Is there a doctor on board

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Dr.Evil1

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OK so I was reading the street diagnostician thread and it got me thinking about this topic. I was once on a plane and had the "is there a doctor on board" request. I was called to the seat of a guy who had chest pain and a history of CAD. I ended up giving him ASA and nitro, putting in an IV etc. I didn't have access to EKG or a monitor other than a AICD. We did not divert as it was near the end of the flight and it was an international flight and there were customs/immigration issues to deal with. I called the hospital that he was transported to and found out he was having a STEMI. My sister (PA) also had a similar situation except they made contact with the some sort of medical authority and were able to get this guys records and they ended up diverting the flight and landing early in order to drop this guy off. That was a domestic flight and the incident occurred early in the flight. A third incident happened to a friend of mine who is also a EM resident on a flight where a guy had a seizure. They also diverted the flight to take the guy off the plane. This was basically because my buddy was like "well normally people will have 1 seizure and then be alright but if this guy continues to have seizures then it will be very difficult to manage him on the plane".

I guess that I was wondering when you should tell the pilots to divert a flight? The easy answer would be to say that if the person was sick enough to need me to come over to their seat then they should be taken off the plane. I would think that this would also be the safest legally as well. I kicked myself for not being more forceful in my protestations that the plane be diverted. The problem was that they kept on asking for my license number etc and this was back when I was an intern so I didn't know it and it was educationally limited. Also I had no idea if this guy just had indigestion or as actually having a MI. From the experiences of my friend and sister getting them to divert isn't all that hard, you just explain how this could get much worse and they are already on the way down. Just wondering what the rest of you would actually do.
 
OK so I was reading the street diagnostician thread and it got me thinking about this topic. I was once on a plane and had the "is there a doctor on board" request. I was called to the seat of a guy who had chest pain and a history of CAD. I ended up giving him ASA and nitro, putting in an IV etc. I didn't have access to EKG or a monitor other than a AICD. We did not divert as it was near the end of the flight and it was an international flight and there were customs/immigration issues to deal with. I called the hospital that he was transported to and found out he was having a STEMI. My sister (PA) also had a similar situation except they made contact with the some sort of medical authority and were able to get this guys records and they ended up diverting the flight and landing early in order to drop this guy off. That was a domestic flight and the incident occurred early in the flight. A third incident happened to a friend of mine who is also a EM resident on a flight where a guy had a seizure. They also diverted the flight to take the guy off the plane. This was basically because my buddy was like "well normally people will have 1 seizure and then be alright but if this guy continues to have seizures then it will be very difficult to manage him on the plane".

I guess that I was wondering when you should tell the pilots to divert a flight? The easy answer would be to say that if the person was sick enough to need me to come over to their seat then they should be taken off the plane. I would think that this would also be the safest legally as well. I kicked myself for not being more forceful in my protestations that the plane be diverted. The problem was that they kept on asking for my license number etc and this was back when I was an intern so I didn't know it and it was educationally limited. Also I had no idea if this guy just had indigestion or as actually having a MI. From the experiences of my friend and sister getting them to divert isn't all that hard, you just explain how this could get much worse and they are already on the way down. Just wondering what the rest of you would actually do.

That's pretty F-ed up. I wouldn't give it to them. They can either let you handle the case temporarily or they can go hunting for someone else. Talk about no good deed goes unpunished.😡
 
I had to do this once on a plane back from ACEP. It was funny because there were like 20 doctors on board.

I think as far as diverting you have to ask yourself if this patient needs additional urgent medical attention. If so, you have to decide how fast they need it. IMHO, even if you decide that they need to land the plane right then, you're at least an hour from a gate assuming there is somewhere to land nearby. Someone in a previous thread on this subject also noted that once the aircraft pulls back from the gate you are at least 15 minutes from being able to get anyone off that plane. So it's a big guessing game - I was able to check vitals and things looked OK so I basically rode with them until the plane landed and sent them to an ED.

As far as the license thing - the airline folks just want to know that you're not some con man who gets off on playing doctor. At least in NC you get a little pocket license to carry around - I just flashed that and everything was kosher.

My biggest surprise was that when I asked for the med kit they brought me the little dinky first aid kit. Thankfully having sat through a couple lectures on this and from the previous thread I knew that there was a larger kit somewhere on board and they were eventually able to scrounge that up for me but I expected them to know what I was talking about when I asked.
 
