Human medicine: what can we do and what can't we do?

[Electrophile]

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Something I've always wondered...as fully qualified vets now or in the future, what are we allowed to do and not allowed to do in terms of human medicine? Especially in cases of emergencies or other life threatening situations?

The reason I ask is that one of the vets I shadowed with was involved in rural fire and rescue (please keep in mind he didn't tell me that many details, sorry!). He told me that one time he was out on a call with the fire department and the paramedics he was with could not get an IV started in a guy they were working on. He ended up having to do it or the guy would have died. So he did and the patient lived. Unfortunately, one of them reported him and he got into some sort of trouble for it (don't know if it was a fine or what).

Basically, I don't want to get into trouble for saving someone's life in an emergency situation. 🙄 But what's the deal? What are we allowed to do and what are we not allowed to do?

 

[AuburnPreVet]

I could be wrong -- but I've always been under the assumption that a veterinary degree doesn't give you any right to practice on a human beyond what a non-degree'd individual could do. Ie., offer a band-aid, call 911, maybe CPR. Anything beyond that seems like a huge liability.

Even MDs are hesitant to help in an emergency due to the liability due to insurance gaps when not in the hospitals/clinics in which they have "hospital privileges," an appropriate patient-physician relationship, medical record, etc.

 

[julieDVM]

DVMs have absolutely no business whatsoever doing anything to a human. you're not trained to work on humans, you're not licensed to work on humans, and you're not covered (insurance wise) to work on humans.

in other words - we're not doctors. we're veterinarians.

 

[Electrophile]

DVMs have absolutely no business whatsoever doing anything to a human. you're not trained to work on humans, you're not licensed to work on humans, and you're not covered (insurance wise) to work on humans.

in other words - we're not doctors. we're veterinarians.

Yes, thanks, I know that. I wasn't planning on walking into the ER and soliciting my services. 🙄

I mean more like there's a car accident you were a witness to or were involved in or whatever and hey, someone's going to die if you don't do something within the next minute because the ambulance has been called, but they ain't gonna make it in time. And maybe you just happen to be in your truck with your Porta Vet, so you've got at least maybe a few supplies to help stabilize them. Julie, would you really let someone die just so you wouldn't get sued? I'm not sure if I could live with myself if that was the case...

On a lighter note, I always kind of wish that Jack on LOST was a vet just to see a different side of things as I wonder if that would be handled differently. Then again, most vets aren't as whiny as Jack.

 

[banditalfi]

On a lighter note, I always kind of wish that Jack on LOST was a vet just to see a different side of things as I wonder if that would be handled differently. Then again, most vets aren't as whiny as Jack.

Not to hijack this thread, but, yes, that would have been awesome. Personally, however, I think the show could be even more awesome if the writers decided that instead of writing an episode where nothing happens until the last minute and so you hate yourself for watching, but will definitely tune in next week... if instead of that they could write a nice episode that doesn't have five minutes of sappy music with people moving in slow-mo. Oh, also fake monsters and invisible people.

 

[julieDVM]

Yes, thanks, I know that. I wasn't planning on walking into the ER and soliciting my services. 🙄

I mean more like there's a car accident you were a witness to or were involved in or whatever and hey, someone's going to die if you don't do something within the next minute because the ambulance has been called, but they ain't gonna make it in time. And maybe you just happen to be in your truck with your Porta Vet, so you've got at least maybe a few supplies to help stabilize them. Julie, would you really let someone die just so you wouldn't get sued? I'm not sure if I could live with myself if that was the case...

On a lighter note, I always kind of wish that Jack on LOST was a vet just to see a different side of things as I wonder if that would be handled differently. Then again, most vets aren't as whiny as Jack.

Other than the most basic CPR, i'm not going to do anything more. I do not have any training to treat people, nor am i willing to extrapolate animal medicine and surgery to that of people. I firmly believe (and so do all the lawyers out there) that veterinarians have NO business treating people. Even in emergencies. You're playing with fire if you do.

 

[david594]

The reason I ask is that one of the vets I shadowed with was involved in rural fire and rescue (please keep in mind he didn't tell me that many details, sorry!). He told me that one time he was out on a call with the fire department and the paramedics he was with could not get an IV started in a guy they were working on. He ended up having to do it or the guy would have died. So he did and the patient lived. Unfortunately, one of them reported him and he got into some sort of trouble for it (don't know if it was a fine or what).

