Guest guest Posted February 28, 2006 Report Share Posted February 28, 2006 A question for those of you familiar with fire department based FROs. I was recently told that as a volunteer ff I cannot treat a patient. I was told that the FD needs to be registered as an FRO and have an agreement with the EMS company who transports. This area the FD covers is around 10 miles from a hospital, however some areas are even further. It is considered a rural area. The EMS service complained about Albuterol being administered to a patient having an asthma attack by a medic who is a volunteer ff and a medic with another company. It was recognized that the pt was having a severe asthma attack, and a ff who has a child with asthma routinely carries oxygen, nebulizers and Albuterol just in case. Would this not fall under Good Samaritan laws based on the fact that anyone who has been around asthma sufferers would recognize and attack and know to give a treatment if available? Also does a person who is teaching ff classes on training day at the FD required to have a fire specific instructor cert or can it also be EMS or PD? Salvador Capuchino Jr EMT-Paramedic/Volunteer FF __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 28, 2006 Report Share Posted February 28, 2006 A question for those of you familiar with fire department based FROs. I was recently told that as a volunteer ff I cannot treat a patient. I was told that the FD needs to be registered as an FRO and have an agreement with the EMS company who transports. This area the FD covers is around 10 miles from a hospital, however some areas are even further. It is considered a rural area. The EMS service complained about Albuterol being administered to a patient having an asthma attack by a medic who is a volunteer ff and a medic with another company. It was recognized that the pt was having a severe asthma attack, and a ff who has a child with asthma routinely carries oxygen, nebulizers and Albuterol just in case. Would this not fall under Good Samaritan laws based on the fact that anyone who has been around asthma sufferers would recognize and attack and know to give a treatment if available? Also does a person who is teaching ff classes on training day at the FD required to have a fire specific instructor cert or can it also be EMS or PD? Salvador Capuchino Jr EMT-Paramedic/Volunteer FF __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 It is my understanding that a Paramedic or Intermediate cannot do any ALS skills, unless the EMS provider and medical director are both comfortable with the FRO performing these skills. I would think it would be a liability issue for a FRO to do ALS skills, like medication administration, intubation, IV's, IO's, etc. I may be wrong. Just me 2 cents. Take care. R EMT-P www.parisems.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 It is my understanding that a Paramedic or Intermediate cannot do any ALS skills, unless the EMS provider and medical director are both comfortable with the FRO performing these skills. I would think it would be a liability issue for a FRO to do ALS skills, like medication administration, intubation, IV's, IO's, etc. I may be wrong. Just me 2 cents. Take care. R EMT-P www.parisems.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 It is my understanding that a Paramedic or Intermediate cannot do any ALS skills, unless the EMS provider and medical director are both comfortable with the FRO performing these skills. I would think it would be a liability issue for a FRO to do ALS skills, like medication administration, intubation, IV's, IO's, etc. I may be wrong. Just me 2 cents. Take care. R EMT-P www.parisems.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 If you are a certified first responder,and you have a medical director that allows you to work off your providers advanced protocols,then yes,Advanced skills may be used. Some agencies,such as Fort Worth,have limited ALS intervention protocols. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 If you are a certified first responder,and you have a medical director that allows you to work off your providers advanced protocols,then yes,Advanced skills may be used. Some agencies,such as Fort Worth,have limited ALS intervention protocols. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 I am the Medical Officer for a fire department, we have our medical director which is also the medical director for the EMS agency that is based here and not to mention that I also work for the EMS agency. We have several agreements with the EMS and MD. Now if it was a situation where we have it on our truck then yes we can administer it under the direct protocol of the EMS agency. Our protocols and the agencies protocols are just about the same except for some meds that we cannot administer. I do not think that it would fall under the Good Samaritan act because he is trained in the medical field and knows what to do in case of something like that even though he has a child with asthma, he is trained to give O2, neb, and albuterol. Just what I think. JTMEDIC Re: Volunteer FF treating patients A question for those of you familiar with fire department based FROs. I was recently told that as a volunteer ff I cannot treat a patient. I was told that the FD needs to be registered as an FRO and have an agreement with the EMS company who transports. This area the FD covers is around 10 miles from a hospital, however some areas are even further. It is considered a rural area. The EMS service complained about Albuterol being administered to a patient having an asthma attack by a medic who is a volunteer ff and a medic with another company. It was recognized that the pt was having a severe asthma attack, and a ff who has a child with asthma routinely carries