My biggest surprise was that when I asked for the med kit they brought me the little dinky first aid kit. Thankfully having sat through a couple lectures on this and from the previous thread I knew that there was a larger kit somewhere on board and they were eventually able to scrounge that up for me but I expected them to know what I was talking about when I asked.
What things do they carry in the med kit? It seems strange that they wouldn't have an ECG monitor on the OP's flight, as I'm assuming they'd at least have all the routine ACLS drugs on board.
 
I guess that I was wondering when you should tell the pilots to divert a flight?
In your case I'd say time is myocardium, so they should land ASAP. Of course by the time they get the plane landed and the gentleman to a hospital, you're probably outside of the reperfusion window anyhow. Hmmm...
 
I guess supplies varies by flight service/aircraft. But from I understand the MD you contact is in some sort the Medical Command doctor (service) for the flight service. On diverting the flight it all depends on how soon you can land, or can return to point of departure. At least in my view as a prehospital provider alot of "is there a doctor" calls require some degree of prehospital understanding before you go dashing off into the wind.
 
The ultimate responsibility of the plane and all the passengers is the pilot's. Certainly you should get as much weight behind your recommendations as possible (as mentioned before there might be ground online medical support available), but ultimately, unless you risk imprisonment for overpowering the flight crew and landing the plane yourself, the pilot's the boss. Incidentally, same goes with medivac flights--the pilot, not flight RN or flight doc, is the boss.

It isn't easy getting a plane to land quickly--you did everything right... right medications, right recommendations to the pilot... you were working in a resource-poor environment with many factors out of your control (location, weather, flight path, nearest airports, etc).
 
In your case I'd say time is myocardium, so they should land ASAP. Of course by the time they get the plane landed and the gentleman to a hospital, you're probably outside of the reperfusion window anyhow. Hmmm...

But the trick is that you don't know whether the patient is having a STEMI or a muscle ache when you're up in the air. It would be an easy decision if you knew the patient was having a real MI.
 
I heard (in a lecture on this, I think), that the airlines have contracts with certain hospitals that serve as medical control, and the pilot will choose to divert based on that physician's decision via radio instead of on the suggestion of the physician on board. Don't know if this is really true, but I wouldn't be surprised due to the legal risk on the part of the airline. It would be frustrating if you disagreed with the physician on the ground however.

Wow, that's pretty wild that you had a STEMI patient on an airplane.
 
Sorry for the temporary thread hijack. Reminds me of a story from the news a few years ago.


http://www.medicalnewstoday.com/articles/5118.php

Heart attack woman on plane - 15 cardiologists on board
Main Category: Public Health
Article Date: 02 Jan 2004 - 0:00 PST

If you fall ill on a flight, you have to hope there is a doctor on board. So Dorothy Fletcher can count herself lucky.

When she suffered a heart attack on a transatlantic flight from Manchester to Florida, she turned out to be on a plane full of cardiologists.

Fifteen experts on their way to a cardiology conference responded when a stewardess asked for medical assistance.

They stood up en masse and rushed to save Mrs Fletcher, 67, from Liverpool. They fed drips into her arms and used an onboard medical kit to control the life-threatening attack.

The plane was diverted to North Carolina, where Mrs Fletcher was treated in the intensive care unit.

The grandmother had been travelling with her daughter to attend her daughter's wedding when she experienced acute chest pains. Speaking from her home in Liverpool yesterday, Mrs Fletcher recalled: 'I couldn't believe what happened. All these people came rushing down the aircraft towards me. The doctors were wonderful. They saved my life.

'My daughter was with me and you can imagine how she felt when all these doctors stood up. I wish I could thank them but I have no idea who they were, other than that they were going to a conference in Orlando.'

She spent two days in the Charlotte Medical Centre after the heart attack on 7 November, but managed to attend the wedding at Lake Berkeley, Kissimmee, the following week.

Her daughter, Christine Penman, 32, who married her fianc� Gareth, said: '2003 was my best and almost my worst of years. We'll see in the new year by giving thanks that my mum got through what she did.

'We owe those cardiologists and the airline so much. My mum wouldn't be here today if it wasn't for those doctors but in the rush, we didn't even know any of their names - and we still don't.'
 
So, if you save someone's life in the air do you get, like, a free ticket or some peanuts or something?
 
So, if you save someone's life in the air do you get, like, a free ticket or some peanuts or something?

Yes, but the moment you accept anything you may no longer be covered by the Good Samaritan Law. I would STRONGLY urge people to turn down everything - first class upgrades, free drinks, vouchers, etc for this reason. Whether or not this does invalidate any claim of protection of the Good Samaritan Law is unclear, but I personally would hate to be the test case.
 
