Re: Volunteer FF treating patients

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

________________________________________________________________________

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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!

March 1, 2006

Sal,

I haven’t taken a lay-person first-aid course in a long time, but believe that

manual spinal precautions are well within the abilities and training of the lay

rescuer. When I was a lifeguard we were trained in spinal immobilization

precautions and in the use of manual spinal immobilization procedures. I would

not however be so willing to place a cervical collar, KED, or move the patient

to a back board with out a protocol in place.

Also, any lay person can take the AED course from either the AHA or ARC.

There are AED’s available for use by the general public everywhere now. Our

schools here in Tyler have them hanging on the walls beside fire extinguishers.

They are in the concourse at DFW International Airport.

There are certain laws that apply to the purchase and use of AED’s. The Texas

Health & Safety Code Chapter 779 deals exclusively with Automated External

Defibrillators. I encourage you to read it and become familiar with it.

http://www.capitol.state.tx.us/statutes/statutes.html

Tater

salvador capuchino wrote: 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

>

> __________________________________________________

>

March 1, 2006

Sal,

I haven’t taken a lay-person first-aid course in a long time, but believe that

manual spinal precautions are well within the abilities and training of the lay

rescuer. When I was a lifeguard we were trained in spinal immobilization

precautions and in the use of manual spinal immobilization procedures. I would

not however be so willing to place a cervical collar, KED, or move the patient

to a back board with out a protocol in place.

Also, any lay person can take the AED course from either the AHA or ARC.

There are AED’s available for use by the general public everywhere now. Our

schools here in Tyler have them hanging on the walls beside fire extinguishers.

They are in the concourse at DFW International Airport.

There are certain laws that apply to the purchase and use of AED’s. The Texas

Health & Safety Code Chapter 779 deals exclusively with Automated External

Defibrillators. I encourage you to read it and become familiar with it.

http://www.capitol.state.tx.us/statutes/statutes.html

Tater

salvador capuchino wrote: 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

>

> __________________________________________________

>

March 1, 2006

Damn, ! You're talking more and more like a lawyer.

GG

> Sal,

> Â Â

> Â As a Volunteer FF you can treat patients.Â You can provide anything that

> the common layperson can provide even in the absence of a FR agreement or

> protocols.Â There is no requirement that your FD be a registered FRO to

provide

> treatment or other medical interventions.Â EMTâ€™s and Paramedics are not

> autonomous so you must have some type of medical oversight to provide

specialized

> treatments.

> Â Â

> Â 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.Â So, the way I see it you have 4 options.Â

> Â Â

> Â Option 1: Your employer provides you with written permission to operate

> under their protocols at all times, even if off duty.Â

> Â Â

> Â 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.Â

> Â Â

> Â Option 3: Your Volunteer FD has a written FR agreement (even in the

> absence of being a registered FRO) to operate under their protocols.Â

> Â Â

> Â Option 4: Your Volunteer FD contracts with a medical director and they

> provide protocols for you to operate under.

> Â Â

> Â I canâ€™t think of another situation but I might have missed one.Â

Albuterol

> is a prescription medication, and is not available to the common lay

> person.Â Therefore, it can not be administered without a protocol in place to

allow

> such administration.Â This would be no different than administering oxygen,

> intubating, cardioverting, starting an IV, administering morphine, or any

> other skill that required a physicianâ€™s oversight.

> Â Â

> Â 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.Â

> 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.

> Â Â

>

> 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.Â This section applies without regard to whether the care is

provided

> for or in expectation of remuneration.

>

> Subsection 74.153.Â STANDARD OF PROOF IN CASES INVOLVING EMERGENCY MEDICAL

> CARE.Â 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.

>

> Â§ 74.154.Â JURY INSTRUCTIONS IN CASES INVOLVING EMERGENCY MEDICAL CARE.Â

> (a)Â 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)Â 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)Â the presence or lack of a preexisting physician-patient relationship or

> health care provider-patient relationship;

>

> (3)Â the circumstances constituting the emergency;Â andÂ Â Â Â Â Â Â

Â Â Â

> Â Â

>

> (4)Â the circumstances surrounding the delivery of the emergency medical

> care.