oxygen, nebulizers and Albuterol just in case. Would this not fall under Good Samaritan laws based on the fact that anyone who has been around asthma sufferers would recognize and attack and know to give a treatment if available? Also does a person who is teaching ff classes on training day at the FD required to have a fire specific instructor cert or can it also be EMS or PD? Salvador Capuchino Jr EMT-Paramedic/Volunteer FF __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 I am the Medical Officer for a fire department, we have our medical director which is also the medical director for the EMS agency that is based here and not to mention that I also work for the EMS agency. We have several agreements with the EMS and MD. Now if it was a situation where we have it on our truck then yes we can administer it under the direct protocol of the EMS agency. Our protocols and the agencies protocols are just about the same except for some meds that we cannot administer. I do not think that it would fall under the Good Samaritan act because he is trained in the medical field and knows what to do in case of something like that even though he has a child with asthma, he is trained to give O2, neb, and albuterol. Just what I think. JTMEDIC Re: Volunteer FF treating patients A question for those of you familiar with fire department based FROs. I was recently told that as a volunteer ff I cannot treat a patient. I was told that the FD needs to be registered as an FRO and have an agreement with the EMS company who transports. This area the FD covers is around 10 miles from a hospital, however some areas are even further. It is considered a rural area. The EMS service complained about Albuterol being administered to a patient having an asthma attack by a medic who is a volunteer ff and a medic with another company. It was recognized that the pt was having a severe asthma attack, and a ff who has a child with asthma routinely carries oxygen, nebulizers and Albuterol just in case. Would this not fall under Good Samaritan laws based on the fact that anyone who has been around asthma sufferers would recognize and attack and know to give a treatment if available? Also does a person who is teaching ff classes on training day at the FD required to have a fire specific instructor cert or can it also be EMS or PD? Salvador Capuchino Jr EMT-Paramedic/Volunteer FF __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 I am the Medical Officer for a fire department, we have our medical director which is also the medical director for the EMS agency that is based here and not to mention that I also work for the EMS agency. We have several agreements with the EMS and MD. Now if it was a situation where we have it on our truck then yes we can administer it under the direct protocol of the EMS agency. Our protocols and the agencies protocols are just about the same except for some meds that we cannot administer. I do not think that it would fall under the Good Samaritan act because he is trained in the medical field and knows what to do in case of something like that even though he has a child with asthma, he is trained to give O2, neb, and albuterol. Just what I think. JTMEDIC Re: Volunteer FF treating patients A question for those of you familiar with fire department based FROs. I was recently told that as a volunteer ff I cannot treat a patient. I was told that the FD needs to be registered as an FRO and have an agreement with the EMS company who transports. This area the FD covers is around 10 miles from a hospital, however some areas are even further. It is considered a rural area. The EMS service complained about Albuterol being administered to a patient having an asthma attack by a medic who is a volunteer ff and a medic with another company. It was recognized that the pt was having a severe asthma attack, and a ff who has a child with asthma routinely carries oxygen, nebulizers and Albuterol just in case. Would this not fall under Good Samaritan laws based on the fact that anyone who has been around asthma sufferers would recognize and attack and know to give a treatment if available? Also does a person who is teaching ff classes on training day at the FD required to have a fire specific instructor cert or can it also be EMS or PD? Salvador Capuchino Jr EMT-Paramedic/Volunteer FF __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Albuterol is a BLS med. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Albuterol is a BLS med. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Depends on the organization's protocols as determined by the medical director, Sal. -Wes Ogilvie, MPA, JD, EMT-B Attorney at Law/Emergency Medical Technician Austin, Texas Re: Re: Volunteer FF treating patients Albuterol is a BLS med. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Depends on the organization's protocols as determined by the medical director, Sal. -Wes Ogilvie, MPA, JD, EMT-B Attorney at Law/Emergency Medical Technician Austin, Texas Re: Re: Volunteer FF treating patients Albuterol is a BLS med. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 But it is a Med, which requires a Medical Director to administer Re: Re: Volunteer FF treating patients Albuterol is a BLS med. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 But it is a Med, which requires a Medical Director to administer Re: Re: Volunteer FF treating patients Albuterol is a BLS med. