoms of anaphalaxis is ASKING AND BEGGING for a full arrest- or at least the need for an advanced airway on the most difficult possible terms.

The thing to remember is that anaphalaxis can progress extremely quickly to a full arrest- sometimes in a matter of a few minutes.
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I don't even know what this is in reference too. I said I would use the epi-pen provided nobody else stepped up


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NysEms2117 said:
I don't even know what this is in reference too. I said I would use the epi-pen provided nobody else stepped up


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Yea I'm not sure what he's getting at with some of these posts.

Honestly unless I've witnessed the event, am by myself and no other help is available I don't get involved beyond calling 911. Usually I have my family with me and am not stopping or even for the slightest second potentially exposing my family to some risk.

Thankfully I haven't come across an in-flight emergency yet....
 
FLdoc2011 said:
In basic, use reasonable/common sense based on what you know. No need to play "dumb".
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Yes sir/ma'am :)


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FLdoc2011 said:
Yea I'm not sure what he's getting at with some of these posts.

Honestly unless I've witnessed the event, am by myself and no other help is available I don't get involved beyond calling 911. Usually I have my family with me and am not stopping or even for the slightest second potentially exposing my family to some risk.

Thankfully I haven't come across an in-flight emergency yet....
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This x100000 except the whole flight thing. I cannot justify putting my family in harms way.


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FLdoc2011 said:
I think you're crossing over into what a lot of us probably think is that it's ethical to help if you can but that's a different topic. I'm purely talking about what's spelled out in law. Certainly not spelled out that we must carry even basic equipment or stop/help at all.
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Right, but the common law and case law controls the statutory law. The definition of "Gross Negligence" at common law is "lacking even the slightest care, that a reasonable and prudent person would take"- and the case law has made clear that that definition is subject to a person's documented level of training. You also have to understand that most jurors will side with EMS personel providing treatment- because when you think about it, I seriously DOUBT anyone is really going to CARE about the technicalities of things when their laying on the ground in bad shape at best and fixing to die at worst- I just don't see someone Asking me If I'm on the clock or questioning my credentials in a technical way, in light of such circumstances. Hence, legal liability isn't an issue unless you do something so incredibly stupid that every one of us would be wondering which short bus dropped you off at the scene kind of thing.
 
Thanks for your input, but I think when it comes to the law I'll do my own interpreting :).
 
bakertaylor28 said:
Right, but the common law and case law controls the statutory law. The definition of "Gross Negligence" at common law is "lacking even the slightest care, that a reasonable and prudent person would take"- and the case law has made clear that that definition is subject to a person's documented level of training. You also have to understand that most jurors will side with EMS personel providing treatment- because when you think about it, I seriously DOUBT anyone is really going to CARE about the technicalities of things when their laying on the ground in bad shape at best and fixing to die at worst- I just don't see someone Asking me If I'm on the clock or questioning my credentials in a technical way, in light of such circumstances. Hence, legal liability isn't an issue unless you do something so incredibly stupid that every one of us would be wondering which short bus dropped you off at the scene kind of thing.
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Legal liability is always an issue, you'll find out soon enough. Yea at that particular moment the victim may not care but a few weeks later when they're trying to figure out how they can get some money out of the incident then you can bet they'll be looking for any possible avenue.

If I'm even at a point where I'm relying on a juror to decide (even if they side with me and I did everything right) then my life has already been turned upside down.
 
FLdoc2011 said:
Legal liability is always an issue, you'll find out soon enough. Yea at that particular moment the victim may not care but a few weeks later when they're trying to figure out how they can get some money out of the incident then you can bet they'll be looking for any possible avenue.

If I'm even at a point where I'm relying on a juror to decide (even if they side with me and I did everything right) then my life has already been turned upside down.
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Yes, and filing a lawsuit under such pretenses runs on the borderline illegal in most states- could be considered vexatious litigation- which the courts tend not to be fond of at the very least. Not only that- but any more, medical malpractice type litigation is NOT a get-rich quick scheme- it takes a considerable investment of cash to file these types of cases. The reason why, is because plaintiff has burden of proof, which means plaintiff has to pay the initial hefty fees for expert witnesses before their even allowed to file. Otherwise, the courts have a tendency to dismiss the case as mere conclusory allegations. This has been part of the med-malpractice overhaul in the last 20 years or so- nowdays with anything medical, in most states, you have to have an expert from the same field as the named defendant agreeing that there was negligence, before the courts will even allow you to file.

