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Originally Posted by Burned Out

A good Samaritan law covers an average person from being sued, when attempting to aid someone by means that would be considered common sense by an average adult.
Once you use equipment, and I don't mean gloves or a pocket mask but advanced level equipment not found in a standard first aid kit, you have now gone beyond the scope of an average person.

As a medic, if you are off duty, you are not working under the scope of your EMS Director. Unless, they have it in writing that they expect their medics to perform off duty.
As a licensed DR. you are working under the scope of your license. If you are not an emergency medicine specialist. a Lawyer is going to use that against you.

Now, as long as you act within the scope of your training, you have a good chance of being ok. But, just doing it opens the avenue to be sued.
Acting as joe average person does not.

Now let's talk about GOOD SAMARITAN LAWS.
Having the gear to act under your scope of practice is not illegal nor will it open you up to any out-of-the-ordinary legal issues when dealing with Good Sam. Unless you can find any state whose laws disagree with this, you have nothing to stand on. Legal precedences also disagrees with you.

Realistically, you don't need to be in violation of ANY law to be sued. You can sue a ham sandwich if you don't like the way it tastes. The court decides if you were, in fact, in violation of the law.

I don't need to cite laws. You are trying to bend a law to fit your desire.
My point being: As soon as you step out of your car, with advanced equipment, you are no longer covered under the good Samaritan laws.
You are also working outside your scope of practice. Civil laws are laws of inclusion, not exclusion. They don't have to say it is illegal for you to do it, they aren't trying to arrest you. Just setting guidelines of what is appropriate.

We can argue about this forever. But one of us is wrong. We most likely just have to agree to disagree. Anyone can take my posts in anyway they see fit.

Anything beyond BLS and you are practicing medicine without a license. Around here in Fl a medic was caught doing an IV on a car wreck off duty and the Medical Director took there patch and had the state take there cert away and black flag them from the future. I don't think carrying BLS stuff with get you into any trouble, but please use your head...

Burned Out, I see your home base is Illinois so I will address specifically Illinois law as it pertains to EMS workers and good sam laws. In Illinois, if your are licensed as an EMS worker, no matter if you are on or off duty, you are held to the standards of your license. If you get out of your car with advanced equipment or no equipment at all you are still held responsible for the interventions and treatments you provide. If you get out of your car with only a pair of gloves at an auto accident and provide care you are responsible to provide care to your level. As an example, if at an auto accident, you get out with a pair of gloves and hold c-spine and the patient later dies from injuries associated with a broken neck, you will be sued. But you won't be held negligent because you performed care to your level and the equipment available to you. Now, if you get out of your car with a pair of gloves and decide to remove the patient without maintaining c-spine (pretending the vehicle is not about to explode, catch on fire, fall off a cliff, etc.) and the patient later dies from complications of a broken neck, you will be sued and found negligent. You will be negligent even though you had no equipment, were off duty, and only acting out of the kindness of your heart. So, that is one reason I dial 911, keep driving, and don't loose sleep over not stopping.

Now, if you get into advanced procedures but operate to the standard of the average provider of your level, you may still be sued but you won't be found negligent and monetarily responsible. However, you may run into problems with operating with out medical command and practicing medicine without a license, etc., etc., and probably loose your license.

These remarks are based only on Illinois laws and not meant to represent the laws of any other state, providence, territory, or Rhode Island. Nor am I a lawyer so you should not listen to any of this information and you should consult your local spawn of evil for real legal advice that you have to pay for to get.

Originally Posted by Burned Out

I don't need to cite laws. You are trying to bend a law to fit your desire.
My point being: As soon as you step out of your car, with advanced equipment, you are no longer covered under the good Samaritan laws.

That certainly is not the case in any Good Samaritan laws I've seen. Can you cite your local Good Sam. law and put the section in bold that says you are not allowed to provide ALS care?