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 But it is a Med, which requires a Medical Director to administer Re: Re: Volunteer FF treating patients Albuterol is a BLS med. --- medicswat wrote: > It is my understanding that a Paramedic or > Intermediate cannot do any > ALS skills, unless the EMS provider and medical > director are both > comfortable with the FRO performing these skills. I > would think it > would be a liability issue for a FRO to do ALS > skills, like medication > administration, intubation, IV's, IO's, etc. I may > be wrong. Just me 2 > cents. Take care. > > R EMT-P > www.parisems.com > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Sal, As a Volunteer FF you can treat patients. You can provide anything that the common layperson can provide even in the absence of a FR agreement or protocols. There is no requirement that your FD be a registered FRO to provide treatment or other medical interventions. EMT’s and Paramedics are not autonomous so you must have some type of medical oversight to provide specialized treatments. In order to be able to provide these specialized treatments (those that the common layperson can not provide) you must have protocols to operate under. So, the way I see it you have 4 options. Option 1: Your employer provides you with written permission to operate under their protocols at all times, even if off duty. Option 2: Your Volunteer FD is a registered FRO and has protocols from a licensed EMS agency that services your area to operate under their protocols. Option 3: Your Volunteer FD has a written FR agreement (even in the absence of being a registered FRO) to operate under their protocols. Option 4: Your Volunteer FD contracts with a medical director and they provide protocols for you to operate under. I can’t think of another situation but I might have missed one. Albuterol is a prescription medication, and is not available to the common lay person. Therefore, it can not be administered without a protocol in place to allow such administration. This would be no different than administering oxygen, intubating, cardioverting, starting an IV, administering morphine, or any other skill that required a physician’s oversight. If you can go as a lay person to the local Red Cross office and take a class on first aid and learn a treatment, (bandaging & splinting, bleeding control, shock prevention, etc) then you can do it without a protocol in place. Otherwise, pick an option above or formulate one that provides a written binding agreement between you as a FD FR and some medical control entity. As for the Good Samaritan Law: The Texas Civil Practice & Remedies Code Chapter 74 Subsection 74.152. UNLICENSED MEDICAL PERSONNEL. Persons not licensed or certified in the healing arts who in good faith administer emergency care as emergency medical service personnel are not liable in civil damages for an act performed in administering the care unless the act is willfully or wantonly negligent. This section applies without regard to whether the care is provided for or in expectation of remuneration. Subsection 74.153. STANDARD OF PROOF IN CASES INVOLVING EMERGENCY MEDICAL CARE. In a suit involving a health care liability claim against a physician or health care provider for injury to or death of a patient arising out of the provision of emergency medical care in a hospital emergency department or obstetrical unit or in a surgical suite immediately following the evaluation or treatment of a patient in a hospital emergency department, the claimant bringing the suit may prove that the treatment or lack of treatment by the physician or health care provider departed from accepted standards of medical care or health care only if the claimant shows by a preponderance of the evidence that the physician or health care provider, with willful and wanton negligence, deviated from the degree of care and skill that is reasonably expected of an ordinarily prudent physician or health care provider in the same or similar circumstances. § 74.154. JURY INSTRUCTIONS IN CASES INVOLVING EMERGENCY MEDICAL CARE. (a) In an action for damages that involves a claim of negligence arising from the provision of emergency medical care in a hospital emergency department or obstetrical unit or in a surgical suite immediately following the evaluation or treatment of a patient in a hospital emergency department, the court shall instruct the jury to consider, together with all other relevant matters: (1) whether the person providing care did or did not have the patient's medical history or was able or unable to obtain a full medical history, including the knowledge of preexisting medical conditions, allergies, and medications; (2) the presence or lack of a preexisting physician-patient relationship or health care provider-patient relationship; (3) the circumstances constituting the emergency; and (4) the circumstances surrounding the delivery of the emergency medical care. ( The provisions of Subsection (a) do not apply to medical care or treatment: (1) that occurs after the patient is stabilized and is capable of receiving medical treatment as a non-emergency patient; (2) that is unrelated to the original medical emergency; or (3) that is related to an emergency caused in whole or in part by the negligence of the defendant. Keep in mind; you’re talking Civil Damages when you say the Good Samaritan Law. This simply means if sued, you can claim this as a defense. This does not mean that you can’t be prosecuted by the DA for an act or censured by DSHS for acting outside your certification. Don’t confuse criminal acts or omissions with civil liability. They are completely different things, remember OJ???? Tater salvador capuchino wrote: A question for those of you familiar with fire department based FROs. I was recently told that as a volunteer ff I cannot treat a patient. I was told that the FD needs to be registered as an FRO and have an agreement with the EMS company who transports. This area the FD covers is around 10 miles from a hospital, however some areas are even further. It is considered a rural area. The EMS service complained about Albuterol being administered to a patient