Who in their right mind would report them? I wouldn't ride in an ambulance with someone who would report a coworker for something like this. The vet didn't make the decision, the paramedic asked him to do it. Medic had to think it was in the best interest of the patient for the vet to try it and clearly wouldnt have reported him.... but if someone else reports him(unless it was the patient) then something is just messed up with that agency.

Legally he has no medical authority to start an IV on a person as that is something that only a paramedic or an EMT-I acting under the license of the regional medical director via the guidelines set out in the standard operating procedures and state regulation.

 

[Electrophile]

I firmly believe (and so do all the lawyers out there) that veterinarians have NO business treating people. Even in emergencies. You're playing with fire if you do.

Remind me never to bother to save any of the lawyers. Especially one who would rather die than live. Oh well. One less lawyer out there, right? 😀

What really bothers me is that we supposedly have no training to deal with people. Then why, in only 1 semester, have we already learned dozens and dozens of human corollaries to animal physiological processes and diseases? Other than a small number who end up going into research for human diseases using animal models, why bother? Why do med students that I know complain that they get so many animal examples? Some research is easier to do on humans or is better described, and vice versa for animals, sure. But really, I think it boils down to the fact that humans are just another animal and humans don't tend to want to admit that to themselves. That in turn goes back to the old fashioned "humans are superior to animals" mentality in thinking we are somehow vastly different from all the rest of the beasts.

I'm not going to want to start practicing human medicine, don't get me wrong. But to say we have *no* training on people isn't quite accurate either. Legal or not, to not save the life a fellow human being OR animal just because you're afraid of being sued is just sad. Then again, I was pre-law before I was pre-vet, so I understand it's a reality (and yet another reason I passed on a guaranteed spot in Missouri's law school in favor of grad school and then vet school). Alrighty, enough philosophy.

David, I don't know the details of the story at all and I could tell he was rather annoyed, so I didn't press. But it's an interesting scenario all the same.

 

[WhtsThFrequency]

People are now suing people for saving lives?? Good lord...I really hate humanity sometimes.

I understand the legal ramifications but seriously. WHO would sue a person for attempting to save a life when there was no one else as competent around (for example, a vet keeping a car crash victim alive by whatever means, before medical personnel got there)

 

[Hollycozza]

I am pretty sure (or at least I remember hearing, someone back me up or correct me if they know) that in the UK in an emergency a vet can operate on a person but a doctor can never operate on an animal.

As far as helping out in an emergency I know in Australia we are covered by Good Samaritan laws where you can't really get into trouble if you were trying to help. So by all means I would avoid trying open heart massage, but surely an IV line is not that big a deal ...................................... ???

Its a good thread!

 

[theunraveler]

I am pretty sure (or at least I remember hearing, someone back me up or correct me if they know) that in the UK in an emergency a vet can operate on a person but a doctor can never operate on an animal.

As far as helping out in an emergency I know in Australia we are covered by Good Samaritan laws where you can't really get into trouble if you were trying to help. So by all means I would avoid trying open heart massage, but surely an IV line is not that big a deal ...................................... ???

Its a good thread!

i guess they werent bull****ting when they said "real doctors can treat more than one species".... 😀

 

[Electrophile]

I am pretty sure (or at least I remember hearing, someone back me up or correct me if they know) that in the UK in an emergency a vet can operate on a person but a doctor can never operate on an animal.

That's interesting if true...I don't watch Grey's Anatomy (just LOST!), but someone told me once there was an episode where the main character tried to operate on a deer hit by a car or something? And then there was the James Belushi movie K-9 where he rushes his injured partner, a German shepherd, into the ER and demands that they operate. Obviously that's TV and movies, but that makes me wonder what American human doctors can do.

I looked up a few things on Good Samaritan Law and according to Wikipedia (so take with a grain of salt), all German citizens must take first aid before getting their drivers license, so you must give aid to the best of your ability. Interesting...anyway, here's a site for nurses:

http://medi-smart.com/gslaw.htm


This link may not work, but according to this book, no physician has ever been successfully sued for voluntarily and in good will coming to someone's aid:

http://books.google.com/books?id=6F...ts=hfRfVVjtN3&sig=cdc3BNn_NoOEeFieGYSty6k3nqU

 

[Bill59]

But what's the deal? What are we allowed to do and what are we not allowed to do?

You are allowed to do whatever any other non-MD, non-EMT, etc. person is allowed to do. No more, no less.