Illinois is where I live, but I haven't worked there in years. You are also making my point. You are agreeing, that you are opened up to lawsuit. That is my point. And yes, you are acting out of the scope of your practice, as soon as you step out of your car.
Your license is valid, on or off duty. Your authority to perform is not. A paramedic, intermediate, basic, PA or any other non MD. works UNDER the license of an MD. They are not covered by that license, while off duty, unless that agency they work for specifically mentions in writing that you are authorized to do so.

Laviathan:
You are also confused about good Samaritan laws.
As I mentioned previously, they are laws of INCLUSION. They are NOT laws of EXCLUSION.
What that means is, they only refer to what/who is covered, not what/who is not covered.
That leaves a lot of ambiguity for lawyers to manipulate.

And again, nowhere in any of my posts, did I say you would be successfully sued. All I said was, you leave yourself open to a lawsuit.

Public Act 094-0504
HB3033 Enrolled LRB094 06563 DRJ 36653 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois, represented in the General Assembly:
Section 5. The Emergency Medical Services (EMS) Systems Act is amended by changing Section 3.50 as follows:
(210 ILCS 50/3.50) Sec. 3.50. Emergency Medical Technician (EMT) Licensure. (a) "Emergency Medical Technician-Basic" or "EMT-B" means a person who has successfully completed a course of instruction in basic life support as prescribed by the Department, is currently licensed by the Department in accordance with standards prescribed by this Act and rules adopted by the Department pursuant to this Act, and practices within an EMS System. (b) "Emergency Medical Technician-Intermediate" or "EMT-I" means a person who has successfully completed a course of instruction in intermediate life support as prescribed by the Department, is currently licensed by the Department in accordance with standards prescribed by this Act and rules adopted by the Department pursuant to this Act, and practices within an Intermediate or Advanced Life Support EMS System. (c) "Emergency Medical Technician-Paramedic" or "EMT-P" means a person who has successfully completed a course of instruction in advanced life support care as prescribed by the Department, is licensed by the Department in accordance with standards prescribed by this Act and rules adopted by the Department pursuant to this Act, and practices within an Advanced Life Support EMS System. (d) The Department shall have the authority and responsibility to: (1) Prescribe education and training requirements, which includes training in the use of epinephrine, for all
levels of EMT, based on the respective national curricula of the United States Department of Transportation and any modifications to such curricula specified by the Department through rules adopted pursuant to this Act; (2) Prescribe licensure testing requirements for all levels of EMT, which shall include a requirement that all phases of instruction, training, and field experience be completed before taking the EMT licensure examination. Candidates may elect to take the National Registry of Emergency Medical Technicians examination in lieu of the Department's examination, but are responsible for making their own arrangements for taking the National Registry examination; (3) License individuals as an EMT-B, EMT-I, or EMT-P who have met the Department's education, training and testing requirements; (4) Prescribe annual continuing education and relicensure requirements for all levels of EMT; (5) Relicense individuals as an EMT-B, EMT-I, or EMT-P every 4 years, based on their compliance with continuing education and relicensure requirements; (6) Grant inactive status to any EMT who qualifies, based on standards and procedures established by the Department in rules adopted pursuant to this Act; (7) Charge each candidate for EMT a fee to be submitted with an application for a licensure examination; (8) Suspend, revoke, or refuse to renew the license of an EMT, after an opportunity for a hearing, when findings show one or more of the following: (A) The EMT has not met continuing education or relicensure requirements as prescribed by the Department; (B) The EMT has failed to maintain proficiency in the level of skills for which he or she is licensed; (C) The EMT, during the provision of medical services, engaged in dishonorable, unethical or
unprofessional conduct of a character likely to deceive, defraud or harm the public; (D) The EMT has failed to maintain or has violated standards of performance and conduct as prescribed by the Department in rules adopted pursuant to this Act or his or her EMS System's Program Plan; (E) The EMT is physically impaired to the extent that he or she cannot physically perform the skills and functions for which he or she is licensed, as verified by a physician, unless the person is on inactive status pursuant to Department regulations; (F) The EMT is mentally impaired to the extent that he or she cannot exercise the appropriate judgment, skill and safety for performing the functions for which he or she is licensed, as verified by a physician, unless the person is on inactive status pursuant to Department regulations; or (G) The EMT has violated this Act or any rule adopted by the Department pursuant to this Act. The education requirements prescribed by the Department under this subsection must allow for the suspension of those requirements in the case of a member of the armed services or reserve forces of the United States or a member of the Illinois National Guard who is on active duty pursuant to an executive order of the President of the United States, an act of the Congress of the United States, or an order of the Governor at the time that the member would otherwise be required to fulfill a particular education requirement. Such a person must fulfill the education requirement within 6 months after his or her release from active duty. (e) In the event that any rule of the Department or an EMS Medical Director that requires testing for drug use as a condition for EMT licensure conflicts with or duplicates a provision of a collective bargaining agreement that requires testing for drug use, that rule shall not apply to any person covered by the collective bargaining agreement.
(Source: P.A. 92-376, eff. 8-15-01.)








