Medical Control Question

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NJEMT95

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I'm going to be working at a residential summer camp this summer as a counselor but will also be expected to assist in medical emergencies. Can I operate under my EMT scope of practice? There is an MD at the location full-time - can she function as my medical control? Also, my certification is not for the state where the camp is located.
 
That might be a question for the office of EMS in the state you'll be working in. If that state offers reciprocity, and the doctor is an approved medical director… Then maybe, and that's a big maybe, yes.

However, my gut is telling me that you will be able to act as a basic first aid provider only.

Don't count on advice from an online forum to keep you out of legal issues. It's worth talking to the powers that be to make sure you stay on the up and up and stay out of trouble. Start with the EMS office in the state that your camp is in. If you start now, you might be able to get reciprocity and move ahead with working as an EMT in that state.
 
Thanks. Yeah - I know it's a big maybe. I mainly just posted to see if it's even a remote possibility before I start dealing with state bureaucracies.
 
The answer is ultimately no the way you describe it. Too much is out of place. Without reciprocity your certification doesn't exist. You are just a guy/gal who knows first aid.


Outside of basic first aid, what are you really in need of a medical director for at the EMT level at a summer camp?
 
You will certainly need to obtain a license in that state to get this done.

You may run into problems having the MD be your "medical control" because you are not a licensed EMS agency, and setting one of those up could be pretty intensive.
 
First aid. The MD can give you orders as though to a bystander.
To act as an EMT, you need a license or certif valid where you will be, protocols, tools, and medical control to oversee and sign off your work.
 
Sure I agree with the above posters, but in truth I'm not sure it really matters. The truth is if this MD is on the scene of the emergency with you and they are helping them, I don't think you'd get in anymore trouble than if the MD was directing bystanders to help them hold pressure on bleeding or hold c-spine.

Now if the MD is going to be authorizing you to provide treatment beyond normal first aid, ie you are going to be carrying around 02, an epi pen not prescribed to the patient, nitro etc, that's a lot more trouble.

I think it's important to remember the difference between being hired as a full time camp councilor who has medical training, and being hired as an EMT. If you were being hired as the full time camp EMT, especially if there was not a full time doctor, you would be in a much risker position then if you were just expected to use your training to help if there was an emergency. I think most people would expect a camp councilor who had been trained as a RN, a firefighter, a lifeguard to help with an emergency even if they weren't "working" in that capacity.
 
I disclaim I am not a legal expert, but I would think if there was an MD on scene it would fall into the "borrowed servant" category.

She might ask you to do something, and accept full responsibility for the outcome, but you probably would not be in the clear if you tried to perform something beyond what you were trained to do without first clarifying that was beyond your training.

Keep in mind med control does not have unlimited authority, and there is more than one case where EMS providers got in big trouble following medical control direction.

The case in NJ of an emergent field c-section stands out in my mind the most.

Doctor got a slap on the wrist and told never to do that again.

Medics lost their certs.
 
Veneficus; said:
, but you probably would not be in the clear if you tried to perform something beyond what you were trained to do without first clarifying that was beyond your training.
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Just to be clear on this, even if you say "I'm not trained to do this," that doesn't allow you to do things that you aren't trained in. So if an MD tells an EMT "stick in this chest tube," you aren't absolved of responsibility for violating the standard of care as an EMT and you could lose your cert.

Now that is different from someone telling you to do something that is within your scope of practice. What gets tricky is when you aren't offically working. For the EMT I don't think it's a big deal, because the things EMTs can do are basically the same as what a reasonable civilian could do (hold pressure on bleeding, make a splint.) I think where it gets very grey is what an off duty paramedic can do when an MD tells them to do something that would normally be in their scope of care.

