Guest guest Posted January 13, 2011 Report Share Posted January 13, 2011 agreed. varying shades of gray. (that's different from ' a whiter shade of pale'... that's a procol harem tune. this is no sh*t - I actually worked somewhere which would not allow emt-basics to check blood sugar with a glucometer (as a knee jerk reaction to someone getting a dirty lancet stick in the past) jim davis paramedic > Jodi, > > What a person can do on an ambulance varies from state to state. A physician has a license that allows him to practice medicine anywhere in the state at any time. However, he does not automatically have the right to take over care at a scene when paramedics are present. Generally, if he wishes to assume care, he must accompany the patient to the hospital and issue all orders. If he orders you to do something against protocol, the way to handle it is to get him in touch with med control physician and let them hash it out. > > I do not believe that a PA or an RN has any power to assume care from you. PAs and nurses practice under a physician's orders. Unless they are a part of the system you're in, I don't think they have the right to practice in your ambulance. > > The easiest way to get a definitive answer is to call Robin Gil and ask her. I'll bet she has the answer on the tip of her tongue. > > Next, there is no legal liability for having a first aid kit in your car or in not having one. When you are outside the state where you are certified, you are on the level of a Boy Scout, meaning you can do first aid only. If you choose to do it, you are bound to do it competently, but only to First Aid level. You don't need medical control to do first aid. You do need medical control to do anything invasive or give a drug. > > I carry no advanced equipment since I would have no authority to use it. My paramedic has no validity in a state where I am not certified. I COULD ask for and receive medical control if a physician were willing to do it, but the chances of that happening are nil. I would have no idea how to contact an online physician on my cellphone. > > The best legal reference is a book named Legal Medicine, published by Mosby. It is not specific for EMS but general. However, it does cover lots of basic legal stuff about medicine. > > Happy reading. > > GG > > PA or RN on Scene other legalities > > GG, > > Here is an off the wall question for you: Presently we have Protocols in > place for Physician On Scene and the requirement that physician be willing > to escort a Patient to the hospital if he/she so desires to provide aid but > what if you run across a Physician Assistant or an RN with field > experience/training as in a Flight Nurse? Are they also legally responsible > for the Patient so long as they agree to escort to the hospital? Either one > is the next echelon higher in care. Would you consider patient care to be > more of a cooperative work in the later case based on scope of practice and > equipment expected to be available? Is there some literature or > state/federal statute that I can review that you can assist me with? > > I am on a role here.. Here is the other can: It has been advised EMS > personnel remove First Aid Kits from their vehicles as it may also become a > legal liability. Here is the what if; what if I am traveling away from home > area and come upon a desolate scene where I am the only medically trained > person available. How does one request medical control or is it possible? > Regardless of whether or not it is a band aid or an ET tube. Where does > layperson give way to Paramedicine in a court of Law? Especially where no > foreseeable survivability exists without it. I am leaving common sense out > of this because my Cert is near and dear to my heart and my pocket book. > > Long ago during class you had pointed out a legal reference for EMS. I don't > suppose you recall the reference? > > J. Meere > > CEP, Arizona Ambulance > > U.S. Army, Retired > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2011 Report Share Posted January 13, 2011 agreed. varying shades of gray. (that's different from ' a whiter shade of pale'... that's a procol harem tune. this is no sh*t - I actually worked somewhere which would not allow emt-basics to check blood sugar with a glucometer (as a knee jerk reaction to someone getting a dirty lancet stick in the past) jim davis paramedic > Jodi, > > What a person can do on an ambulance varies from state to state. A physician has a license that allows him to practice medicine anywhere in the state at any time. However, he does not automatically have the right to take over care at a scene when paramedics are present. Generally, if he wishes to assume care, he must accompany the patient to the hospital and issue all orders. If he orders you to do something against protocol, the way to handle it is to get him in touch with med control physician and let them hash it out. > > I do not believe that a PA or an RN has any power to assume care from you. PAs and nurses practice under a physician's orders. Unless they are a part of the system you're in, I don't think they have the right to practice in your ambulance. > > The easiest way to get a definitive answer is to call Robin Gil and ask her. I'll