having an asthma attack by a medic who is a volunteer ff and a medic with another company. It was recognized that the pt was having a severe asthma attack, and a ff who has a child with asthma routinely carries oxygen, nebulizers and Albuterol just in case. Would this not fall under Good Samaritan laws based on the fact that anyone who has been around asthma sufferers would recognize and attack and know to give a treatment if available? Also does a person who is teaching ff classes on training day at the FD required to have a fire specific instructor cert or can it also be EMS or PD? Salvador Capuchino Jr EMT-Paramedic/Volunteer FF __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Sal, As a Volunteer FF you can treat patients. You can provide anything that the common layperson can provide even in the absence of a FR agreement or protocols. There is no requirement that your FD be a registered FRO to provide treatment or other medical interventions. EMT’s and Paramedics are not autonomous so you must have some type of medical oversight to provide specialized treatments. In order to be able to provide these specialized treatments (those that the common layperson can not provide) you must have protocols to operate under. So, the way I see it you have 4 options. Option 1: Your employer provides you with written permission to operate under their protocols at all times, even if off duty. Option 2: Your Volunteer FD is a registered FRO and has protocols from a licensed EMS agency that services your area to operate under their protocols. Option 3: Your Volunteer FD has a written FR agreement (even in the absence of being a registered FRO) to operate under their protocols. Option 4: Your Volunteer FD contracts with a medical director and they provide protocols for you to operate under. I can’t think of another situation but I might have missed one. Albuterol is a prescription medication, and is not available to the common lay person. Therefore, it can not be administered without a protocol in place to allow such administration. This would be no different than administering oxygen, intubating, cardioverting, starting an IV, administering morphine, or any other skill that required a physician’s oversight. If you can go as a lay person to the local Red Cross office and take a class on first aid and learn a treatment, (bandaging & splinting, bleeding control, shock prevention, etc) then you can do it without a protocol in place. Otherwise, pick an option above or formulate one that provides a written binding agreement between you as a FD FR and some medical control entity. As for the Good Samaritan Law: The Texas Civil Practice & Remedies Code Chapter 74 Subsection 74.152. UNLICENSED MEDICAL PERSONNEL. Persons not licensed or certified in the healing arts who in good faith administer emergency care as emergency medical service personnel are not liable in civil damages for an act performed in administering the care unless the act is willfully or wantonly negligent. This section applies without regard to whether the care is provided for or in expectation of remuneration. Subsection 74.153. STANDARD OF PROOF IN CASES INVOLVING EMERGENCY MEDICAL CARE. In a suit involving a health care liability claim against a physician or health care provider for injury to or death of a patient arising out of the provision of emergency medical care in a hospital emergency department or obstetrical unit or in a surgical suite immediately following the evaluation or treatment of a patient in a hospital emergency department, the claimant bringing the suit may prove that the treatment or lack of treatment by the physician or health care provider departed from accepted standards of medical care or health care only if the claimant shows by a preponderance of the evidence that the physician or health care provider, with willful and wanton negligence, deviated from the degree of care and skill that is reasonably expected of an ordinarily prudent physician or health care provider in the same or similar circumstances. § 74.154. JURY INSTRUCTIONS IN CASES INVOLVING EMERGENCY MEDICAL CARE. (a) In an action for damages that involves a claim of negligence arising from the provision of emergency medical care in a hospital emergency department or obstetrical unit or in a surgical suite immediately following the evaluation or treatment of a patient in a hospital emergency department, the court shall instruct the jury to consider, together with all other relevant matters: (1) whether the person providing care did or did not have the patient's medical history or was able or unable to obtain a full medical history, including the knowledge of preexisting medical conditions, allergies, and medications; (2) the presence or lack of a preexisting physician-patient relationship or health care provider-patient relationship; (3) the circumstances constituting the emergency; and (4) the circumstances surrounding the delivery of the emergency medical care. ( The provisions of Subsection (a) do not apply to medical care or treatment: (1) that occurs after the patient is stabilized and is capable of receiving medical treatment as a non-emergency patient; (2) that is unrelated to the original medical emergency; or (3) that is related to an emergency caused in whole or in part by the negligence of the defendant. Keep in mind; you’re talking Civil Damages when you say the Good Samaritan Law. This simply means if sued, you can claim this as a defense. This does not mean that you can’t be prosecuted by the DA for an act or censured by DSHS for acting outside your certification. Don’t confuse criminal acts or omissions with civil liability. They are completely different things, remember OJ???? Tater salvador capuchino wrote: A question for those of you familiar with