Can I perform ALS interventions?

Adriel Stoltzfus

Adriel Stoltzfus

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Does anyone know if I can perform ALS interventions if I come upon a scene in my personal vehicle and I have an ALS bag? I am an Indiana Advanced life support provider.
 
If you're off duty then in short, no. You're not providing care under a medical director when off duty. Call 911 and carry on.
 
No. Best practice is to call 911 and move on. You cant even apply oxygen in that scenario.

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Well after seeing your indiana certs I have to ask. Are you on a volunteer EMS agency? That will change things a little. Im assuming so because the only logical reason to actually have the green light card is if you volunteer.......though even then I done condone POV lights regardless of the color


ETA: yes, curiosity got the best of me on how long youve been a practicing ALS provider cause this is a situation with pretty serious legal ramifications that you should have know the answer too before you even tested.

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Most jurisdictions have legislation that states your assistance is limited to standard first aid. I've also seen legislation that allows volunteer organizations who lack medical control to perform ALS interventions, but their protocols include more contraindications and are already outlined and agreed upon by the primary EMS agency.

Why do you have an ALS bag with you? Are you an EMS volunteer?
 
It comes down to medical direction. Do you have any when you're not on the truck? If not, stay away. If so (like everyone that works for my medical director), maybe.
 
Only if your medical director has authorized you to have that equipment, and authorized you to use it while not "on duty."

Otherwise it's practicing medicine without a license in many jurisdictions... and there could be unpleasant questions as to how you physically acquired the ALS gear. and supplies.
 
Tigger said:
It comes down to medical direction. Do you have any when you're not on the truck? If not, stay away. If so (like everyone that works for my medical director), maybe.
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Corollary: If you don't know, you're safest operating under the assumption that you *may not* perform ALS procedures off duty.
 
EpiEMS said:
Corollary: If you don't know, you're safest operating under the assumption that you *may not* perform ALS procedures off duty.
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I would still be loathe to perform independent ALS interventions as just a bystander. Friend gets jacked up in the backcountry? Do what you think is right says the medical director. Out resort skiing or driving through the middle of nowhere and come upon something rough? See if the AHJ has ALS equipment available (he's a skier/outdoorsy person and many ski patrols and volly ambulances do have ALS equipment but less access to ALS providers). But I'm not going to do anything besides first aid outside of that.
 
Im hard pressed to perform any ALS intervention when im not getting paid. Even when im on a run as a firefighter, if the medic ask me to do something outside of an EMT scope my employer will clock me in for it thats more do to cover the department). Even then I rarely do it unless absolutely necessary.

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Tigger said:
Do what you think is right says the medical director.
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This...I don't love. I'd rather have some clear "Yes"/"No" guidance. Do what I think is right requires that I know he'll go to bat for me in front of a court.
 
Depends on the circumstances. If I'm with my buddies in the back country and someone has a real need for ALS which I mysteriously could provide (say, a severe allergic reaction for which I had benadryl), sure. If we're talking courtesy IVs, not so much.
 
EpiEMS said:
This...I don't love. I'd rather have some clear "Yes"/"No" guidance. Do what I think is right requires that I know he'll go to bat for me in front of a court.
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This is mostly in terms of trauma care, which is realistically where a few ALS interventions could actually matter. I also do think he would fight for us but obviously we have nothing in writing.
 
Tigger said:
This is mostly in terms of trauma care, which is realistically where a few ALS interventions could actually matter. I also do think he would fight for us but obviously we have nothing in writing.
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Fair enough - though I have to imagine those situations are few and far between.
 
The biggest issue I see here is that you have an "ALS bag" in you personal vehicle and then how you acquired said ALS equipment. Technically you need a physician's prescription for ALS medications and equipment. You could be charged with theft and possession of prescription medications without a prescription if you didn't get your equipment through correct channels.
 
What they said...

Also, depending on where in Indiana you're working, you also have to take into consideration that if it was discovered that you provided ALS interventions prior to on duty EMS arriving on scene, it WILL be annotated. Our EPCR has tabs for meds/treatments provided prior to EMS arrival, and you can bet any medics responding will ensure that ALS interventions provided prior to arrival will be documented to the fullest in their narrative...no medic who values their certification will accept responsibility for ALS interventions they didn't do, good or bad. This is bound to come back to you, and if it makes it back to your medical director, then you're at risk of losing your certification.
 
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