bet she has the answer on the tip of her tongue. > > Next, there is no legal liability for having a first aid kit in your car or in not having one. When you are outside the state where you are certified, you are on the level of a Boy Scout, meaning you can do first aid only. If you choose to do it, you are bound to do it competently, but only to First Aid level. You don't need medical control to do first aid. You do need medical control to do anything invasive or give a drug. > > I carry no advanced equipment since I would have no authority to use it. My paramedic has no validity in a state where I am not certified. I COULD ask for and receive medical control if a physician were willing to do it, but the chances of that happening are nil. I would have no idea how to contact an online physician on my cellphone. > > The best legal reference is a book named Legal Medicine, published by Mosby. It is not specific for EMS but general. However, it does cover lots of basic legal stuff about medicine. > > Happy reading. > > GG > > PA or RN on Scene other legalities > > GG, > > Here is an off the wall question for you: Presently we have Protocols in > place for Physician On Scene and the requirement that physician be willing > to escort a Patient to the hospital if he/she so desires to provide aid but > what if you run across a Physician Assistant or an RN with field > experience/training as in a Flight Nurse? Are they also legally responsible > for the Patient so long as they agree to escort to the hospital? Either one > is the next echelon higher in care. Would you consider patient care to be > more of a cooperative work in the later case based on scope of practice and > equipment expected to be available? Is there some literature or > state/federal statute that I can review that you can assist me with? > > I am on a role here.. Here is the other can: It has been advised EMS > personnel remove First Aid Kits from their vehicles as it may also become a > legal liability. Here is the what if; what if I am traveling away from home > area and come upon a desolate scene where I am the only medically trained > person available. How does one request medical control or is it possible? > Regardless of whether or not it is a band aid or an ET tube. Where does > layperson give way to Paramedicine in a court of Law? Especially where no > foreseeable survivability exists without it. I am leaving common sense out > of this because my Cert is near and dear to my heart and my pocket book. > > Long ago during class you had pointed out a legal reference for EMS. I don't > suppose you recall the reference? > > J. Meere > > CEP, Arizona Ambulance > > U.S. Army, Retired > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2011 Report Share Posted January 13, 2011 agreed. varying shades of gray. (that's different from ' a whiter shade of pale'... that's a procol harem tune. this is no sh*t - I actually worked somewhere which would not allow emt-basics to check blood sugar with a glucometer (as a knee jerk reaction to someone getting a dirty lancet stick in the past) jim davis paramedic > Jodi, > > What a person can do on an ambulance varies from state to state. A physician has a license that allows him to practice medicine anywhere in the state at any time. However, he does not automatically have the right to take over care at a scene when paramedics are present. Generally, if he wishes to assume care, he must accompany the patient to the hospital and issue all orders. If he orders you to do something against protocol, the way to handle it is to get him in touch with med control physician and let them hash it out. > > I do not believe that a PA or an RN has any power to assume care from you. PAs and nurses practice under a physician's orders. Unless they are a part of the system you're in, I don't think they have the right to practice in your ambulance. > > The easiest way to get a definitive answer is to call Robin Gil and ask her. I'll bet she has the answer on the tip of her tongue. > > Next, there is no legal liability for having a first aid kit in your car or in not having one. When you are outside the state where you are certified, you are on the level of a Boy Scout, meaning you can do first aid only. If you choose to do it, you are bound to do it competently, but only to First Aid level. You don't need medical control to do first aid. You do need medical control to do anything invasive or give a drug. > > I carry no advanced equipment since I would have no authority to use it. My paramedic has no validity in a state where I am not certified. I COULD ask for and receive medical control if a physician were willing to do it, but the chances of that happening are nil. I would have no idea how to contact an online physician on my cellphone. > > The best legal reference is a book named Legal Medicine, published by Mosby. It is not specific for EMS but general. However, it does cover lots of basic legal stuff about medicine. > > Happy reading. > > GG > > PA or RN on Scene other legalities > > GG, > > Here is an off the wall question for you: Presently we have Protocols in > place for Physician On Scene and the requirement that physician be willing > to escort a Patient to the