Of course, in my particular state, I can't be sued for medical malpractice- because of the fact that I am recieving education with a state university teaching hospital. This is because Kentucky's immunity laws extend to anyone whom is in any way affiliated with a hospital owned and operated by the state. Therefore, at this point, I don't even have to worry about liability- I have to worry about the hospital admins, the attendings, and the state regulatory agencies.
 
bakertaylor28 said:
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. QUOTE]
Does this include compressions?
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Uh, use some common sense. I was NOT talking about compressions. Though compressions certainly aren't going to get you far in such circumstances.
 
bakertaylor28 said:
Uh, use some common sense. I was NOT talking about compressions. Though compressions certainly aren't going to get you far in such circumstances.
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All I had to go off of what was you said and in that you said "....there's about ZERO chance someone's getting CPR from me....", which is why I asked for clarification. Compressions are kinda important and 0 CPR= 0 compressions to me.
 
StCEMT said:
All I had to go off of what was you said and in that you said "....there's about ZERO chance someone's getting CPR from me....", which is why I asked for clarification. Compressions are kinda important and 0 CPR= 0 compressions to me.
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Well gee, If I have to be THAT specific. The point I was making was that unless we're dating I'm NOT kissing you... CPR or not. :-D After All thats what the BVM is for...smh
 
bakertaylor28 said:
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)
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I think you should stick to doctoring over lawyering.
 
bakertaylor28 said:
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.
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It's been a 3-5 years now, but two PA medics were de-certed permanently for practicing without a license off duty. One from Lancaster, and one from Schuylkill County. I read of another from Maryland, career medic/ff in the city who ended up doing ALS skills riding along on a county unit but without the authority to practice also had his MD cert pulled also, maybe 2.5 years ago now. I didn't follow up but at least one was explaining why he had an IV and other stuff in his car and looking at theft charges, fired from his company, etc...

Pennsylvania, Title 35 § 8154 (B) Obstruction of EMS is a summary offense.
http://www.legis.state.pa.us/cfdocs...tl=35&div=00.&chpt=081.&sctn=054.&subsctn=000

Maryland was a summary or lowest misdemeanor,... Most states I am aware of haven't upgraded that to felony. When actually occurring, it's _theoretically_ possible that assaulting EMS is a felony, but always ends up a summary disturbing the peace charge unless there is serious injury or complications, the DA's are busy and don't give a damn.

Some states vary. Delaware, for example, from what I recall - any off duty paramedic can be "activated" and become "on duty" but just needs to report it. Doesn't work if he is in, say, New Jersey though, and they are "on the clock" when activated. They're also a government model and not a third party, or hospital based type.

It's been my experience the prehospital laws in most states predicate your ability to practice EMS as dependent upon a Medical Director's medical license. Police and EMS are apples and oranges, and the closest similarly would be could a local Louisiana sheriff make an arrest while on vacation, in a bar, in New York City? Off duty firefighters can't just hop on a truck in another city and go to a job, pack up and go interior...
 
dutemplar said:
Maryland was a summary or lowest misdemeanor,... Most states I am aware of haven't upgraded that to felony.
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NYS is bringing it to a class E felony in 2017... Well possession of a hypodermic instrument.(im sure criminal mischief could stick, misconduct, ect ect)
Also give me a few weeks with a case, and i'm pretty sure i can get some charges to stick.
However....
"
S 195.16 Obstructing emergency medical services.
A person is guilty of obstructing emergency medical services when he
or she intentionally and unreasonably obstructs the efforts of any
service, technician, personnel, system or unit specified in section
three thousand one of the public health law in the performance of their
duties.
Obstructing emergency medical services is a class A misdemeanor.
"
Great points though :P bravo sir!
 
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