fire department based FROs. I was recently told that as a volunteer ff I cannot treat a patient. I was told that the FD needs to be registered as an FRO and have an agreement with the EMS company who transports. This area the FD covers is around 10 miles from a hospital, however some areas are even further. It is considered a rural area. The EMS service complained about Albuterol being administered to a patient having an asthma attack by a medic who is a volunteer ff and a medic with another company. It was recognized that the pt was having a severe asthma attack, and a ff who has a child with asthma routinely carries oxygen, nebulizers and Albuterol just in case. Would this not fall under Good Samaritan laws based on the fact that anyone who has been around asthma sufferers would recognize and attack and know to give a treatment if available? Also does a person who is teaching ff classes on training day at the FD required to have a fire specific instructor cert or can it also be EMS or PD? Salvador Capuchino Jr EMT-Paramedic/Volunteer FF __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Sal, As a Volunteer FF you can treat patients. You can provide anything that the common layperson can provide even in the absence of a FR agreement or protocols. There is no requirement that your FD be a registered FRO to provide treatment or other medical interventions. EMT’s and Paramedics are not autonomous so you must have some type of medical oversight to provide specialized treatments. In order to be able to provide these specialized treatments (those that the common layperson can not provide) you must have protocols to operate under. So, the way I see it you have 4 options. Option 1: Your employer provides you with written permission to operate under their protocols at all times, even if off duty. Option 2: Your Volunteer FD is a registered FRO and has protocols from a licensed EMS agency that services your area to operate under their protocols. Option 3: Your Volunteer FD has a written FR agreement (even in the absence of being a registered FRO) to operate under their protocols. Option 4: Your Volunteer FD contracts with a medical director and they provide protocols for you to operate under. I can’t think of another situation but I might have missed one. Albuterol is a prescription medication, and is not available to the common lay person. Therefore, it can not be administered without a protocol in place to allow such administration. This would be no different than administering oxygen, intubating, cardioverting, starting an IV, administering morphine, or any other skill that required a physician’s oversight. If you can go as a lay person to the local Red Cross office and take a class on first aid and learn a treatment, (bandaging & splinting, bleeding control, shock prevention, etc) then you can do it without a protocol in place. Otherwise, pick an option above or formulate one that provides a written binding agreement between you as a FD FR and some medical control entity. As for the Good Samaritan Law: The Texas Civil Practice & Remedies Code Chapter 74 Subsection 74.152. UNLICENSED MEDICAL PERSONNEL. Persons not licensed or certified in the healing arts who in good faith administer emergency care as emergency medical service personnel are not liable in civil damages for an act performed in administering the care unless the act is willfully or wantonly negligent. This section applies without regard to whether the care is provided for or in expectation of remuneration. Subsection 74.153. STANDARD OF PROOF IN CASES INVOLVING EMERGENCY MEDICAL CARE. In a suit involving a health care liability claim against a physician or health care provider for injury to or death of a patient arising out of the provision of emergency medical care in a hospital emergency department or obstetrical unit or in a surgical suite immediately following the evaluation or treatment of a patient in a hospital emergency department, the claimant bringing the suit may prove that the treatment or lack of treatment by the physician or health care provider departed from accepted standards of medical care or health care only if the claimant shows by a preponderance of the evidence that the physician or health care provider, with willful and wanton negligence, deviated from the degree of care and skill that is reasonably expected of an ordinarily prudent physician or health care provider in the same or similar circumstances. § 74.154. JURY INSTRUCTIONS IN CASES INVOLVING EMERGENCY MEDICAL CARE. (a) In an action for damages that involves a claim of negligence arising from the provision of emergency medical care in a hospital emergency department or obstetrical unit or in a surgical suite immediately following the evaluation or treatment of a patient in a hospital emergency department, the court shall instruct the jury to consider, together with all other relevant matters: (1) whether the person providing care did or did not have the patient's medical history or was able or unable to obtain a full medical history, including the knowledge of preexisting medical conditions, allergies, and medications; (2) the presence or lack of a preexisting physician-patient relationship or health care provider-patient relationship; (3) the circumstances constituting the emergency; and (4) the circumstances surrounding the delivery of the emergency medical care. ( The provisions of Subsection (a) do not apply to medical care or treatment: (1) that occurs after the patient is stabilized and is capable of receiving medical treatment as a non-emergency patient; (2) that is unrelated to the original medical emergency; or (3) that is related to an emergency caused in whole or in part by the negligence of the defendant. Keep in mind; you’re talking Civil Damages when