The fact that you're a graduate DVM, have taken physiology classes, whatever is meaningless.

Usually that means the most helpful thing you can do is call 911.

 

[tkim]

Basically, I don't want to get into trouble for saving someone's life in an emergency situation. 🙄 But what's the deal? What are we allowed to do and what are we not allowed to do?

You won't get into trouble for saving someone's life. The trouble starts when you try to do things beyond your scope of training and things go horribly wrong.

A psychiatrist who decides that he can perform an emergency tracheostomy that he saw once during internship and proceeds to sever the carotids by using a too generous incision should be held liable. They don't practice that sort of medicine, so they should perform good BLS and CPR and call it a day.

If you perform up to the level of what a 'reasonable' person would do, Good Samaritan laws should protect you from lawsuits in the US. If you try to get fancy and overstep your level of training or skill, Good Samaritan laws will not protect you.

 

[ri23]

That's interesting if true...I don't watch Grey's Anatomy (just LOST!), but someone told me once there was an episode where the main character tried to operate on a deer hit by a car or something? And then there was the James Belushi movie K-9 where he rushes his injured partner, a German shepherd, into the ER and demands that they operate. Obviously that's TV and movies, but that makes me wonder what American human doctors can do.

I looked up a few things on Good Samaritan Law and according to Wikipedia (so take with a grain of salt), all German citizens must take first aid before getting their drivers license, so you must give aid to the best of your ability. Interesting...anyway, here's a site for nurses:

http://medi-smart.com/gslaw.htm




This link may not work, but according to this book, no physician has ever been successfully sued for voluntarily and in good will coming to someone's aid:

http://books.google.com/books?id=6F...ts=hfRfVVjtN3&sig=cdc3BNn_NoOEeFieGYSty6k3nqU

Working on an HBC deer wouldn't have the complications that working on a person would, as there wouldn't be lawsuits if something went horribly wrong.

 

[yakpool]

In our animal law class, we were told that anyone can help an animal in need as long as s/he does not claim to be a vet and receive service payment. That will protect you from being sued by helping to save lives. I am not sure about human medicine. I would think it makes sense if there is no human doctor around, under emergency situation, people who tries to help saving lives should be protected.

 

[chris03333]

Other than the most basic CPR, i'm not going to do anything more. I do not have any training to treat people, nor am i willing to extrapolate animal medicine and surgery to that of people. I firmly believe (and so do all the lawyers out there) that veterinarians have NO business treating people. Even in emergencies. You're playing with fire if you do.

Agreed👍

 

[Electrophile]

Because I'm obviously a sucker for ethics and ethics issues, new scenario. 😀

You're out hunting with a friend in the middle of nowhere (the nearest town with a doctor is 5 hours by helicopter/plane at the fastest) in winter up in Alaska or Canada. There is an accident and your friend somehow shoots themselves in the thigh with their own rifle (don't ask me how...just go with me here). It's bleeding pretty badly and even with a tourniquet, they won't last the 10 hours to bring a plane there and back. You have your trusty truck and Porta Vet with you with basic supplies and a sterile surgical pack. What do you do? 😱

 

[banditalfi]

Because I'm obviously a sucker for ethics and ethics issues, new scenario. 😀

You're out hunting with a friend in the middle of nowhere (the nearest town with a doctor is 5 hours by helicopter/plane at the fastest) in winter up in Alaska or Canada. There is an accident and your friend somehow shoots themselves in the thigh with their own rifle (don't ask me how...just go with me here). It's bleeding pretty badly and even with a tourniquet, they won't last the 10 hours to bring a plane there and back. You have your trusty truck and Porta Vet with you with basic supplies and a sterile surgical pack. What do you do? 😱

I just wanted to say that, considering it took me about 6 hours to fly from NY to CA they must really be in the middle of nowhere! And you drove there?! With your porta vet and sterile surgical pack?! Were you planning to rehabilitate injured wildlife? Then what's the rifle for? 😉

But, if it's your friend, you could just do it and if anyone questions then you will have to play dumb and say a traveling doctor happened to pass by and save your friend. And if it's in Canada I don't think they could touch you in the US, anyway 🙂

 

[Electrophile]

You can't land a Boeing 747 if you're going hunting out in the middle of the Canadian or Alaskan wilderness. 😛 It's usually bush planes or helicopters. Haven't you people ever read Gary Paulsen when you were kids? The rifle is to be used as a bite bar for your friend who can't handle firearms properly while you are digging the bullet outta their leg. 😀 And a truck's a truck, Porta Vet or not!