Yes, but the moment you accept anything you may no longer be covered by the Good Samaritan Law. I would STRONGLY urge people to turn down everything - first class upgrades, free drinks, vouchers, etc for this reason. Whether or not this does invalidate any claim of protection of the Good Samaritan Law is unclear, but I personally would hate to be the test case.

Ooohhh, good point. No peanuts for me. Not even those plastic wings or the deck of cards.
 
on a flight recently i asked to check out the in-flight med bag & was pleasantly surprised about the amt of meds they have. they have ASA, NTG, Dilantin, Atropine, Epi, etc & a whole bunch of other nice stuff
 
on a flight recently i asked to check out the in-flight med bag & was pleasantly surprised about the amt of meds they have. they have ASA, NTG, Dilantin, Atropine, Epi, etc & a whole bunch of other nice stuff

Is there a reason you find it necessary to post this under an anonymous user name rather than your own?
 
As far as STEIM's are concerned - does each airline track their respective door to balloon times?

I agree with not accepting compensation for helping out but I would be hard pressed to turn down a pair of plastic pilot wings.
 
wouldn't you if you ever got on a plane and asked to check out the in flight med bag?
 
There has been a lot of discussion about not being covered under the Good Samaritan Law if you get a free upgrade to first class, free ticket, etc. from the airline. I think the end result is that you are still covered, so long as you don't expect such freebies as bonafide reimbursement. However, as with anything, what happens before a jury remains to be tested. It's best not to test the waters.

Regarding diverting this flight, one has to keep in mind the customs issue. For this plane to divert, go through immigration (which includes unloading luggage and moving luggage through customs), etc. would cause the plane to be on the ground for at least 1 1/2-2 hours at a very minimum. Couple that with delayed flights, tying up a terminal, etc., and you could easily run the cost of the delay up into the millions of dollars.

Personally, I think you made a wise decision not to divert. Unless someone is having a cardiac arrest, respiratory arrest, active seizure, or some other problem that is witnessed in the air, then it's probably safe to continue onward if it's within a reasonable time frame. Yes, if you had an EKG monitor and knew the person was having a STEMI, that would be reason to divert. However, you can't divert the plane for every chest pain. How many patients do you see in the ED with chest pain who are not having a STEMI? Quite a few, and the same can be said true of those on an airplane.
 
In your case I'd say time is myocardium, so they should land ASAP. Of course by the time they get the plane landed and the gentleman to a hospital, you're probably outside of the reperfusion window anyhow. Hmmm...

The reperfusion window is up to 12 hours. The goal is 90 minutes, however the studies demonstrate benefit up to 12 hours. If I was convinced that there was a high probability that the person was having a heart attack, and that we could get to good medical facility within the 12 hour period I would tell the pilot to divert the plane. If the story was not good, or there was no good landing site in range the best bet is to continue to the destination.
 
There has been a lot of discussion about not being covered under the Good Samaritan Law if you get a free upgrade to first class, free ticket, etc. from the airline. I think the end result is that you are still covered, so long as you don't expect such freebies as bonafide reimbursement. However, as with anything, what happens before a jury remains to be tested. It's best not to test the waters.

Regarding diverting this flight, one has to keep in mind the customs issue. For this plane to divert, go through immigration (which includes unloading luggage and moving luggage through customs), etc. would cause the plane to be on the ground for at least 1 1/2-2 hours at a very minimum. Couple that with delayed flights, tying up a terminal, etc., and you could easily run the cost of the delay up into the millions of dollars.

Personally, I think you made a wise decision not to divert. Unless someone is having a cardiac arrest, respiratory arrest, active seizure, or some other problem that is witnessed in the air, then it's probably safe to continue onward if it's within a reasonable time frame. Yes, if you had an EKG monitor and knew the person was having a STEMI, that would be reason to divert. However, you can't divert the plane for every chest pain. How many patients do you see in the ED with chest pain who are not having a STEMI? Quite a few, and the same can be said true of those on an airplane.

So, does anyone actually know what the Good Samaritan laws say? I was taught that (at least in California), these laws only apply to BLS. If you start an IV, give drugs (ASA, NTG), basically do any treatment other than giving oxygen, you're on your own. So if you give grandma a shot of NTG and her pressure bottoms out and bad things happen, you might really regret it.

Anyone else heard similar limitations to the Good Samaritan laws?
 