you say the Good Samaritan Law. This simply means if sued, you can claim this as a defense. This does not mean that you can’t be prosecuted by the DA for an act or censured by DSHS for acting outside your certification. Don’t confuse criminal acts or omissions with civil liability. They are completely different things, remember OJ???? Tater salvador capuchino wrote: A question for those of you familiar with fire department based FROs. I was recently told that as a volunteer ff I cannot treat a patient. I was told that the FD needs to be registered as an FRO and have an agreement with the EMS company who transports. This area the FD covers is around 10 miles from a hospital, however some areas are even further. It is considered a rural area. The EMS service complained about Albuterol being administered to a patient having an asthma attack by a medic who is a volunteer ff and a medic with another company. It was recognized that the pt was having a severe asthma attack, and a ff who has a child with asthma routinely carries oxygen, nebulizers and Albuterol just in case. Would this not fall under Good Samaritan laws based on the fact that anyone who has been around asthma sufferers would recognize and attack and know to give a treatment if available? Also does a person who is teaching ff classes on training day at the FD required to have a fire specific instructor cert or can it also be EMS or PD? Salvador Capuchino Jr EMT-Paramedic/Volunteer FF __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Okay Tateer, out of all the responses, yours akes the most sense. Now I am worried about this issue because we respond to all MVCs in the area, so this means that we shouldn't even be placing patients on SMR because the common lay person is not trained in this. As for AEDs, we have training in using them, but no protocols, therefore, should we be using them? There are aot of FDs here in the Valley that carry AEDs and are not registered as FROs, so I guess the liability here falls with the cities? Salvador Capuchino Jr EMT-P/Volunteer FF --- " E. Tate " wrote: > Sal, > > As a Volunteer FF you can treat patients. You can > provide anything that the common layperson can > provide even in the absence of a FR agreement or > protocols. There is no requirement that your FD be > a registered FRO to provide treatment or other > medical interventions. EMT’s and Paramedics are not > autonomous so you must have some type of medical > oversight to provide specialized treatments. > > In order to be able to provide these specialized > treatments (those that the common layperson can not > provide) you must have protocols to operate under. > So, the way I see it you have 4 options. > > Option 1: Your employer provides you with written > permission to operate under their protocols at all > times, even if off duty. > > Option 2: Your Volunteer FD is a registered FRO > and has protocols from a licensed EMS agency that > services your area to operate under their protocols. > > > Option 3: Your Volunteer FD has a written FR > agreement (even in the absence of being a registered > FRO) to operate under their protocols. > > Option 4: Your Volunteer FD contracts with a > medical director and they provide protocols for you > to operate under. > > I can’t think of another situation but I might > have missed one. Albuterol is a prescription > medication, and is not available to the common lay > person. Therefore, it can not be administered > without a protocol in place to allow such > administration. This would be no different than > administering oxygen, intubating, cardioverting, > starting an IV, administering morphine, or any other > skill that required a physician’s oversight. > > If you can go as a lay person to the local Red > Cross office and take a class on first aid and learn > a treatment, (bandaging & splinting, bleeding > control, shock prevention, etc) then you can do it > without a protocol in place. Otherwise, pick an > option above or formulate one that provides a > written binding agreement between you as a FD FR and > some medical control entity. > > > As for the Good Samaritan Law: The Texas Civil > Practice & Remedies Code Chapter 74 > > > > Subsection 74.152. UNLICENSED MEDICAL PERSONNEL. > Persons not licensed or certified in the healing > arts who in good faith administer emergency care as > emergency medical service personnel are not liable > in civil damages for an act performed in > administering the care unless the act is willfully > or wantonly negligent. This section applies without > regard to whether the care is provided for or in > expectation of remuneration. > > Subsection 74.153. STANDARD OF PROOF IN CASES > INVOLVING EMERGENCY MEDICAL CARE. In a suit > involving a health care liability claim against a > physician or health care provider for injury to or > death of a patient arising out of the provision of > emergency medical care in a hospital emergency > department or obstetrical unit or in a surgical > suite immediately following the evaluation or > treatment of a patient in a hospital emergency > department, the claimant bringing the suit may prove > that the treatment or lack of treatment by the > physician or health care provider departed from > accepted standards of medical care or health care > only if the claimant shows by a preponderance of the > evidence that the physician or health care provider, > with willful and wanton negligence, deviated from > the degree of care and skill that is reasonably > expected of an ordinarily prudent physician or > health care provider in the same or similar > circumstances. > > § 74.154. JURY INSTRUCTIONS IN CASES INVOLVING > EMERGENCY MEDICAL CARE. (a) In an action for > damages that involves a claim of negligence arising > from the provision of emergency medical