(745 ILCS 49/70)
Sec. 70. Law enforcement officers, firemen, Emergency Medical Technicians (EMTs) and First Responders; exemption from civil liability for emergency care. Any law enforcement officer or fireman as defined in Section 2 of the Line of Duty Compensation Act, any "emergency medical technician (EMT)" as defined in Section 3.50 of the Emergency Medical Services (EMS) Systems Act, and any "first responder" as defined in Section 3.60 of the Emergency Medical Services (EMS) Systems Act, who in good faith provides emergency care without fee or compensation to any person shall not, as a result of his or her acts or omissions, except willful and wanton misconduct on the part of the person, in providing the care, be liable to a person to whom such care is provided for civil damages.
(Source: P.A. 93‑1047, eff. 10‑18‑04; 94‑826, eff. 1‑1‑07.)




Now again, YES, I am talking scope of practice, and this is where people screw up. You are NOT in your scope of practice when you exit your car.
The key words in the EMS act is "Practices within an EMS system." Unless it is in writing, when you are off duty, you are NOT practicing within that system.

Originally Posted by Burned Out

Now again, YES, I am talking scope of practice, and this is where people screw up. You are NOT in your scope of practice when you exit your car.
The key words in the EMS act is "Practices within an EMS system." Unless it is in writing, when you are off duty, you are NOT practicing within that system.
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Hahahahaha. The law just said that if you render aid, you are not subject to liability. Stepping out of a car is NOT contrary to ANY scope of practice... especially a field like EMS which can be (and sometimes is) plectron-based. If anything, that law ENCOURAGES EMTs, CFRs and the rest to help where they are able because there will be NO liability for doing so. It says that if you provide care that is consistent with the standard of care, you are NOT opened up to any liability from the person to whom you rendered that care. How are you that confused?

Again, it is not ME that is confused.
LOOK at the law. It says, when acting IN a SYSTEM.
When you get out of your car, you are NOT acting in your system.
When you RESPOND to a call that has been dispatched, in your pov as a volunteer, that is not the same as stopping by some accident you saw 10 miles out of your district you work in.

One last comment:
Ask your system director, if he/she will cover you if you treat somebody while off duty. (and also out of your districts limits)

Then, you will have your answer.

I'll be interested to here their responses.

Originally Posted by Burned Out

Again, it is not ME that is confused.
LOOK at the law. It says, when acting IN a SYSTEM.
When you get out of your car, you are NOT acting in your system.
When you RESPOND to a call that has been dispatched, in your pov as a volunteer, that is not the same as stopping by some accident you saw 10 miles out of your district you work in.

It does not say "when acting in a system" anywhere. It refers to the "Emergency Medical Services Systems" law that you posted right above it...

You are correct, but right in that LAW I posted, it states you must be "Acting in a system."

The G.S. law STATES you must meet the EMS law. The EMS law STATES you MUST be acting in a System.

Originally Posted by Burned Out

You are correct, but right in that LAW I posted, it states you must be "Acting in a system."

The G.S. law STATES you must meet the EMS law. The EMS law STATES you MUST be acting in a System.