Funny story, last time I flew someone got sick and the stewardess and myself got talking about the whole license thing. She told me about a time when they asked for a doctor overhead for a patient having chest pain and a women presented stating she was a doctor and after evaluating the patient requested to divert the plane. After the patient was off the stewardess asked her for her license info and it turns out the lady was a doctor of scientology!
 
So, does anyone actually know what the Good Samaritan laws say? I was taught that (at least in California), these laws only apply to BLS. If you start an IV, give drugs (ASA, NTG), basically do any treatment other than giving oxygen, you're on your own. So if you give grandma a shot of NTG and her pressure bottoms out and bad things happen, you might really regret it.

Anyone else heard similar limitations to the Good Samaritan laws?
Good Samaritan laws vary WIDELY by state. Some states don't even have them. Some states explicitly exclude licensed healthcare professionals, even if they are volunteering their services without pay.

The federal Good Samaritan law that applies to airline passengers reads as follows:

"(a) Liability of air carriers.--An air carrier shall not be liable for damages in any action brought in a Federal or State court arising out of the performance of the air carrier in obtaining or attempting to obtain the assistance of a passenger in an in-flight medical emergency, or out of the acts or omissions of the passenger rendering the assistance, if the passenger is not an employee or agent of the carrier and the carrier in good faith believes that the passenger is a medically qualified individual.

"(b) Liability of individuals.--An individual shall not be liable for damages in any action brought in a Federal or State court arising out of the acts or omissions of the individual in providing or attempting to provide assistance in the case of an in-flight medical emergency unless the individual, while rendering such assistance, is guilty of gross negligence or willful misconduct.
 
Good Samaritan laws vary WIDELY by state. Some states don't even have them. Some states explicitly exclude licensed healthcare professionals, even if they are volunteering their services without pay.

The federal Good Samaritan law that applies to airline passengers reads as follows:

"(a) Liability of air carriers.--An air carrier shall not be liable for damages in any action brought in a Federal or State court arising out of the performance of the air carrier in obtaining or attempting to obtain the assistance of a passenger in an in-flight medical emergency, or out of the acts or omissions of the passenger rendering the assistance, if the passenger is not an employee or agent of the carrier and the carrier in good faith believes that the passenger is a medically qualified individual.

"(b) Liability of individuals.--An individual shall not be liable for damages in any action brought in a Federal or State court arising out of the acts or omissions of the individual in providing or attempting to provide assistance in the case of an in-flight medical emergency unless the individual, while rendering such assistance, is guilty of gross negligence or willful misconduct.

SD -

There is one caveat to the rule you posted. It only applies to interstate flights. A flight originating and landing in a single state is bound by the rules of that state. So a flight from Sacramento to San Diego would be bound by California's laws, not the regulations on interstate travel. I'm not sure what happens if a flight is diverted to an airport in the original state (i.e., if a flight from Cincinnati to NYC is diverted medically to Cleveland does Federal or Ohio law apply?).
 
SD -

There is one caveat to the rule you posted. It only applies to interstate flights. A flight originating and landing in a single state is bound by the rules of that state. So a flight from Sacramento to San Diego would be bound by California's laws, not the regulations on interstate travel. I'm not sure what happens if a flight is diverted to an airport in the original state (i.e., if a flight from Cincinnati to NYC is diverted medically to Cleveland does Federal or Ohio law apply?).


I think your wrong on that. The air is United States air space, and the water is United States Waters.... there is no Texas airspace or Texas waters (as much as we wished there was) (by waters I mean the sea).

In other words, if I wish to fly my plane ONLY around my town, I still have to follow ALL FAA rules and regulations. With water, I think its within 2 miles of shore state reigstration and such cross covers, outside of that, its US coast guard....
 
I think your wrong on that. The air is United States air space, and the water is United States Waters.... there is no Texas airspace or Texas waters (as much as we wished there was) (by waters I mean the sea).

In other words, if I wish to fly my plane ONLY around my town, I still have to follow ALL FAA rules and regulations. With water, I think its within 2 miles of shore state reigstration and such cross covers, outside of that, its US coast guard....

I was always taught that the federal rules applied because of the interstate commerce clause of the Constitution. If an "intrastate" flight occurs, that doesn't meet the rule and local rules apply.

I have my private pilot ticket, and I could see where you are right too. Any lawyers out there have the answer?
 
I was always taught that the federal rules applied because of the interstate commerce clause of the Constitution. If an "intrastate" flight occurs, that doesn't meet the rule and local rules apply.

