Emergency care

willdaniel76 said:

What are the limits to the level of care a Podiatrist can give in an emergency situation? Obviously they aren't going to let you guys cut into someone in any form without knowing what to do if things go bad but I'm more interested in the informal setting. Car accident, "Is there a doctor here?" kind of thing etc.

Surely you'd know more then a typical bystander giving basic first-aid but would using your knowledge to help someone open you to risk legally etc

I know its an open ended question but thought I'd gather some responses.

Let me edit with a clearer example: If you came across someone that needed a surgical airway could\would you do what needed to be done? This isn't a question of having the knowledge to know what to do obviously.

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The Good Samaritan laws vary from state to state. In most cases you are required to declare your credentials and not abandon the patient if you begin aid. In most states, you are NOT REQUIRED to provide aid, but in some states there is a duty to act.

The scope of practice does not apply to rendering aid in an emergency under the auspices of the Good Samaritan law.

You are protected from liability if you do not receive (or expect to receive) financial compensation, and are not grossly negligent. Thus, a medical professional is not protected by the Good Samaritan law if you are in your office and hospital.

Case example 1: Patient comes in to your office for a diabetic foot ulcer, arrests and you begin CPR. Your are obligated to provide medical aid, not protected from liability, are required to practice in your scope (although many states have exclusions and case law for emergencies). And technically you can bill for the service.

Case example 2: You are on an airplane, someone chokes, you are the only doctor on board. Provide care, eventually the patient becomes unconscious and you perform a surgical airway. Your airway attempt pushed the obstruction further down the trachea. Patient dies. Good samaritan law applies. Protected from liability. I'm not certain which jurisdiction is used when on an airplane in interstate or international travel.

I have assisted in 3 in flight emergencies. An MI, a loss of consciousness, and GI distress. If you fly frequently, it's good to review an article on in flight emergencies so that you're aware of the physiologic differences and limits when at altitude.

willdaniel76 said:

Makes sense. I'd imagine it would be hard to stop a good doctor, in any field, from helping someone in distress. I remember being overseas and they told us if things ever got real bad, it would be the Dentists running triage while the other physicians did their thing. That's what got me wondering.

Did your 3 mid-flight patients turn out ok?

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MI was on a flight SEA to DCA. Diverted and landed in STL. He was conscious and I would assume to do well when he was offloaded.

Unconscious patient was on a flight ORD to LAX, diverted to LAS. She was unconscious for 20 min, never regained consciousness. Don't know how she did.

GI distress was ORD to MIA. The pilot increased the cabin pressure. He used the lav and was okay for the flight.

You don't hear how the patients do afterward. The paramedics pick them up and that's the last you know.