 

[banditalfi]

Haven't you people ever read Gary Paulsen when you were kids?

No, but I did see the episode of Lucy/Desi Comedy Hour when everyone goes to Alaska and it was freezing and they found out the hotel was ten minutes away by plane and Fred said that they better make sure Hawaii is better before they make it a state. Oh, Lucy.

But back to ethics (or semi-ethics). I think vets have a better understanding of how meds will affect different animals than MDs because vets treat so many different species (I know - duh). That being said, there are some drugs that are wonderful in people, but horrible in dogs, or work great in dogs, but kill a cat. But, yet, I have heard stories more than once about the vet that gave his daughter drug X or the dentist that have his dog drug Y - it never turns out well. And, yes, I am currently medicating a rash on my arm with aquaphor... and animax.

 

[LittleBit]

I agree with the people above who said that you can't legally do anything more than a lay person could do. This discussion reminds me of the time that I dislocated my thumb skiing, and the ski patrol / first aid station people couldn't pop it back in because we were within reasonable driving distance from an emergency room.

If I was present for an emergency, I would probably try to do everything I could to make sure that the other person didn't die, but if it were non life threatening, I would definitely wait for the ambulance or take them to the ER. Even making sure the other person knows you're not a doctor and getting their consent won't save you from a lawsuit later if something goes wrong, so make sure that if you act that it's necessary & worth the possible fall out.

 

[VAgirl]

For me the situation would change if it was a friend or family member. Not that it's necessarily ethically different, but there are differences. For one, if I really thought my intervention could save them in a situation when there didn't seem to be any other options, it would matter far less to me that there might be any potential negative ramifications for me. But then, it's easier to assume that those you love would understand you were doing something in a desperate situation, with their best interest in mind, and when you felt you had no other choice.

With a stranger, there are too many unknowns. With a loved one, I would be unable to stand by and do nothing.

 

[Bill59]

You're out hunting with a friend in the middle of nowhere (the nearest town with a doctor is 5 hours by helicopter/plane at the fastest) in winter up in Alaska or Canada. There is an accident and your friend somehow shoots themselves in the thigh with their own rifle (don't ask me how...just go with me here). It's bleeding pretty badly and even with a tourniquet, they won't last the 10 hours to bring a plane there and back. You have your trusty truck and Porta Vet with you with basic supplies and a sterile surgical pack. What do you do? 😱

Turn to Lassie and say, "Go get help, Girl!"

 

[JIKJen124]

Because I'm obviously a sucker for ethics and ethics issues, new scenario. 😀

You're out hunting with a friend in the middle of nowhere (the nearest town with a doctor is 5 hours by helicopter/plane at the fastest) in winter up in Alaska or Canada. There is an accident and your friend somehow shoots themselves in the thigh with their own rifle (don't ask me how...just go with me here). It's bleeding pretty badly and even with a tourniquet, they won't last the 10 hours to bring a plane there and back. You have your trusty truck and Porta Vet with you with basic supplies and a sterile surgical pack. What do you do? 😱

Hope that you're certified as a wilderness first-responder, and thus have the ability to help without fear of law suit?

 

[Habibti]

Because I'm obviously a sucker for ethics and ethics issues, new scenario. 😀

You're out hunting with a friend in the middle of nowhere (the nearest town with a doctor is 5 hours by helicopter/plane at the fastest) in winter up in Alaska or Canada. There is an accident and your friend somehow shoots themselves in the thigh with their own rifle (don't ask me how...just go with me here). It's bleeding pretty badly and even with a tourniquet, they won't last the 10 hours to bring a plane there and back. You have your trusty truck and Porta Vet with you with basic supplies and a sterile surgical pack. What do you do? 😱

If the person is going to die anyways, what do you have to lose by trying to save them? You could prolong, or even save, their life. Yeah, they could end up maimed, but they're alive. It's unfortunate that many here would let people die because they're afraid of being sued. How would you tell your friend 'yeah... I know you'll die without any help, but I just don't want to get sued. Sorry.'

Since you do have a method of communication, you could first call for help and then, perhaps, be led through the best course of action for your friend.