I think you're reading in to that part the wrong way. It does not say that you must be acting within the system to be an EMT. It says that, to be an EMT, you must participate in an EMS system to have a valid certification - it is protecting the title of EMT to be used in the pre-hospital environment. That section prevents a hospital from hiring me to work on a floor as an EMT, because the EMT is trained specifically for the pre-hospital management and care of a patient. That is the state's way of keeping control of EMT training and the scope of practice. If it were the way that you're reading it, then the individual wouldn't be certified, but rather only the service would be certified to provide care and would therefore be responsible for the qualification of its staff.

Obviously, there's some elasticity in the interpretation of the wording of the law, but I really don't think its meaning is the way that you're taking it. The second law that you posted is obviously talking about off-duty aid because it mentions a lack of compensation. Obviously, all of the positions given in that law are (or at least can be) paid positions. If you are reading these laws correctly, there is no reason for the state to have even published the second law (except for volunteers who are definitely in the minority of the population).

Paid meaning, you are not accepting payment for your services AT THE TIME GIVEN. You aren't charging the people you are helping.
When you are off duty, you are not working for ANY EMS system.

As I have said, go ask your director if he/she is willing to put his license at risk for your off duty activities. I suspect I know their answers.

Also ask past rescue rangers about their fun experiences with lawyers and mad Directors when they went all rescue ranger on somebody.

You already had one example given to you.

Last: I said, much earlier, one of us is wrong. We can argue forever, or we can agree to disagree.

I used my log in name for a reason. The name alone should tell people, what my outlook on EMS is. They should keep that in mind, when they read my posts. I did that on purpose, so people can see I am giving them a biased comment.

Missouri Revised Statutes
Chapter 537
Torts and Actions for Damages
Section 537.037

Emergency care, no civil liability, exceptions (Good Samaritan law).

537.037. 1. Any physician or surgeon, registered professional nurse or licensed practical nurse licensed to practice in this state under the provisions of chapter 334 or 335, RSMo, or licensed to practice under the equivalent laws of any other state and any person licensed as a mobile emergency medical technician under the provisions of chapter 190, RSMo, may:

(1) In good faith render emergency care or assistance, without compensation, at the scene of an emergency or accident, and shall not be liable for any civil damages for acts or omissions other than damages occasioned by gross negligence or by willful or wanton acts or omissions by such person in rendering such emergency care;

(2) In good faith render emergency care or assistance, without compensation, to any minor involved in an accident, or in competitive sports, or other emergency at the scene of an accident, without first obtaining the consent of the parent or guardian of the minor, and shall not be liable for any civil damages other than damages occasioned by gross negligence or by willful or wanton acts or omissions by such person in rendering the emergency care.

2. Any other person who has been trained to provide first aid in a standard recognized training program may, without compensation, render emergency care or assistance to the level for which he or she has been trained, at the scene of an emergency or accident, and shall not be liable for civil damages for acts or omissions other than damages occasioned by gross negligence or by willful or wanton acts or omissions by such person in rendering such emergency care.

3. Any mental health professional, as defined in section 632.005, RSMo, or substance abuse counselor, as defined in section 631.005, RSMo, or any practicing medical, osteopathic, or chiropractic physician, or certified nurse practitioner, or physicians' assistant may in good faith render suicide prevention interventions at the scene of a threatened suicide and shall not be liable for any civil damages for acts or omissions other than damages occasioned by gross negligence or by willful or wanton acts or omissions by such person in rendering such suicide prevention interventions.

4. Any other person who has been trained to provide suicide prevention interventions in a standard recognized training program may, without compensation, render suicide prevention interventions to the level for which such person has been trained at the scene of a threatened suicide and shall not be liable for civil damages for acts or omissions other than damages occasioned by gross negligence or by willful or wanton acts or omissions by such person in rendering such suicide prevention interventions.

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So in Missouri, you are protected if you stop and provide emergency care while not on duty, so long as you stay within your training and scope.

I have already posted both laws. Do you not know how to read? It says right in the Samaritan law, you must meet the EMS law. It says right in the EMS law, you must be working IN a system.
When you are off duty, and DEFINITELY when you are outside the boundaries of your systems district, you are NOT working in a system. As I said, unless your director specifically has it in writing that you are authorized to do so.