I have my private pilot ticket, and I could see where you are right too. Any lawyers out there have the answer?
No, the law applies to all domestic flights regardless of origin or destination. It does not apply to international flights.

Federal law preempts state law when they are the governing authority (e.g., aviation, telecommunications, etc.).
 
" unless the individual, while rendering such assistance, is guilty of gross negligence or willful misconduct.

It should be noted that this leaves Good Samaritans open to culpability as "gross negligence or willful misconduct" is open to interpretation. I'd hope a competent, well-intentioned physician wouldn't loose this kind of caes, but it's a very real possibility.
 
So here's one that's gonna be a nightmare for the docs and nurses who tried to help out on the plane:

http://news.aol.com/story/_a/dispute-over-womans-death-on-flight/20080225074609990001

Obviously the family is talking lawsuit. At worst those people will get named in the suit. At best they're gonna have to testify because the family will need them to say the O2 wasn't working. And just to make that pill harder to swallow where will the trial be? Haiti? New York? Miami? The witnesses will get to travel to which ever destination the legal system chooses. Granted that won't be for several years but they're sure to see a string of subpoenas and depositions until then.
 
No, the law applies to all domestic flights regardless of origin or destination. It does not apply to international flights.

Federal law preempts state law when they are the governing authority (e.g., aviation, telecommunications, etc.).

Plus, you could get real nitpicky when saying that flight booking and management that occurred prior to the flight entering into the air more than likely involved communications across state lines
 
So here's one that's gonna be a nightmare for the docs and nurses who tried to help out on the plane:

http://news.aol.com/story/_a/dispute-over-womans-death-on-flight/20080225074609990001

Obviously the family is talking lawsuit. At worst those people will get named in the suit. At best they're gonna have to testify because the family will need them to say the O2 wasn't working. And just to make that pill harder to swallow where will the trial be? Haiti? New York? Miami? The witnesses will get to travel to which ever destination the legal system chooses. Granted that won't be for several years but they're sure to see a string of subpoenas and depositions until then.

Just hope the doctors took a moment to write everything they did down so they remember in a decade and a half from now when this thing goes to trial. I could see some angry lawyer somehow blaming all of this on the random _________ologist who was on the plane and hadn't run a code in 8 years...
 
How would you have liked sitting in first class for another few hours with some dead person on the ground under a sheet! At least someone had the decency to call the code and not work this lady with a bag valve mask and compressions for 45+ minutes to Miami!
 
How would you have liked sitting in first class for another few hours with some dead person on the ground under a sheet!
That wouldn't have bothered me.


Once while on my second year trauma rotation (needless to say I was tired) I had crashed out on a gurney in the decon shower which at UC Davis is this fairly big, tiled room at the end of the hallway leading from the ambi doors to the resus bays. I'd been out for about 40 minutes (most sleep I got on that whole rotation) when my pager woke me up. Look over and someone had parked another gurney with a body on it next to me. The wild thing was that my first thought was not "Ewwwwww!" It was that it must have been a medical patient because my trauma pager hadn't gone off.
 
The flight apparently never stopped in Miami. I wonder what laws apply about pronouncing a patient dead on an airplane, and then continuing over multiple states to your original destination?

Regarding the AED not working properly, I'm betting she had a non-shockable rhythm (probably asystole from hypoxia or PEA from a PE maybe?). The AED probably functioned properly.
 
This topic has found its way over to firehouse.com in the EMS forum and with it a few intersting points. If you were the doctor on the other end (Medical Command) and were speaking to a Paramedic worried about doing ALS because he is out of his state/county would you grant them permission to do ALS? Would it change your orders at all if the Paramedic had National Registry?
 
I would certainly grant the medic permission to do ALS. Aside from the fact that this falls squarely under my "any port in a storm" reasoning, one can make the argument that the average medic is going to be as well or better equipped to handle an ALS emergency than the average non-emergency physician, intensivist or anesthesiologist. The latter three are among the few docs who deal with ACLS on a daily basis AND have the procedural skills to get the IV in and administer the drugs.

This topic has found its way over to firehouse.com in the EMS forum and with it a few intersting points. If you were the doctor on the other end (Medical Command) and were speaking to a Paramedic worried about doing ALS because he is out of his state/county would you grant them permission to do ALS? Would it change your orders at all if the Paramedic had National Registry?
 
cnn.com has a new follow up story which is pretty decent, basically what the airlines carry, how a MD is contacted in flight, the kits that are carried, etc and basically saying "dont fly if your sick".