hospital if he/she so desires to provide aid but > what if you run across a Physician Assistant or an RN with field > experience/training as in a Flight Nurse? Are they also legally responsible > for the Patient so long as they agree to escort to the hospital? Either one > is the next echelon higher in care. Would you consider patient care to be > more of a cooperative work in the later case based on scope of practice and > equipment expected to be available? Is there some literature or > state/federal statute that I can review that you can assist me with? > > I am on a role here.. Here is the other can: It has been advised EMS > personnel remove First Aid Kits from their vehicles as it may also become a > legal liability. Here is the what if; what if I am traveling away from home > area and come upon a desolate scene where I am the only medically trained > person available. How does one request medical control or is it possible? > Regardless of whether or not it is a band aid or an ET tube. Where does > layperson give way to Paramedicine in a court of Law? Especially where no > foreseeable survivability exists without it. I am leaving common sense out > of this because my Cert is near and dear to my heart and my pocket book. > > Long ago during class you had pointed out a legal reference for EMS. I don't > suppose you recall the reference? > > J. Meere > > CEP, Arizona Ambulance > > U.S. Army, Retired > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2011 Report Share Posted January 13, 2011 I also used to work at a location where it was officially against protocols for Basics to do d-sticks. Did we do them anyway? Yep. Because when it comes down to it... If somebody's LIFE depends on it - that person may die if you don't do X... If you don't identify and correct their hypoglycemia before they start to seize or lose consciousness... If you don't give them an Epi pen, or an albuterol BVM treatment... I'm not sure I could stand there and watch someone die, knowing I have both the tools and knowledge to save them. Hm... Some ex-boyfriends may be exempt from that rule, but I'm not sure I could stand there and watch a STRANGER die... Alyssa Woods, NREMT-B CPR Instructor > agreed. varying shades of gray. (that's different from ' a whiter shade of pale'... that's a procol harem tune. this is no sh*t - I actually worked somewhere which would not allow emt-basics to check blood sugar with a glucometer (as a knee jerk reaction to someone getting a dirty lancet stick in the past) > > jim davis > paramedic > > > > > Jodi, > > > > What a person can do on an ambulance varies from state to state. A physician has a license that allows him to practice medicine anywhere in the state at any time. However, he does not automatically have the right to take over care at a scene when paramedics are present. Generally, if he wishes to assume care, he must accompany the patient to the hospital and issue all orders. If he orders you to do something against protocol, the way to handle it is to get him in touch with med control physician and let them hash it out. > > > > I do not believe that a PA or an RN has any power to assume care from you. PAs and nurses practice under a physician's orders. Unless they are a part of the system you're in, I don't think they have the right to practice in your ambulance. > > > > The easiest way to get a definitive answer is to call Robin Gil and ask her. I'll bet she has the answer on the tip of her tongue. > > > > Next, there is no legal liability for having a first aid kit in your car or in not having one. When you are outside the state where you are certified, you are on the level of a Boy Scout, meaning you can do first aid only. If you choose to do it, you are bound to do it competently, but only to First Aid level. You don't need medical control to do first aid. You do need medical control to do anything invasive or give a drug. > > > > I carry no advanced equipment since I would have no authority to use it. My paramedic has no validity in a state where I am not certified. I COULD ask for and receive medical control if a physician were willing to do it, but the chances of that happening are nil. I would have no idea how to contact an online physician on my cellphone. > > > > The best legal reference is a book named Legal Medicine, published by Mosby. It is not specific for EMS but general. However, it does cover lots of basic legal stuff about medicine. > > > > Happy reading. > > > > GG > > > > PA or RN on Scene other legalities > > > > GG, > > > > Here is an off the wall question for you: Presently we have Protocols in > > place for Physician On Scene and the requirement that physician be willing > > to escort a Patient to the hospital if he/she so desires to provide aid but > > what if you run across a Physician Assistant or an RN with field > > experience/training as in a Flight Nurse? Are they also legally responsible > > for the Patient so long as they agree to escort to the hospital? Either one > > is the next echelon higher in care. Would you consider patient care to be > > more of a cooperative work in the later case based on scope of practice and > > equipment expected to be available? Is there some literature or > > state/federal