Bringing back the Good Samaritan Law (in Wisconsin): "Currently, under the "Good Samaritan law", a person who in good faith renders emergency care at the scene of an emergency or accident is immune from civil liability for his or her acts or omissions in rendering the emergency care. This immunity does not apply to employes who are trained in health care or who are health care professionals in rendering emergency care for compensation and within the scope of their usual and customary employment or practice at or enroute to a hospital, at a physician’s office or at the scene of an emergency or accident." As a veterinarian, you are acting as a civilian as you are not acting 'within the scope of their usual and customary employment or practice' and hence are exempt from civil suits.

 

[VeganSoprano]

I think you're covered as a Good Samaritan as long as you stop what you are doing when the human medical professionals arrive on the scene.

I think if a paramedic or EMT or whomever solicits your help to do anything, you can do it and any liability is on the person who told you to do it. You're acting within the chain of command yourself - deferring to the person who is properly licensed to do whatever is being done.

 

[Emio]

Turn to Lassie and say, "Go get help, Girl!"

this post, and this post alone, made this thread worth reading.

 

[david594]

Hope that you're certified as a wilderness first-responder, and thus have the ability to help without fear of law suit?

Completely wrong. If you are certified as a wilderness first responder then you have a clearly defined scope for what you can and cannot do. You are also no longer protected by the Good Samaritan laws as your training is specific to wilderness rescue and you are no longer just considered a lay person.

Since you do have a method of communication, you could first call for help and then, perhaps, be led through the best course of action for your friend.

By far the single best suggestion would be to do this.

 

[JIKJen124]

I think you misinterpreted what I meant. I know that wilderness first responders have a defined training and scope of what they are allowed to do. Little to do with skills that they may have from their veterinary training.

 

[All4MyDaughter]

In regard to the OP, the DVM could not be sued by the patient for malpractice, etc. if the patient lived and suffered no damages as a result of the DVMs conduct.

There are three basic elements to proving negligence:

1. Duty breached - a DVM would certainly be breaching his duty (his duty is to refrain from the practice of human medicine and restrict his practice to animals) by practicing medicine of any kind (beyond BLS or first aid, which could be construed as a civilian task) on a human.

2. Damages - if the patient lived and was not injured the claim fails on this basis. If the patient suffered an injury the claim may proceed.

3. Direct Causation - this is often the most difficult to prove. Say the DVM started the IV successfully but the patient died anyway during the course of care. You would have to establish that the DVM's IV was the DIRECT cause of death. This is challenging and often impossible.

If you don't have all three you cannot prove negligence.


That takes care of the "being sued" part of it but there is a completely separate issue:

The DVM could most certainly be sanctioned by his professional licensure board for practicing medicine on a human, since it is outside of his scope. He could also be charged with practicing human medicine without a license. Whether this would happen would depend on the professional licensure board and the civil authorities in the relevant jurisdiction.

 

[Slothbear]

Other than the most basic CPR, i'm not going to do anything more. I do not have any training to treat people, nor am i willing to extrapolate animal medicine and surgery to that of people. I firmly believe (and so do all the lawyers out there) that veterinarians have NO business treating people. Even in emergencies. You're playing with fire if you do.

What about primate vets? You really think primate vet for a zoo would have no business starting an IV on someone in an emergency situation? Forget legal liability, I'm talking simply about know-how.

 

[julieDVM]

What about primate vets? You really think primate vet for a zoo would have no business starting an IV on someone in an emergency situation? Forget legal liability, I'm talking simply about know-how.

No. NO vet has any business performing medical procedures on people in ANY situation. This includes simple procedures like putting in IV catheters. (this doesn't include basic CPR - which is acceptable for any person to do).

Why are IVs started... they're started so you can administer IV drugs and fluids. Under what circumstances would any DVM be in a position to administer drugs to human patients? Under what circumstances would a DVM be administering fluid therapy to human patients? There are NEVER any circumstances where this would be appropriate.

I could start an IV in a person. I could likely do a splenectomy in a person. I could likely put a chest tube in a person. Should I? Absolutely not. We're not talking about whether DVMs are technically able to do procedures on people. We're talking about whether they ethically (or legally) should.

I maintain that if you perform a procedure on a person beyond that of basic CPR, you are practicing human medicine without a license.

MDs and DVMs have similar training - there's no question about it. But your license to practice veterinary medicine is very specific.

