No duty to act, but repercussions if I did?

[LCotto]

Thanks everyone for the information. I have class today so I'm wondering what we hear.

 

[Tigger]

Second: the law does not define what is right and wrong. The terms "legal" and "moral" are not synonyms.

Exactly. That is the purpose of these lectures, to remind students of this. There isn't a right answer, but there is room for a decent discussion to highlight that sometimes healthcare puts you in an unfortunate place.

This, and similar scenarios, should've been covered in your EMT-B class. I don't understand how someone who's in a medic school, still doesn't know the right answer to this.

So what is the right answer then? Is there one? Is it different for different people?

When the time comes, make sure you pay attention to the chapter on Patient Abandonment.

I think it's a bit questionable as to whether or not that this constitutes abandonment as there is no provider/patient established relationship. Just a bystander, with minimal obligation.

Nothing solid to show as a reference, but I heard this story too. Not sure about the off-duty part though, technically (and legally) it falls under the Good Samaritan.

Invasive airway procedures are definitely not covered by any sort of Good Samaritan Act.

 

[Qulevrius]

Invasive airway procedures are definitely not covered by any sort of Good Samaritan Act.

CA Health & Safety Code, Section 1799.102 (a):

No person who in good faith, and not for compensation, renders emergency medical or nonmedical care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission other than an act or omission constituting gross negligence or willful or wanton misconduct. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.

I do not know which state you're from, but in CA the Good Samaritan Law doesn't care how invasive the procedure is, as long as the person performing it is not being paid to do it.

 

[DesertMedic66]

CA Health & Safety Code, Section 1799.102 (a):

No person who in good faith, and not for compensation, renders emergency medical or nonmedical care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission other than an act or omission constituting gross negligence or willful or wanton misconduct. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.

I do not know which state you're from, but in CA the Good Samaritan Law doesn't care how invasive the procedure is, as long as the person performing it is not being paid to do it.

That law does cover off duty personnel to an extent. However you start to run into practicing medicine without a license (a lot of the devices that we use require a prescription to buy).

 

[Qulevrius]

That law does cover off duty personnel to an extent. However you start to run into practicing medicine without a license (a lot of the devices that we use require a prescription to buy).

Ok, then does it apply to someone who has, according to OP, 'has left a cricothyrotomy kit in his pocket' - which by association means that the procedure is within his/her scope of practice ? The way I see it (and the way it had been outlined during my training), it definitely falls under the GSL.

 

[DesertMedic66]

Ok, then does it apply to someone who has, according to OP, 'has left a cricothyrotomy kit in his pocket' - which by association means that the procedure is within his/her scope of practice ? The way I see it (and the way it had been outlined during my training), it definitely falls under the GSL.

When you are off duty there is no scope of practice. A scope of practice is made by a medical director for employees who are working under them, so to speak. When you are off duty you are not working under a medical director and really anything aside from basic life support can very easily be considered practicing medicine without a license. Thats why you don't see people working as a paramedic at events who are not part of a company.

 

[Chimpie]

I think it's a bit questionable as to whether or not that this constitutes abandonment as there is no provider/patient established relationship. Just a bystander, with minimal obligation.

I agree, however, as you posted..

Invasive airway procedures are definitely not covered by any sort of Good Samaritan Act.

Especially if he's carrying a kit for this specific procedure.

In the end, it's all up to the laws of the state you're in, how good your lawyer is and the competency of those deciding your fate in a trial.

 

[Qulevrius]

When you are off duty there is no scope of practice. A scope of practice is made by a medical director for employees who are working under them, so to speak. When you are off duty you are not working under a medical director and really anything aside from basic life support can very easily be considered practicing medicine without a license. Thats why you don't see people working as a paramedic at events who are not part of a company.

Gotcha, thanks. By 'scope of practice' I only meant that the person in question knows what they're doing, as opposed to being a witch doctor.

In the end, it's all up to the laws of the state you're in, how good your lawyer is and the competency of those deciding your fate in a trial.

I guess this is the part that I refused to understand, from a moral perspective.

 

[DesertMedic66]

Gotcha, thanks. By 'scope of practice' I only meant that the person in question knows what they're doing, as opposed to being a witch doctor.



I guess this is the part that I refused to understand, from a moral perspective.

Knows what they are doing is no where near scope of practice. In my area in CA we are not allowed to intubate anyone under 8 years old. In my medic program we covered pediatric intubation so I know how to do it but if I do it while working I will instantly be fired and have my medic license pulled because its not in my counties scope of practice.

 

[Qulevrius]

@DesertMedic66 last question: what is then the difference between 'practicing medicine without license' and 'acting in good faith' ? If it's not the tools or the knowledge, where's the line being drawn ?

 

[DesertMedic66]

@DesertMedic66 last question: what is then the difference between 'practicing medicine without license' and 'acting in good faith' ? If it's not the tools or the knowledge, where's the line being drawn ?

That whole area is a gray area. There is no line. I think its safe to say that if any piece of equipment you are using that requires a prescription from a doctor is practicing without a license

 

[Qulevrius]

Perfect, thanks you.

 

[Tigger]

See, there is no "right answer from EMT school."

As said, when you are not working under a medical director, you have no scope practice. As far as I am aware, there is no state in which this is not true. If you have no scope of practice, you're left with basic first aid, interventions that a reasonable person would perform. A crich is not one of those. That is a medical procedure. You need a medical director to do that. No good samaritan act is going to protect you from practicing medicine off duty.

 

[Qulevrius]

You're right, there's no 'right answer'. The school made it look like there is, but I'm glad that there's always someone on this website who can call out any BS we've been fed with. Live and learn.