statute that I can review that you can assist me with? > > > > I am on a role here.. Here is the other can: It has been advised EMS > > personnel remove First Aid Kits from their vehicles as it may also become a > > legal liability. Here is the what if; what if I am traveling away from home > > area and come upon a desolate scene where I am the only medically trained > > person available. How does one request medical control or is it possible? > > Regardless of whether or not it is a band aid or an ET tube. Where does > > layperson give way to Paramedicine in a court of Law? Especially where no > > foreseeable survivability exists without it. I am leaving common sense out > > of this because my Cert is near and dear to my heart and my pocket book. > > > > Long ago during class you had pointed out a legal reference for EMS. I don't > > suppose you recall the reference? > > > > J. Meere > > > > CEP, Arizona Ambulance > > > > U.S. Army, Retired > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2011 Report Share Posted January 13, 2011 I also used to work at a location where it was officially against protocols for Basics to do d-sticks. Did we do them anyway? Yep. Because when it comes down to it... If somebody's LIFE depends on it - that person may die if you don't do X... If you don't identify and correct their hypoglycemia before they start to seize or lose consciousness... If you don't give them an Epi pen, or an albuterol BVM treatment... I'm not sure I could stand there and watch someone die, knowing I have both the tools and knowledge to save them. Hm... Some ex-boyfriends may be exempt from that rule, but I'm not sure I could stand there and watch a STRANGER die... Alyssa Woods, NREMT-B CPR Instructor > agreed. varying shades of gray. (that's different from ' a whiter shade of pale'... that's a procol harem tune. this is no sh*t - I actually worked somewhere which would not allow emt-basics to check blood sugar with a glucometer (as a knee jerk reaction to someone getting a dirty lancet stick in the past) > > jim davis > paramedic > > > > > Jodi, > > > > What a person can do on an ambulance varies from state to state. A physician has a license that allows him to practice medicine anywhere in the state at any time. However, he does not automatically have the right to take over care at a scene when paramedics are present. Generally, if he wishes to assume care, he must accompany the patient to the hospital and issue all orders. If he orders you to do something against protocol, the way to handle it is to get him in touch with med control physician and let them hash it out. > > > > I do not believe that a PA or an RN has any power to assume care from you. PAs and nurses practice under a physician's orders. Unless they are a part of the system you're in, I don't think they have the right to practice in your ambulance. > > > > The easiest way to get a definitive answer is to call Robin Gil and ask her. I'll bet she has the answer on the tip of her tongue. > > > > Next, there is no legal liability for having a first aid kit in your car or in not having one. When you are outside the state where you are certified, you are on the level of a Boy Scout, meaning you can do first aid only. If you choose to do it, you are bound to do it competently, but only to First Aid level. You don't need medical control to do first aid. You do need medical control to do anything invasive or give a drug. > > > > I carry no advanced equipment since I would have no authority to use it. My paramedic has no validity in a state where I am not certified. I COULD ask for and receive medical control if a physician were willing to do it, but the chances of that happening are nil. I would have no idea how to contact an online physician on my cellphone. > > > > The best legal reference is a book named Legal Medicine, published by Mosby. It is not specific for EMS but general. However, it does cover lots of basic legal stuff about medicine. > > > > Happy reading. > > > > GG > > > > PA or RN on Scene other legalities > > > > GG, > > > > Here is an off the wall question for you: Presently we have Protocols in > > place for Physician On Scene and the requirement that physician be willing > > to escort a Patient to the hospital if he/she so desires to provide aid but > > what if you run across a Physician Assistant or an RN with field > > experience/training as in a Flight Nurse? Are they also legally responsible > > for the Patient so long as they agree to escort to the hospital? Either one > > is the next echelon higher in care. Would you consider patient care to be > > more of a cooperative work in the later case based on scope of practice and > > equipment expected to be available? Is there some literature or > > state/federal statute that I can review that you can assist me with? > > > > I am on a role here.. Here is the other can: It has been advised EMS > > personnel remove First Aid Kits from their vehicles as it may also become a > > legal liability. Here is the what if; what if I am traveling away from home > > area and come upon a desolate scene where I am the only medically trained > > person available. How does one request medical control or is it possible? > > Regardless