 

[theunraveler]

No. NO vet has any business performing medical procedures on people in ANY situation. This includes simple procedures like putting in IV catheters. (this doesn't include basic CPR - which is acceptable for any person to do).

Why are IVs started... they're started so you can administer IV drugs and fluids. Under what circumstances would any DVM be in a position to administer drugs to human patients? Under what circumstances would a DVM be administering fluid therapy to human patients? There are NEVER any circumstances where this would be appropriate.

I could start an IV in a person. I could likely do a splenectomy in a person. I could likely put a chest tube in a person. Should I? Absolutely not. We're not talking about whether DVMs are technically able to do procedures on people. We're talking about whether they ethically (or legally) should.

I maintain that if you perform a procedure on a person beyond that of basic CPR, you are practicing human medicine without a license.

MDs and DVMs have similar training - there's no question about it. But your license to practice veterinary medicine is very specific.

lets say ur in a warzone, society has broken down...no law and order...many dead and many more injured...would u apply ur skills then?

 

[Bill59]

2. Damages - if the patient lived and was not injured the claim fails on this basis. If the patient suffered an injury the claim may proceed.

But trial lawyers can find damages quicker than a vet can find fleas. Their motto: Some types of pain are very difficult to disprove.

 

[All4MyDaughter]

But trial lawyers can find damages quicker than a vet can find fleas. Their motto: Some types of pain are very difficult to disprove.

Perhaps, but it may be difficult to prove that the pain is a DIRECT result of the DVM's action. See #3 in my post above.

It's still better, IMHO, for DVMs to not practice on humans for whatever reason.

 

[Bill59]

Perhaps, but it may be difficult to prove that the pain is a DIRECT result of the DVM's action. See #3 in my post above.

It's still better, IMHO, for DVMs to not practice on humans for whatever reason.

We agree on the second point.

On the first point, you seem to think that you actually have to directly cause damage as a result of substandard care to be effectively sued. In theory that's true. And in theory there's no difference between theory and practice.

In practice there is.

At least in the predatory legal system in the US, the court system has very little to do with finding the truth. In fact if the truth comes out in court, a lawyer screwed up.

It's hard enough -- almost impossible in fact -- to never get sued treating human patients if you are a licensed physician. If a veterinarian starts doing that, you will quickly be ankle deep in saliva from all the drooling trial lawyers lining up to take the case.

The fact that you did everything correct from a medical standpoint has little if anything to do with the matter.

 

[chris03333]

What about primate vets? You really think primate vet for a zoo would have no business starting an IV on someone in an emergency situation? Forget legal liability, I'm talking simply about know-how.

Speaking as a primate vet....

No I would not touch a human! Human skin is VERY different from monkeys and even apes. So I can not say that I have the know how either. When I start an IV on a monkey (usually back leg) it is not how I have seen it done in human. When I start an IV in an ape, it is in the arm, but not at the same position as what I have seen in a human.

Besides humans are gross

 

[Slothbear]

Besides humans are gross

touche!

 

[CookieBear]

Speaking as a primate vet....

No I would not touch a human! Human skin is VERY different from monkeys and even apes. So I can not say that I have the know how either. When I start an IV on a monkey (usually back leg) it is not how I have seen it done in human. When I start an IV in an ape, it is in the arm, but not at the same position as what I have seen in a human.

Besides humans are gross

Chris, out of curiosity, because I've heard this, but never looked up any reality for myself: When working on [non-human] primates, you operate under 'blood borne' protocol, yes? I've heard cap/gown/gloves/mask? Is that only in certain situations, or in any when you are going to be near them or touching, etc.?

 

[All4MyDaughter]

On the first point, you seem to think that you actually have to directly cause damage as a result of substandard care to be effectively sued. In theory that's true. And in theory there's no difference between theory and practice.

Yeah, I do think that. That's what I learned in my law course. Here's the relevant part from the prof's notes:

Direct causation – breech of duty directly lead to damages in a direct, unbroken link. Example: Rx for Lutrexin (old Rx to support pregnancy). RPh dispensed Lactinex (pro-biotic). Woman had miscarriage. May or may not have benefited from Lutrexin. Lactinex could not have caused miscarriage. So, no direct causation.

 

[Bill59]

That's my point -- there's the theory you learn in a classroom and the practice of what actually happens in the real world.

 

[chris03333]

Chris, out of curiosity, because I've heard this, but never looked up any reality for myself: When working on [non-human] primates, you operate under 'blood borne' protocol, yes? I've heard cap/gown/gloves/mask? Is that only in certain situations, or in any when you are going to be near them or touching, etc.?