Why do none of you realize, a Paramedic license means NOTHING without the license of a MD to work under.

I posted examples of Law. Quit asking me to find out things for you. Look up prior court cases of medics who performed off duty, FLmedic already gave you one.

Originally Posted by Burned Out

I have already posted both laws. Do you not know how to read? It says right in the Samaritan law, you must meet the EMS law. It says right in the EMS law, you must be working IN a system.
When you are off duty, and DEFINITELY when you are outside the boundaries of your systems district, you are NOT working in a system. As I said, unless your director specifically has it in writing that you are authorized to do so.

Why do none of you realize, a Paramedic license means NOTHING without the license of a MD to work under.

I posted examples of Law. Quit asking me to find out things for you. Look up prior court cases of medics who performed off duty, FLmedic already gave you one.

It would help if you would be more specific about what scope issues you are talking about. I think I already agreed that for California at least, paramedics are restricted to an EMT-basic scope of practice when off duty. So at least in that state, it would definitely be illegal to carry around ALS equipment and do ALS procedures off duty (and stupid, as I acknowledged earlier).

This has NOTHING to do with Good Samaritan laws.

However, BLS equipment would be fine and certainly would not affect one's protection by the Good Samaritan law.

I stated it, more than once, in earlier posts.
If you get out, with equipment that would be in a standard store bought first aid kit, you would be fine.

Band aids, dressings, pocket mask, ice pack, roller gauze, etc.

If you get out with any other type of equipment, that now leads into the scope of practice issue.
And again, scope of practice is only an issue as a point that once you are off duty or out of your district, you are out of your scope of practice.
When you are acting in this capacity, you are not acting as a licensed EMS member. You are acting as a normal civilian.

Originally Posted by Burned Out

I stated it, more than once, in earlier posts.
If you get out, with equipment that would be in a standard store bought first aid kit, you would be fine.

Band aids, dressings, pocket mask, ice pack, roller gauze, etc.

If you get out with any other type of equipment, that now leads into the scope of practice issue.
And again, scope of practice is only an issue as a point that once you are off duty or out of your district, you are out of your scope of practice.
When you are acting in this capacity, you are not acting as a licensed EMS member. You are acting as a normal civilian.

Actually, what you said in your first post was "get out with nothing" and you're fine. I think that's what prompted the debate. Dressing, gauze, masks, gloves, etc. count as "BLS equipment" to me (i.e., more than "nothing").

I use the "boy scout scope" when helping off-duty: CPR, AED if available, splinting, controlling bleeding, and most importantly activating the EMS system.

Do people really carry personally-owned ALS kits in their vehicles? That's insane. Medics, as physician extenders, cannot perform invasive skills without orders. Unless you're medical director has explicitly "blessed you" when you're off-duty you are practicing without a license. Not smart.

Yes, many of us have seen a lot of rescue rangers carrying FULL jump bags in their cars!!!!!!!
The original poster was talking about more than just just standard first aid stuff.
Yes, I did say "nothing" in my first post. I did not consider the standard first aid kit, as I was keeping the Ricky Rescue Ranger in mind. I later pointed out that standard first aid equipment would be ok. The arguments continued, and even escalated.

Oh, and even an AED can get you in trouble. I don't recommend that either.
AEDs are required to have a specific set of documentation and approval prior to being placed in a public location, or used in any emergency vehicle or setting.
Every AED is required to maintain this documentation and follow a proper maintenance (or check) routine.
If you carry one in your car, it needs to meet that standard, and you must be able to prove it.

The main issue with AEDs is that you need a prescription to buy one in the first place.

I would also assert that you would be fine carrying a BP cuff, stethoscope, and even stuff like OP airways although to me that's a little stupid. A BVM is certainly a BLS item.

Does anyone know if there are states where ALS skills can be used off duty? I didn't know if California was unusually restrictive on that or not.

Regardless, the most time-critical interventions are all BLS so this point is moot unless you are Ricky Rescue.

