Liability issues

[leviathan]

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I'm currently working for my university's housing department for security and evening patrols for any emergencies that arise. I have a few legal questions that I'm trying to find out about. I know things may differ depending on jurisdiction, but I wanted to get some advice on the liability issues for using BLS skills (eg. applying oxygen masks or using BVM, inserting oral or nasopharyngeal airways, defibrillation with approved external medical direction/authority). The company only supplies me with a basic first aid kit (bandages and a pocket mask), however, I could always bring in my own supplies from my volunteer association. So in your jurisdiction:

1. If I was to improperly use BLS equipment, would I or the company be held liable?
2. If I was to NOT use the full extent of my training, would I or the company be held liable?

 

[viostorm]

Here is some professional advice, leave your volunteering away from work. Do what you are paid to do with what they give you and no more. Work within the current system for handling medical emergencies.

1. If I was to improperly use BLS equipment, would I or the company be held liable?
2. If I was to NOT use the full extent of my training, would I or the company be held liable?

Basically, unless you can bring an AED, nothing you do will save someone. It isn't worth it to be a "rescue randy". If you find someone with a medical emergency just call 911 and keep them safe.

 

[leviathan]

Here is some professional advice, leave your volunteering away from work. Do what you are paid to do with what they give you and no more. Work within the current system for handling medical emergencies.

Basically, unless you can bring an AED, nothing you do will save someone. It isn't worth it to be a "rescue randy". If you find someone with a medical emergency just call 911 and keep them safe.

So there isn't any benefit, for example, by giving O2 to a patient in shock? I'm not sure how that makes me a 'rescue randy' if I just want to make sure I'm doing everything possible for patients. If you're saying there isn't any benefit to those supplies, then yeah, I wouldn't bother using them.

 

[greytmedic]

I'll tell you about my area.

First, if by "improperly use BLS equipment" you mean you perform BLS skills and screw something up, yes you will be held liable because you are licensed. Your company will alse be named in any lawsuit because that is where the money is and they employ you. If "improperly use BLS equipment" you mean performing BLS skills with out working for an approved BLS provider, you will be held liable since you are licensed. If you hold a license you no longer fall under the "good samaritan" act and are responsible for any skills you perform to be with in the scope of practice and professional standards.

Secondly, if you carry and treat people with BLS equipment you probably have to be a member of the EMS system where you work. If you put BLS equipment on a vehicle, that vehicle must be certified as a non-transport vehicle and is subject to inspections and regulations. Don't forget as an EMT-B, I, or P you are operating under the license of the medical director. An EMT license does not give you authority to treat people with out regulation just because you throw some equipment in your trunk.

Finally, carrying around oxygen supplies, not a good idea. Not only are there OSHA regulations about restraining and storing O2 bottles, let's not forget O2 is a drug. It requires standing protocols for an EMT-B, I, or P to administer any drug, including oxygen. If you deliver O2 without the proper protocols you are practicing medicine with out a license.

If you feel the need to perform medical skills at your new job you might suggest getting the company to initiate a First Responder program. You have to remember that as a BLS provider you are not license to practice medicine. You are operating under the jurisdiction, license, and insurance of the medical director which requires protocols, regulations, and lots and lots of paperwork. This is how it is in my state, if I remember right aren't you from Canada? Things might be different there, but that is just my experience and 2 cents.

 

[docB]

Don't bring your own stuff. If you use the provided equipment equipment up to the level of your training you should be covered by your company. If you bring your own stuff and use it, even if you do it correctly, and things go to hell you are screwed.

A few additional points:
-You could easily be construed as having a duty to act because you are an employee who is there to respond to calls and you have been given a first aid kit. It's unlikely that you'll be covered by the good sam law.
-Any EMS or other agency that uses medical equipment has a procedure to insure that it is inspected, usable, in dates and so on. Eg. the rig is gone over every shift, weekly and monthly and documented. If you use your own whatever you won't be able to prove to the plaintiff's lawyer that it was good.
-You can not be held liable for not doing something advanced that you are trained for because you don't have the equiment. Imagine a surgeon getting sued for don't "acting to the level of his training" because he doesn't have an OR in his pocket.