care in a > hospital emergency department or obstetrical unit or > in a surgical suite immediately following the > evaluation or treatment of a patient in a hospital > emergency department, the court shall instruct the > jury to consider, together with all other relevant > matters: > > (1) whether the person providing care did or did > not have the patient's medical history or was able > or unable to obtain a full medical history, > including the knowledge of preexisting medical > conditions, allergies, and medications; > > (2) the presence or lack of a preexisting > physician-patient relationship or health care > provider-patient relationship; > > (3) the circumstances constituting the emergency; > and > > (4) the circumstances surrounding the delivery of > the emergency medical care. > > ( The provisions of Subsection (a) do not apply > to medical care or treatment: > > (1) that occurs after the patient is stabilized and > is capable of receiving medical treatment as a > non-emergency patient; > > (2) that is unrelated to the original medical > emergency; or > > (3) that is related to an emergency caused in whole > or in part by the negligence of the defendant. > > > > Keep in mind; you’re talking Civil Damages when you > say the Good Samaritan Law. This simply means if > sued, you can claim this as a defense. This does > not mean that you can’t be prosecuted by the DA for > an act or censured by DSHS for acting outside your > certification. Don’t confuse criminal acts or > omissions with civil liability. They are completely > different things, remember OJ???? > > > Tater > > > salvador capuchino wrote: A > question for those of you familiar with fire > department based FROs. I was recently told that as > a > volunteer ff I cannot treat a patient. I was told > that the FD needs to be registered as an FRO and > have > an agreement with the EMS company who transports. > This area the FD covers is around 10 miles from a > hospital, however some areas are even further. It > is > considered a rural area. The EMS service complained > about Albuterol being administered to a patient > having > an asthma attack by a medic who is a volunteer ff > and > a medic with another company. It was recognized > that > the pt was having a severe asthma attack, and a ff > who > has a child with asthma routinely carries oxygen, > nebulizers and Albuterol just in case. Would this > not > fall under Good Samaritan laws based on the fact > that > anyone who has been around asthma sufferers would > recognize and attack and know to give a treatment if > available? > Also does a person who is teaching ff classes on > training day at the FD required to have a fire > specific instructor cert or can it also be EMS or > PD? > > Salvador Capuchino Jr > EMT-Paramedic/Volunteer FF > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 Okay Tateer, out of all the responses, yours akes the most sense. Now I am worried about this issue because we respond to all MVCs in the area, so this means that we shouldn't even be placing patients on SMR because the common lay person is not trained in this. As for AEDs, we have training in using them, but no protocols, therefore, should we be using them? There are aot of FDs here in the Valley that carry AEDs and are not registered as FROs, so I guess the liability here falls with the cities? Salvador Capuchino Jr EMT-P/Volunteer FF --- " E. Tate " wrote: > Sal, > > As a Volunteer FF you can treat patients. You can > provide anything that the common layperson can > provide even in the absence of a FR agreement or > protocols. There is no requirement that your FD be > a registered FRO to provide treatment or other > medical interventions. EMT’s and Paramedics are not > autonomous so you must have some type of medical > oversight to provide specialized treatments. > > In order to be able to provide these specialized > treatments (those that the common layperson can not > provide) you must have protocols to operate under. > So, the way I see it you have 4 options. > > Option 1: Your employer provides you with written > permission to operate under their protocols at all > times, even if off duty. > > Option 2: Your Volunteer FD is a registered FRO > and has protocols from a licensed EMS agency that > services your area to operate under their protocols. > > > Option 3: Your Volunteer FD has a written FR > agreement (even in the absence of being a registered > FRO) to operate under their protocols. > > Option 4: Your Volunteer FD contracts with a > medical director and they provide protocols for you > to operate under. > > I can’t think of another situation but I might > have missed one. Albuterol is a prescription > medication, and is not available to the common lay > person. Therefore, it can not be administered > without a protocol in place to allow such > administration. This would be no different than > administering oxygen, intubating, cardioverting, > starting an IV, administering morphine, or any other > skill that required a physician’s oversight. > > If you can go as a lay person to the local Red > Cross office and take a class on first aid and learn > a treatment, (bandaging & splinting, bleeding > control, shock prevention, etc) then you can do it > without a protocol in place. Otherwise, pick an > option above or formulate one that provides a > written binding agreement between you as a FD FR and > some medical control entity. > > > As for the Good Samaritan Law: The Texas Civil > Practice & Remedies Code Chapter 74 > > > > Subsection 74.152. UNLICENSED MEDICAL PERSONNEL. > Persons not licensed or certified in the healing > arts who in good faith administer emergency care as > emergency medical service personnel are not liable > in civil damages for an act performed in > administering the care