Originally Posted by pseudoknot

The main issue with AEDs is that you need a prescription to buy one in the first place.

I would also assert that you would be fine carrying a BP cuff, stethoscope, and even stuff like OP airways although to me that's a little stupid. A BVM is certainly a BLS item.

Does anyone know if there are states where ALS skills can be used off duty? I didn't know if California was unusually restrictive on that or not.

Regardless, the most time-critical interventions are all BLS so this point is moot unless you are Ricky Rescue.

Your license is valid for use 24/7/365 where I live. The good samaritan law does not have any restrictions for what degree of care you can provide and be covered. Burned Out's point about state laws restricting EMS practice is an entirely separate issue. His issue is more one of *criminal* liability (practicing medicine without a license) than civil liability (getting sued for rendering care). I don't personally carry any ALS stuff (and very little BLS) in my car, but I do know some that do. Many paramedics I know own their own kits which they prefer to use at work, so they do have equipment in their car on the way to/from work, and presumably at all times. They would be allowed to render assistance off-duty and they would be covered by the good samaritan law in this scenario.

It is a bit of a moot point though. In order for someone to start doing ALS interventions at the scene of an emergency, they would have to have done a primary survey, obtained a critical history from the patient, and a baseline set of vitals. You would never get that far before an ambulance crew showed up.

Leviathan: You must never have been in a rural area!

No, I am talking civil liability, not criminal.

Your license is valid 24/7 only when working IN your system. You are only IN your system, if your director has stated he will cover your license (with HIS license) when off duty our out of your systems limits.


And as i have said before, I am NOT talking about whether you could be successfully, only that you can be sued. A good Samaritan law prevents being able to bring the lawsuit in the first place.

Originally Posted by Burned Out

Leviathan: You must never have been in a rural area!

No, I am talking civil liability, not criminal.

Your license is valid 24/7 only when working IN your system. You are only IN your system, if your director has stated he will cover your license (with HIS license) when off duty our out of your systems limits.

I can't find the link now, but there is a section of our government site which has a FAQ and specifically asks when our licenses are valid. The response is that they are valid 24/7, either when working for the ambulance service, or when acting as a good samaritan. It did make the final comment that your license is not valid when using your services for another company, which is a case that would require a medical director . Things might be different in your neck of the woods; I only vouch for my own.

Leviathan: I just noticed that you are from Vancouver B.C. Are you referring to laws from there?
I know the majority of health care laws are different. I just have no clue in what ways.

Originally Posted by Burned Out

Your license is valid 24/7 only when working IN your system. You are only IN your system, if your director has stated he will cover your license (with HIS license) when off duty our out of your systems limits.

Perhaps I'm missing something, but from my understanding, you seem to be incorrect. Since someone mentioned Illinois. It would seem to me that the wording allows anyone within the scope pursuant as defined can used their skills in an emergency, outside of their normal system without fear of civil suit.

210 ILCS 50/3.150
Immunity from civil liability
(a) Any person, agency or governmental body certified, licensed or authorized pursuant to this Act or rules thereunder, who in good faith provides emergency or non-emergency medical services during a Department approved training course, in the normal course of conducting their duties, or in an emergency, shall not be civilly liable as a result of their acts or omissions in providing such services unless such acts or omissions, including the bypassing of nearby hospitals or medical facilities in accordance with the protocols developed pursuant to this Act, constitute willful and wanton misconduct.

That is absolutely crazy that there are whackers out there carrying around a whole level 1 trauma center in their vehicles. Honestly, would you like to know what you need in your vehicle ---> NOTHING. When your off duty (or not on the clock) there is no need for you to play surgeon in a ditch on the side of a road. Keep driving, call 911 and report the incident. Last time I drove by an accident, there was a 1 minute time delay and coming up the other side of the road was an engine and an ambulance. If an anesthesiologist (sp?) drives by and wants to stop to help the medics knock down the patient with RSI then that is fine. Other than that keep driving.

Originally Posted by Paramedic22

That is absolutely crazy

Yup, cause when seconds matter, help is only minutes away.

