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    Out of Scope Medical Skills During a Disaster


    Battalion Coordinator
    Battalion Coordinator

    Neighborhood : Monterey Hills
    Posts : 48
    Join date : 2016-01-25

    Out of Scope Medical Skills During a Disaster

    Post by Cabrillo-1 on Tue Feb 16, 2016 11:51 pm

    The Good Samaritan Law allows protection of volunteers who help people in medical need as long as the rescuer does not exceed his or her level of training and scope of practice.
    Many CERT members have taken advaned medical training such as Emergency Medical Responder (EMR) and Emergency Medical Technician (EMT).
    Under most circumstances, at least in Los Angeles, Emergency Medical Services (EMS) is minutes away at any given point of time.  Very rarely will a CERT member be on scene for more than a few minutes during a major medical or trauma emergency before paramedics arrive.
    However, CERT teaches us to be prepared for a disaster and to assist ourselves, our families, and our communities when one occurs.  A disaster occurs when civil support services are overwhelmed.  We are taught that during a major disaster, we may be without help for days or even weeks.  We've seen this happen during the floods in the gulf coast and earthquakes in other parts of the world.
    Normal scope of practice limit what EMRs and EMTs can do.  For example, they cannot dispense most medications or perform any technique that involves penetrating a patient (such as with a needle).  They can assist with a patient's epinephrine auto-injector or assist with the patient's own medication.  Providing anything such as anti-biotics or pain medication above a simple over-the-counter advil is beyond scope of practice.
    Military Combat Life Saver training provides some paramedic level skills such as needle chest decompression that EMTs are not allowed to perform.
    Under normal circumstances, it is understood that a CERT trained person will never exceed scope of practice nor level of training.
    The question becomes, what happens during a disaster?  When a state of emergency is declared and EMS is not available for days, is it okay to exceed scope of practice to save a life?
    Is it worth it to risk a lawsuit and loss of protection from Good Samaritan?
    Is there a difference between can and should?
    If, for example, the city has been hit by a massive earthquake and buildings have collapsed, cellphone service is down, and you hear on your emergency alert radio that it may be as long as a week for cell services to be restored and EMS to begin making it to certain suburbs and you have come upon someone who is injured. You've stopped the bleeding but the wound is obviously infected and the patient has a high fever.  You have non-expired antibiotics in your personal kit.  You know that you are not supposed to give someone else your prescribed antibiotics but your patient says he has no known allergies.  Can you give them to him knowing that if you don't he may die from the infection?  Should you do so and risk later legal ramifications?
    Do you even risk carrying equipment and medications in your kit that you are not legally allowed to use on others because of limits of scope and training but you actually know how to use?

    Patrick Botz-Forbes
    CERT Battalion 2 Coordinator
    Monterey Hills Neighborhood Leader

      Current date/time is Sun Jul 15, 2018 2:21 pm