>

> (Â The provisions of Subsection (a) do not apply to medical care or

> treatment:

>

> (1)Â that occurs after the patient is stabilized and is capable of receiving

> medical treatment as a non-emergency patient;

>

> (2)Â that is unrelated to the original medical emergency; orÂ Â Â Â Â Â

Â Â

>

> (3)Â that is related to an emergency caused in whole or in part by the

> negligence of the defendant.

>

> Keep in mind; youâ€™re talking Civil Damages when you say the Good Samaritan

> Law.Â This simply means if sued, you can claim this as a defense.Â This does

> not mean that you canâ€™t be prosecuted by the DA for an act or censured by

DSHS

> for acting outside your certification.Â Donâ€™t confuse criminal acts or

> omissions with civil liability.Â They are completely different things,

remember

> OJ????

> Â Â

> Â Tater

>

> salvador capuchino wrote:Â A question for those of

> you familiar with fire

> department based FROs.Â I was recently told that as a

> volunteer ff I cannot treat a patient.Â 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.Â It is

> considered a rural area.Â 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.Â 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.Â 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

>

> __________________________________________________

>

March 1, 2006

Damn, ! You're talking more and more like a lawyer.

GG

> Sal,

> Â Â

> Â As a Volunteer FF you can treat patients.Â You can provide anything that

> the common layperson can provide even in the absence of a FR agreement or

> protocols.Â There is no requirement that your FD be a registered FRO to

provide

> treatment or other medical interventions.Â EMTâ€™s and Paramedics are not

> autonomous so you must have some type of medical oversight to provide

specialized

> treatments.

> Â Â

> Â 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.Â So, the way I see it you have 4 options.Â

> Â Â

> Â Option 1: Your employer provides you with written permission to operate

> under their protocols at all times, even if off duty.Â

> Â Â

> Â 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.Â

> Â Â

> Â Option 3: Your Volunteer FD has a written FR agreement (even in the

> absence of being a registered FRO) to operate under their protocols.Â

> Â Â

> Â Option 4: Your Volunteer FD contracts with a medical director and they

> provide protocols for you to operate under.

> Â Â

> Â I canâ€™t think of another situation but I might have missed one.Â

Albuterol

> is a prescription medication, and is not available to the common lay

> person.Â Therefore, it can not be administered without a protocol in place to

allow

> such administration.Â This would be no different than administering oxygen,

> intubating, cardioverting, starting an IV, administering morphine, or any

> other skill that required a physicianâ€™s oversight.

> Â Â

> Â 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.Â

> 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.

> Â Â

>

> 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.Â This section applies without regard to whether the care is

provided

> for or in expectation of remuneration.

>

> Subsection 74.153.Â STANDARD OF PROOF IN CASES INVOLVING EMERGENCY MEDICAL

> CARE.Â 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.

>

> Â§ 74.154.Â JURY INSTRUCTIONS IN CASES INVOLVING EMERGENCY MEDICAL CARE.Â

> (a)Â 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)Â 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)Â the presence or lack of a preexisting physician-patient relationship or

> health care provider-patient relationship;

>

> (3)Â the circumstances constituting the emergency;Â andÂ Â Â Â Â Â Â

Â Â Â

> Â Â

>

> (4)Â the circumstances surrounding the delivery of the emergency medical

> care.

>

> (Â The provisions of Subsection (a) do not apply to medical care or

> treatment:

>

> (1)Â that occurs after the patient is stabilized and is capable of receiving

> medical treatment as a non-emergency patient;

>

> (2)Â that is unrelated to the original medical emergency; orÂ Â Â Â Â Â

Â Â

>

> (3)Â that is related to an emergency caused in whole or in part by the

> negligence of the defendant.

>

> Keep in mind; youâ€™re talking Civil Damages when you say the Good Samaritan

> Law.Â This simply means if sued, you can claim this as a defense.Â This does

> not mean that you canâ€™t be prosecuted by the DA for an act or censured by

DSHS

> for acting outside your certification.Â Donâ€™t confuse criminal acts or

> omissions with civil liability.Â They are completely different things,

remember

> OJ????

> Â Â

> Â Tater

>

> salvador capuchino wrote:Â A question for those of

> you familiar with fire

> department based FROs.Â I was recently told that as a

> volunteer ff I cannot treat a patient.Â 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.Â It is

> considered a rural area.Â 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.Â 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.Â 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

>

> __________________________________________________

>

March 1, 2006

Damn, ! You're talking more and more like a lawyer.