Personally if I responded to a in flight code my two medical command contacts would probaby be an inital report and request for termination. Obviously every other situation is situation dependent.
 
The flight apparently never stopped in Miami. I wonder what laws apply about pronouncing a patient dead on an airplane, and then continuing over multiple states to your original destination?

Well if they're dead, since we've already established the severe annoyance of landing a plane then re-taking off, why not just continue. There is a much better chance that the dead person has someone in the destination city who can deal with all of the necessary arrangements than their having one in the random city you land in. Its probably the pilot's call...
 
Well if they're dead, since we've already established the severe annoyance of landing a plane then re-taking off, why not just continue. There is a much better chance that the dead person has someone in the destination city who can deal with all of the necessary arrangements than their having one in the random city you land in. Its probably the pilot's call...
Some laws specifically forbid transferring dead bodies across state lines without proper paperwork.

In what state is this person declared dead?

My question is about state laws, not about the futility of continuing to working a cardiac arrest or diverting a plane. I agree that diverting the plane is incredibly expensive as I mentioned previously.
 
Obviously the family is talking lawsuit. At worst those people will get named in the suit. At best they're gonna have to testify because the family will need them to say the O2 wasn't working. And just to make that pill harder to swallow where will the trial be? Haiti? New York? Miami? The witnesses will get to travel to which ever destination the legal system chooses. Granted that won't be for several years but they're sure to see a string of subpoenas and depositions until then.

so true... this case illustrates that no good deed goes unpunished.


the good samaritan law is supposed to shield you from liability and being sued when there is no obligation to help. however, just having to hire a lawyer to field calls, give depositions (i.e. -- was the oxygen tank functioning?), paying the lawyer for sitting with you at the deposition, traveling to the deposition, lost time from work (if you are paid by the hour -- most private practice -- it makes a huge difference!) -- that's a lot of financial liability ..

so basically,
you're damned if you do and damned if you don't.
i'm sure if anyone found out via the airline manifesto that you were an EM doc and DIDN'T help, someone would try to sue you as well...
 
I'm sure we are all aware you can be sued for anything but to win they actually require a case. I asume the same applies to other health providers but a Paramedic or EMT has no duty to act in this type of situation. Unless your "on duty" as a medical provider on this specific flight they would have no case to say you didn't respond to a call for assistance. Obviously ethical issues exsist in this type of situation but my understanding is that you can only be expected to preform at your certification level and with the equipment provided.

(IE you don't have a cath lab on a plane, but can do proper ACLS with the equipment at hand.)
 
I'm sure we are all aware you can be sued for anything but to win they actually require a case. I asume the same applies to other health providers but a Paramedic or EMT has no duty to act in this type of situation. Unless your "on duty" as a medical provider on this specific flight they would have no case to say you didn't respond to a call for assistance. Obviously ethical issues exsist in this type of situation but my understanding is that you can only be expected to preform at your certification level and with the equipment provided.

(IE you don't have a cath lab on a plane, but can do proper ACLS with the equipment at hand.)

Thats not totally true. New Hampshire state law states that by virtue of being an EMT/Medic you have a duty to act unless the scene is safe (you're wasted off duty or the scene is actually unsafe and you wouldn't do it even if you're working). None of my friends who live in NH are do EMS have anything identifying them as an EMT on their car, just in case they drive by a car wreck and can't stop for whatever reason.
 
Thanks for that correction, rules varry by state.
 
I'm sure we are all aware you can be sued for anything but to win they actually require a case. I asume the same applies to other health providers but a Paramedic or EMT has no duty to act in this type of situation. Unless your "on duty" as a medical provider on this specific flight they would have no case to say you didn't respond to a call for assistance. Obviously ethical issues exsist in this type of situation but my understanding is that you can only be expected to preform at your certification level and with the equipment provided.

(IE you don't have a cath lab on a plane, but can do proper ACLS with the equipment at hand.)

That's true however there's a big BUT. They will likely ultimately get dropped if they are named in the suit BUT they will still have to pay for a lawyer to get them dropped. To get dropped they will at least have to be deposed and testify that they weren't getting paid, what they did, that they weren't grossly negligent, etc., ie. they'll have to prove that they fall under the Good Sam laws. That's lots of $$$ and time. AND it sounds like they will be called to testify about the case, equipment, flight attendent's actions, etc. even if they aren't named in the case. Again $$$ and time.
 
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