of whether or not it is a band aid or an ET tube. Where does > > layperson give way to Paramedicine in a court of Law? Especially where no > > foreseeable survivability exists without it. I am leaving common sense out > > of this because my Cert is near and dear to my heart and my pocket book. > > > > Long ago during class you had pointed out a legal reference for EMS. I don't > > suppose you recall the reference? > > > > J. Meere > > > > CEP, Arizona Ambulance > > > > U.S. Army, Retired > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 14, 2011 Report Share Posted January 14, 2011 Teenage Lifeguards are being taught BVM and administration of O2. Yeah....that kind of freaked me out. I was looking at a LIFEGUARD book, and it looked like an ECA book. But if they are getting the proper training, I dont see a prob with it. As far as what the EMT -? is allowed to do, that lies with the Medical Director. Under protocol, a basic could perform brain surgery, but they would be working under the MD's license, and he/she would be responsible. I once worked for a company where I started IV's and transported, as a basic, but it was under medical protocol, and I had to go through the doctor's " IV certification " class. We got a 50 cent/hr raise for it. (I think it was because this Co. did mainly H to H txps) But it depends on the MD. I approached Dr. Saylak about that years ago, and he said... " Oh...hell no! " He wanted to see the full EMT-I before he would approve that. Coug. I'll keep my Guns, my Freedom and my MONEY, You can keep the " CHANGE. " > Jodi, > > What a person can do on an ambulance varies from state to state. A physician has a license that allows him to practice medicine anywhere in the state at any time. However, he does not automatically have the right to take over care at a scene when paramedics are present. Generally, if he wishes to assume care, he must accompany the patient to the hospital and issue all orders. If he orders you to do something against protocol, the way to handle it is to get him in touch with med control physician and let them hash it out. > > I do not believe that a PA or an RN has any power to assume care from you. PAs and nurses practice under a physician's orders. Unless they are a part of the system you're in, I don't think they have the right to practice in your ambulance. > > The easiest way to get a definitive answer is to call Robin Gil and ask her. I'll bet she has the answer on the tip of her tongue. > > Next, there is no legal liability for having a first aid kit in your car or in not having one. When you are outside the state where you are certified, you are on the level of a Boy Scout, meaning you can do first aid only. If you choose to do it, you are bound to do it competently, but only to First Aid level. You don't need medical control to do first aid. You do need medical control to do anything invasive or give a drug. > > I carry no advanced equipment since I would have no authority to use it. My paramedic has no validity in a state where I am not certified. I COULD ask for and receive medical control if a physician were willing to do it, but the chances of that happening are nil. I would have no idea how to contact an online physician on my cellphone. > > The best legal reference is a book named Legal Medicine, published by Mosby. It is not specific for EMS but general. However, it does cover lots of basic legal stuff about medicine. > > Happy reading. > > GG > > PA or RN on Scene other legalities > > GG, > > Here is an off the wall question for you: Presently we have Protocols in > place for Physician On Scene and the requirement that physician be willing > to escort a Patient to the hospital if he/she so desires to provide aid but > what if you run across a Physician Assistant or an RN with field > experience/training as in a Flight Nurse? Are they also legally responsible > for the Patient so long as they agree to escort to the hospital? Either one > is the next echelon higher in care. Would you consider patient care to be > more of a cooperative work in the later case based on scope of practice and > equipment expected to be available? Is there some literature or > state/federal statute that I can review that you can assist me with? > > I am on a role here.. Here is the other can: It has been advised EMS > personnel remove First Aid Kits from their vehicles as it may also become a > legal liability. Here is the what if; what if I am traveling away from home > area and come upon a desolate scene where I am the only medically trained > person available. How does one request medical control or is it possible? > Regardless of whether or not it is a band aid or an ET tube. Where does > layperson give way to Paramedicine in a court of Law? Especially where no > foreseeable survivability exists without it. I am leaving common sense out > of this because my Cert is near and dear to my heart and my pocket book. > > Long ago during class you had pointed out a legal reference for EMS. I don't > suppose you recall the reference? > > J. Meere > > CEP, Arizona Ambulance > > U.S. Army, Retired > > Quote Link to comment Share on other sites More sharing options...
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