GG

> Sal,

> Â Â

> Â As a Volunteer FF you can treat patients.Â You can provide anything that

> the common layperson can provide even in the absence of a FR agreement or

> protocols.Â There is no requirement that your FD be a registered FRO to

provide

> treatment or other medical interventions.Â EMTâ€™s and Paramedics are not

> autonomous so you must have some type of medical oversight to provide

specialized

> treatments.

> Â Â

> Â 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.Â So, the way I see it you have 4 options.Â

> Â Â

> Â Option 1: Your employer provides you with written permission to operate

> under their protocols at all times, even if off duty.Â

> Â Â

> Â 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.Â

> Â Â

> Â Option 3: Your Volunteer FD has a written FR agreement (even in the

> absence of being a registered FRO) to operate under their protocols.Â

> Â Â

> Â Option 4: Your Volunteer FD contracts with a medical director and they

> provide protocols for you to operate under.

> Â Â

> Â I canâ€™t think of another situation but I might have missed one.Â

Albuterol

> is a prescription medication, and is not available to the common lay

> person.Â Therefore, it can not be administered without a protocol in place to

allow

> such administration.Â This would be no different than administering oxygen,

> intubating, cardioverting, starting an IV, administering morphine, or any

> other skill that required a physicianâ€™s oversight.

> Â Â

> Â 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.Â

> 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.

> Â Â

>

> 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.Â This section applies without regard to whether the care is

provided

> for or in expectation of remuneration.

>

> Subsection 74.153.Â STANDARD OF PROOF IN CASES INVOLVING EMERGENCY MEDICAL

> CARE.Â 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.

>

> Â§ 74.154.Â JURY INSTRUCTIONS IN CASES INVOLVING EMERGENCY MEDICAL CARE.Â

> (a)Â 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)Â 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)Â the presence or lack of a preexisting physician-patient relationship or

> health care provider-patient relationship;

>

> (3)Â the circumstances constituting the emergency;Â andÂ Â Â Â Â Â Â

Â Â Â

> Â Â

>

> (4)Â the circumstances surrounding the delivery of the emergency medical

> care.

>

> (Â The provisions of Subsection (a) do not apply to medical care or

> treatment:

>

> (1)Â that occurs after the patient is stabilized and is capable of receiving

> medical treatment as a non-emergency patient;

>

> (2)Â that is unrelated to the original medical emergency; orÂ Â Â Â Â Â

Â Â

>

> (3)Â that is related to an emergency caused in whole or in part by the

> negligence of the defendant.

>

> Keep in mind; youâ€™re talking Civil Damages when you say the Good Samaritan

> Law.Â This simply means if sued, you can claim this as a defense.Â This does

> not mean that you canâ€™t be prosecuted by the DA for an act or censured by

DSHS

> for acting outside your certification.Â Donâ€™t confuse criminal acts or

> omissions with civil liability.Â They are completely different things,

remember

> OJ????

> Â Â

> Â Tater

>

> salvador capuchino wrote:Â A question for those of

> you familiar with fire

> department based FROs.Â I was recently told that as a

> volunteer ff I cannot treat a patient.Â 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.Â It is

> considered a rural area.Â 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.Â 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.Â 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

>

> __________________________________________________

>

March 1, 2006

Sal,

As a volunteer organization. You should have first responder protocols. I

too went through this many years ago with my local VFD. They were a great

bunch of guys but never really that organized in EMS. To protect you and

your personnel you should have SOP’s and Protocols about your responses and

what is expected from your personnel. Certified or not certified. For

instance our uncertified people were put through a red cross first aid

course and would provide that level of care. Our certified people would

perform a little bit more. But our Paramedics were reigned in to BLS only

at our VFD. But only because that is where the membership was willing to

go. So work with in your organization to build these protocols and SOP’s.

If you need help, you can email me off list. I would love to discuss these

struggles with you.

Good Luck,

Tom

_____

From: [mailto: ] On

Behalf Of salvador capuchino

Sent: Wednesday, March 01, 2006 12:25

To:

Subject: Re: Volunteer FF treating patients

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

>

> __________________________________________________

>

March 1, 2006