unless the act is willfully > or wantonly negligent. This section applies without > regard to whether the care is provided for or in > expectation of remuneration. > > Subsection 74.153. STANDARD OF PROOF IN CASES > INVOLVING EMERGENCY MEDICAL CARE. In a suit > involving a health care liability claim against a > physician or health care provider for injury to or > death of a patient arising out of the provision of > emergency medical care in a hospital emergency > department or obstetrical unit or in a surgical > suite immediately following the evaluation or > treatment of a patient in a hospital emergency > department, the claimant bringing the suit may prove > that the treatment or lack of treatment by the > physician or health care provider departed from > accepted standards of medical care or health care > only if the claimant shows by a preponderance of the > evidence that the physician or health care provider, > with willful and wanton negligence, deviated from > the degree of care and skill that is reasonably > expected of an ordinarily prudent physician or > health care provider in the same or similar > circumstances. > > § 74.154. JURY INSTRUCTIONS IN CASES INVOLVING > EMERGENCY MEDICAL CARE. (a) In an action for > damages that involves a claim of negligence arising > from the provision of emergency medical care in a > hospital emergency department or obstetrical unit or > in a surgical suite immediately following the > evaluation or treatment of a patient in a hospital > emergency department, the court shall instruct the > jury to consider, together with all other relevant > matters: > > (1) whether the person providing care did or did > not have the patient's medical history or was able > or unable to obtain a full medical history, > including the knowledge of preexisting medical > conditions, allergies, and medications; > > (2) the presence or lack of a preexisting > physician-patient relationship or health care > provider-patient relationship; > > (3) the circumstances constituting the emergency; > and > > (4) the circumstances surrounding the delivery of > the emergency medical care. > > ( The provisions of Subsection (a) do not apply > to medical care or treatment: > > (1) that occurs after the patient is stabilized and > is capable of receiving medical treatment as a > non-emergency patient; > > (2) that is unrelated to the original medical > emergency; or > > (3) that is related to an emergency caused in whole > or in part by the negligence of the defendant. > > > > Keep in mind; you’re talking Civil Damages when you > say the Good Samaritan Law. This simply means if > sued, you can claim this as a defense. This does > not mean that you can’t be prosecuted by the DA for > an act or censured by DSHS for acting outside your > certification. Don’t confuse criminal acts or > omissions with civil liability. They are completely > different things, remember OJ???? > > > Tater > > > salvador capuchino wrote: A > question for those of you familiar with fire > department based FROs. I was recently told that as > a > volunteer ff I cannot treat a patient. I was told > that the FD needs to be registered as an FRO and > have > an agreement with the EMS company who transports. > This area the FD covers is around 10 miles from a > hospital, however some areas are even further. It > is > considered a rural area. The EMS service complained > about Albuterol being administered to a patient > having > an asthma attack by a medic who is a volunteer ff > and > a medic with another company. It was recognized > that > the pt was having a severe asthma attack, and a ff > who > has a child with asthma routinely carries oxygen, > nebulizers and Albuterol just in case. Would this > not > fall under Good Samaritan laws based on the fact > that > anyone who has been around asthma sufferers would > recognize and attack and know to give a treatment if > available? > Also does a person who is teaching ff classes on > training day at the FD required to have a fire > specific instructor cert or can it also be EMS or > PD? > > Salvador Capuchino Jr > EMT-Paramedic/Volunteer FF > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 salvador capuchino wrote: > > Albuterol is a BLS med. This sort of statement really bothers me. Albuterol is not a BLS med. There is no such thing as a BLS med. Albuterol is an ALS med that is administered by BLS level providers, but that does not make it a " BLS med. " Sure, it sounds like simple semantics, but it is not. Such terms cheapen the seriousness of medication administration. If you are administering meds, you are practising ALS, regardless of your level of certification. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 salvador capuchino wrote: > > Albuterol is a BLS med. This sort of statement really bothers me. Albuterol is not a BLS med. There is no such thing as a BLS med. Albuterol is an ALS med that is administered by BLS level providers, but that does not make it a " BLS med. " Sure, it sounds like simple semantics, but it is not. Such terms cheapen the seriousness of medication administration. If you are administering meds, you are practising ALS, regardless of your level of certification. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 1, 2006 Report Share Posted March 1, 2006 The common layperson can use an AED, and even purchase one without a prescription now. So, if you carry one, you can use it, if trained to do so. Bruce ________________________________________________________________________ Try Juno Platinum for Free! Then, only $9.95/month! Unlimited Internet Access with 1GB of Email Storage. Visit http://www.juno.com/value to sign up today! Quote Link to comment Share on other sites More sharing options...
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