I wear full protective equipment: ventilated goggles, double nitrile gloves (allergic to latex), mask or respirator depending on the species, gown or full tyvex again depending on the species (but always with long pants which do not go home with me), hair net and water proof shoe covers.

Every places has different protocols. When I worked with gorillas in a zoo I just had scrubs, mask (because I was sick), gloves and shoe covers.

 

[CookieBear]

Gotcha. Thanks for the reply!

 

[Capella]

We learned in our ethics course this semester that veterinarians providing emergency care to humans are only liable for damages if they are grossly negligent. Also, you could be sued if you don't assist. Maybe this is only Oklahoma law, because obviously you guys have learned different perspectives on this.

 

[chris03333]

Also, you could be sued if you don't assist.

Are you sure about this. If so I am glad that I am not in Oklahoma. I am not trained to treat humans. Actually, even my first aid/CPR is expired....

 

[Capella]

Frankly, I'm not sure about a lot of things in that class. Our instructors contradicted each other on several occasions. But as I understood the lecture that day, not getting involved may also constitute negligence. How this would play out in court, who knows?

 

[Edson Farm]

As a veterinary student and paramedic, this discussion really caught my attention. (My partner used to tell human patients I was in vet school once and a while, that was always interesting...) While an interesting topic, law is very clear on the matter. As a few people have already mentioned, veterinarians are no allowed to provide any sort of medical care, emergency or not, to humans. Legally, there is no difference between a lawyer, chef, or veterinarian in this situation. If you do not have a human medical license/certification, you cannot provide human medical care.
Good Samaritan laws will cover those who act in an emergency situation provided their actions fall within a specific set of rules: 1. the provider cannot charge for their services (you can't help someone and ask for $20), 2. they cannot be grossly negligent (eg. twisting a broken arm to verify it is actually broken), 3. the provider must obtain consent (whether informed or implied), 4. the actions must be in the best interest of the patient (no malicious intent), 5. the rescuer must provide the care any other reasonable person of the same level of certification would provide (eg. someone who is breathing shouldn't be getting CPR), and most importantly, 6. the rescuer cannot exceed their scope of practice (like someone with a basic CPR card attempting a thoracocentesis). Again, human medical treatment is not within a veterinarians scope of practice.
An exception would be a situation where a veterinarian, or anyone else for that matter, had a CPR and/or First Aid certification and met all of the above conditions. In this case it would be perfectly acceptable to initiate basic life support measures for, say, a patient with an obstructed airway, but a surgical airway, regardless of whether or not it saves the patients life, is not legal (exceeds the scope of practice). In a strictly legal sense someone without CPR training shouldn't attempt to remove the object from the patients airway at all either, but in a case like this there is far less likelihood that there would be any litigation. Advanced interventions will almost certainly become problematic.
I can tell you right now I'd never ask a vet to start a human IV, etc. because I know it isn't allowed. I wouldn't risk my paramedic license, nor would I risk the vet's license (or my future veterinary license). 99% of the time you get the line after a couple shots anyway even if the patient is difficult (paramedics by the nature of their job get lots of practice with difficult lines in difficult situations!). On top of that there are plenty of other alternatives for the delivery of emergency medications (ET, IO, etc.) in the field. A paramedic who starts thousands of IVs a year on people in a moving ambulance should probably be better than a vet at doing it on a person, just as I'd expect a vet to be far better at putting one in a dog or horse! Perhaps the vet offered and the paramedic was so stressed out they just didn't take the time to consider the legality of it and allowed it to happen. I don't know, I wasn't there, but I'm guessing there was probably more to the original story.

 

[MacGyver]

Frankly, I'm not sure about a lot of things in that class. Our instructors contradicted each other on several occasions. But as I understood the lecture that day, not getting involved may also constitute negligence. How this would play out in court, who knows?

thats bs.

you are NEVER required to assist if you dont want.

 

[MacGyver]

We learned in our ethics course this semester that veterinarians providing emergency care to humans are only liable for damages if they are grossly negligent. Also, you could be sued if you don't assist. Maybe this is only Oklahoma law, because obviously you guys have learned different perspectives on this.

Thats flat out wrong. In no state can ANYBODY, doctor, vet, dentist, opto, nurse, etc be held liable for not getting involved