So if you were a camp councilor, and you were a certified paramedic but did not have an independent license and the MD at camp asked you to start an IV and give some benadryl for an allergic reaction. That's a bit more dodgy.
 
zmedic said:
Just to be clear on this, even if you say "I'm not trained to do this," that doesn't allow you to do things that you aren't trained in. So if an MD tells an EMT "stick in this chest tube," you aren't absolved of responsibility for violating the standard of care as an EMT and you could lose your cert. .
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That is what I was trying to say.

Sorry, rough day for me.
 
NYMedic828 said:
The answer is ultimately no the way you describe it. Too much is out of place. Without reciprocity your certification doesn't exist. You are just a guy/gal who knows first aid.


Outside of basic first aid, what are you really in need of a medical director for at the EMT level at a summer camp?
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There are indeed several camps I know of that will hire emts and LVNs to work I went to one they had them on property and worked in the onsite clinic. I also know Six Flags hires all levels of responders as they are a certified ALS first responder organization at least here in Texas
 
xrsm002 said:
There are indeed several camps I know of that will hire emts and LVNs to work I went to one they had them on property and worked in the onsite clinic. I also know Six Flags hires all levels of responders as they are a certified ALS first responder organization at least here in Texas
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Is that your chinchilla?
 
Veneficus said:
Is that your chinchilla?
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<-----yes that's my chinchilla his name is Einstein because of his large head, I also own 4 dogs, a rat, and a bearded dragon, my wife is a veterinary technician getting ready to test for her Registerd Veterinary Technician certification
 
xrsm002; said:
There are indeed several camps I know of that will hire emts and LVNs to work I went to one they had them on property and worked in the onsite clinic. I also know Six Flags hires all levels of responders as they are a certified ALS first responder organization at least here in Texas
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You do need to keep an eye out, there are places that will hire you to work as an EMT, doesn't mean they know anything about medical direction or what the state requires. My college used to hire us to work at rugby games, eventually we figured out we needed a medical director and had to be certified by the state, but the college hadn't cared about that.

Just to be clear, if you happen to be an EMT and are being hired for another role that's one thing, if you are specifically being hired to provide medical care you should make sure that you are within state guidelines, or are working for an organization that is exempt from state oversight (like many ski areas.)
 
zmedic said:
You do need to keep an eye out, there are places that will hire you to work as an EMT, doesn't mean they know anything about medical direction or what the state requires. My college used to hire us to work at rugby games, eventually we figured out we needed a medical director and had to be certified by the state, but the college hadn't cared about that.

Just to be clear, if you happen to be an EMT and are being hired for another role that's one thing, if you are specifically being hired to provide medical care you should make sure that you are within state guidelines, or are working for an organization that is exempt from state oversight (like many ski areas.)
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I work as an EMT without a medical director as I exempt from state EMS oversight. I work under an athletic trainer's license meaning I can do whatever he can do so long as he educates and approves me to do it. As an ATC can do pretty much everything a basic can do (including med administration), I do not need a medical director as an ATC has an independent license in Colorado.

For IVs I can get an order from a physician, but I am a bit concerned about the legalities associated with that.
 
We need a seminar on this issue, it crops up around summer employment every year.

I think employers many times are ignorant of what they need to go beyond first aid, so either they hire techs then expect them to go be techs without the infrastructure, or they hire EMT's to fill a first aid slot and expect the EMT to exceed their first aid -mandated duties (called "working cheap", or working under your certificate).
 
NYMedic828 said:
Outside of basic first aid, what are you really in need of a medical director for at the EMT level at a summer camp?
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This. Do you really need a medical director to splint some kids broken arm/leg and apply bandages ect.?
 
Sublime said:
This. Do you really need a medical director to splint some kids broken arm/leg and apply bandages ect.?
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I suppose a bee sting/asthmatic reaction is of high potential at a summer camp but responsible parents should be ensuring their child is equipped with the treatment or that someone at the camp is. (Inhaler/epipen)

Helping a 7 year old administer his epi pen isn't exactly acting as an EMT. You are just doing what any sensible person would do to help a child.

When you show up "on-scene" and pull out your own epi pen and administer it the situation changes.
 
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