off duty medics

[medicdude]

so as a licensed medic i am unable to start any iv off duty or i can be charged with practicing medicine without a license as my license is only valid while working for an authorized als provider. i understand medics/corpsmen are trained to start IVs. lets say you have on your person an IV kit. if you see a patient from a car accident, or shooting, or even a medical patient, are you able to start an iv on that person as a good samaritan without any charges? just a curiosity i had.

[Bert Gamble]

You, as a paramedic should know that starting an IV is well beyond the scope of his ability and would not be covered under the good sam law. Same goes with brain surgery and breast implants.

[Desert_Rat]

HUH? I am a Mechanic and I can start an IV. It is not beyond my capabilities. But I also can test breast implants, so what do I know.

[TooPoorForMore]

Any advanced lift support practice, aka intravenous access, needs to be under the authorization of medical direction. If you are off duty, you would not be working under medical direction, ergo it would be considered a no no. It's a matter of liability. Also, Good Samaritan laws do not apply when the good Samaritan exhibits gross negligence, is found reckless or the action is unnecessary. I'm a paramedic supervisor so I hear this kinda question occasionally.

[medicdude]

I understand the regulations for myself as a medic and other medics I just was not sure if ARMY medics were different. The reason I ask is there is a post in the "what do you have in your range bag" thread where a guy states he carries an IV kit.

[medicdude]

TooPoor - Sac Co has recently added that off duty medics may carry and utilize advanced airway devices including ET tubes and laryngyscopes. How Ricky rescue mall ninja tacticool is that

[Army GI]

You, as a paramedic should know that starting an IV is well beyond the scope of his ability and would not be covered under the good sam law. Same goes with brain surgery and breast implants.

Yes and no.

Starting IV's on a civilian is beyond our "authorization." As far as civilians are concerned, we are only trained to EMT-B level. However, US Army medics are well trained to start IV's. Our medical knowledge and what we can perform is only limited by personal experience and by what our medical supervisor will teach us/let us do.

Basically speaking: our scope of practice for civilians is highly regulated in the civilian world. However, on post, and with other soldiers, anything goes.

For example, I've never been in a combat zone and have had to perform chest tube intubation. I was never even taught how to do it at AIT.

However combat medics do it all the time.

I understand the regulations for myself as a medic and other medics I just was not sure if ARMY medics were different. The reason I ask is there is a post in the "what do you have in your range bag" thread where a guy states he carries an IV kit.

You are right in that sense. We can do whatever we want to other soldiers (usually with a PA or an MD supervising) that other EMT-Bs would never do to a civilian. IVs, minor surgical procedures, suturing, etc.

So yes, it happens.

But I think Bert has answered your question which is "is it illegal?" and the answer is yes.

[medicdude]

thanks GI! cleared up what i was looking for.

[Bert Gamble]

Yes and no.

Starting IV's on a civilian is beyond our "authorization." As far as civilians are concerned, we are only trained to EMT-B level. However, US Army medics are well trained to start IV's. Our medical knowledge and what we can perform is only limited by personal experience and by what our medical supervisor will teach us/let us do.

Basically speaking: our scope of practice for civilians is highly regulated in the civilian world. However, on post, and with other soldiers, anything goes.

For example, I've never been in a combat zone and have had to perform chest tube intubation. I was never even taught how to do it at AIT.

However combat medics do it all the time.




You are right in that sense. We can do whatever we want to other soldiers (usually with a PA or an MD supervising) that other EMT-Bs would never do to a civilian. IVs, minor surgical procedures, suturing, etc.

So yes, it happens.

But I think Bert has answered your question which is "is it illegal?" and the answer is yes.

I would just like to say thank you for all that you do. You guys are great.

[Mr.Caketown]

You are in california

You cant administer oxygen without medical direction in that state.

[natrab]

It's best in the state of liability to stick with BLS if you're off duty. Also consider your personal safety. Stopping at a car wreck on the freeway actually creates more risks and potential for problems than passing by it and just calling it in.

We just recently had two people killed while out of their cars trying to help another vehicle that had a solo spin out on 101.

Remember that in most of California we have tons of EMS resources that will be there in minutes if you just call it in (In my county we literally send four fire engines and an ambulance to most freeway accidents). Will your IV save someones life in 5 minutes with no other ALS assessment or treatment tools? I doubt it, and it's not worth the liability risk.

[xeronightmare]

Id hate to ask but when you say "licensed", what do you mean by that?
Are you NREMT-P Certified? Or do you mean 68W Certified?

If you worked EMS in SoCal recently you'll find that different counties have different scope's of practice. For an example, back in the day in SB county Combitubes are gtg for EMT-B's to administer but a big no-no in OC or LA County.

Good Samaritan from what I remember only covers laypersons. If you indeed had some sort of medical training and you do harm, then you are liable.

Also please note that if you do not have a medical license (Paramedic, M.D. P.A-C, etc) it means that you are working under the license of someone who has one. In the military its your MO, that is usually a MD or PA so you operate under their license. As such they establish your scope of practice. In the civilian world every EMS agency has a Chief MO whose license they use.

Again it all comes down to who's license are you operating under. If you don't have one to operate under, then consider if you are willing to be sued for doing good. I used to work ACLS and I have gone to court twice for patients malpractice cases against the company. Stupid, but its a crazy world out there.

Here in SoCal there is usually a ER or ACLS/ALS unit every five miles. Average eta on a call for me was 7 minutes till on scene. I'd highly doubt that making an IV will be beneficial. Why? Three reasons:

1. IV therapy and fluid resuscitation is the LAST thing we should do as Medics. HABC's
2. The time it takes to get a successful IV line is usually 2-3 minutes. Time that could be used to go through HABC's and get pertinent info to get a better assessment of the pt to give to higher med authority. The longer ACLS has to stay to get info the worse it is for your pt.
3. When your pt gets to the ER they take out your line anyways as it's not considered sterile.

In short, its good to know all your skills but laws in Cali restrict you to nil unless you are employed and on the job.

Just my $.02

[medicdude]

i was not asking about myself. i was just curious as to the liability/legality for military medics. you guys obviously didnt read all of my OP or the thread. i am an experienced medic and i know what im doing.

i dont stop at car accidents off duty, i didnt ask about protocols in A county vs B county, i do have a license. this was just a theoretical question based on the guy stating he carries an iv kit in his range bag.

i know state regulations, my FIL runs EMSA. again this question was for military medics.

[gatesbox]

When I was in EMT school, I was told flat out to not stop at an accident off duty once I received th training...at least for EMT-B in Oregon at the time...... The rational was that we had to much knowledge to avoid causation arguments to a negligence claim...if we wanted to live to work another day we would just call 911 and keep driving...there may be better coverage within the law for basic life support, CPR AED now....

[Stormfeather]

Heck, my friends and I all know how to do IV's, We practice weekly, and under multiple altered conditions,

Case in Point



And we are a firm believer in continually cycling fluids to ensure proper hydration!



EMT's, dont try this at home. . . . .