These are things that have found their way into the back seat of my car.... gloves.... trauma shears ( which I honestly put in there for opening packages).... and a pocket mask from my last health fair where someone was giving them out.... maybe some advil

Nope, while off duty all I am covered to do is basic first aid so all I carry is a pocket mask and some gloves and always have a good working cell phone.

OMG I hope people are kidding about this stuff.

I carry nothing, and I look the other way and drive on by if there is an accident.

I carry one of these in my car. I've ordered several more though, in case I stumble upon an MCI.

http://www.statkit.com/

Originally Posted by viostorm

OMG I hope people are kidding about this stuff.

I carry nothing, and I look the other way and drive on by if there is an accident.

Amen

I carried what ever personal equipment I had (BP cuff, steth, first aid fanny pack (waterpark... supplemental to the main gear, DVDs, DVD player, etc) in my car. Why? Becuase my car is what gets me to and from work and I'm too damn lazy to drag my stuff inside my house just to drag it back out the next day. If I end up using any of it off duty, so be it, but it's there for convience, not for some ricky rescue wackeristic intentions (you people know who you are). Just like I carried my pager in my car when off duty. Suffice to say, though, that I did my best to conserve battery power when off duty by turning it off.

I can't sleep.

In the back of the vehicle;

A "Civil Defense" surplus blanket, a boiled MSA bump cap that says "funeral director, x county coroner", a red tube filled with flares, my turnout gear, two bottles of RedCat and necessary cork puller, a box of pink nitrile gloves, an empty PM747 drug box, several pairs of coveralls of various colors, my deputy coroner's bag, a box of white body bags, and the required 16 unit metal first aid kit.

actually in my car at any given time? my maglite, a pair of trauma shears (more for non-trauma cutting though), and a pocket mask...maybe if i'm lucky a pair of gloves...at home...a fanny pack with glucose gel, a sh*tload of bandaids and a couple 5x9s and some 2x2/4x4s...

somewhere around here i have my gung-ho hero bag from my gung-ho newbie days... fully stocked with ob kit, burn/multi trauma dressing, peds and adult collars, tampons/nasal occluders , and a bunch of other junk that i haven't used in forever......anyone want a bag? you pay shipping lol

Best thing you can do off duty is be that awesome RP (reporting party) 911 dispatchers rarely deal with on a daily basis.

What I have and am willing to do for my family, friends, and in the case of a zombie apocalypse? That is another story.

Read the post up north about liability, In my current state there is legislation that only specifies Paramedics (not EMT/not RN/not MD, those are separate) but for medic, you are not liable and are protected, if you can justify your actions and performed them in good faith. This is important because in some states online medical control can tell you one thing and then deny it in court and we all know S**T roles downhill. Its a good checks and balance law. This obviously is not for off duty personnel. Now in smaller areas and departments like the one I want to get on with, where the county and department might only have 10-20 medics and you can respond from home, its grey area as far as I know.

When I was in California in a big system run by privates and you were just a number, if you weren't clocked in, on duty, and in uniform you were nothing, and I would have never gotten involved off duty, nor was I allowed to.

Lets just think reasonably here, no one should be carrying supplies or expecting to perform ALS on their own. I can't think of one ALS skill that can be done (or should be done) by yourself out of your trunk. IV access aside, even that is a stupid idea, yea you start a line but what is your objective? ABCs should be kept BLS.

The only ALS skill I can think of in a 0.00001% of ever happening, is a surgical airway. I actually know a medic who has performed one off duty (he carried one ET tube for this reason, and or digital intubation) and ended up saving the guy.

We are heavily volunteer where I live..."on duty" is a vague term at best...we run 2 ambo's at each station...i have been at a few scenes where the als crew is already out on a call, and a volley bls crew shows up and the **** has already hit the fan...i have seen medics who don't even work for our dept show up on scene and end up saving a pt...

Now this is obviously a different scenario than the cowboy medic who packs the trauma resusc unit into his trunk. he is using all dept supplies etc, but is not technically on the paperwork/dept insurance as a provider.