 

[viostorm]

So there isn't any benefit, for example, by giving O2 to a patient in shock? I'm not sure how that makes me a 'rescue randy' if I just want to make sure I'm doing everything possible for patients. If you're saying there isn't any benefit to those supplies, then yeah, I wouldn't bother using them.

The two BLS interventions that make a difference in my opinion are:

1) AED defib
2) Transport to definitive care.

There is no way you would hurt anyone with oxygen in the minutes before the ambulance gets there ... but personally I seriously doubt if it would ever make a difference in someone living or dying.

If you want to do EMS then my advice is go work on an ambulance where you can use your skills.

 

[leviathan]

I'll tell you about my area.

First, if by "improperly use BLS equipment" you mean you perform BLS skills and screw something up, yes you will be held liable because you are licensed. Your company will alse be named in any lawsuit because that is where the money is and they employ you.

Thanks for the input, that's the answer I was looking for. The whole reason I asked was that I wasn't sure if I might be covered under the Good Samaritan law if I was just performing to the best of my ability and made a mistake. If I wouldn't be covered and there are legal implications from errors, then I wouldn't want to risk that, nor would my company allow me to risk it. 😉

 

[leviathan]

-You can not be held liable for not doing something advanced that you are trained for because you don't have the equiment. Imagine a surgeon getting sued for don't "acting to the level of his training" because he doesn't have an OR in his pocket.

Hahaha, nice. I know what you mean, but the reason I asked that question is because I do store my BLS kit at my place on campus where I work (with the authority to do so). It is there for when I need to bring it to local events I volunteer at. I suppose if I didn't use that equipment nobody would know I had the equipment on hand, anyhow. It's basically the fact that I know it's there,and when I do come into contact with a patient, I would feel guilty knowing it is not far away and deciding not to use it.

 

[leviathan]

The two BLS interventions that make a difference in my opinion are:

1) AED defib
2) Transport to definitive care.

There is no way you would hurt anyone with oxygen in the minutes before the ambulance gets there ... but personally I seriously doubt if it would ever make a difference in someone living or dying.

Well, I do have an AED in my residence as I just noted in the last post. I suppose irrespective of the legal implications, it would not be morally right to withhold using that on someone in cardiac arrest if I know it is around. I'm not sure if there would be any legal repercussions from that, though, since I have medical authority to use it.

If you want to do EMS then my advice is go work on an ambulance where you can use your skills.

I do that already, thanks. 🙂

 

[greytmedic]

Just out of curriosity what is in your BLS kit? Did you buy this kit or was it issued to you by some EMS approved agency? And the AED you have, did you buy this AED, are you "borrowing" it from another agency, or were you issued this AED? Just because there is a difference between a "BLS" kit that contains some bandages and splints(a supped up first aid kit) and a true BLS kit that contains things like AED's, oxygen, other drugs(glucose gel, activated charcoal), and airway adjuncts.

 

[leviathan]

Just out of curriosity what is in your BLS kit? Did you buy this kit or was it issued to you by some EMS approved agency?

It was issued to the organization I volunteer for and am in charge of. It contains an AED, O2 kit, first aid supplies, oral + nasal airways, suction, a BVM, and the rest of your typical BLS stuff.

And the AED you have, did you buy this AED, are you "borrowing" it from another agency, or were you issued this AED?

I issued it to myself and purchased it through my organization, and it is stored and used solely for when I bring it out on volunteer shifts. Although realistically, if someone was to code in my residence neighborhood, I wouldn't hesitate for a second to bring it out and use it. I have a standing order from our medical director to use it and it doesn't indicate any restrictions on *when* I can use it, only on who (ie., a patient who is VSA, >8 yrs of age, etc).

 

[leviathan]

Had an intoxicated female unresponsive to pain stimuli tonight. She was breathing fine and her vitals were normal so I just kept her on her side and got her transported to the hospital by EHS (decided not to use OPA, no O2, etc). Thanks for the advice, everyone.