10 First Aid Myths

AORE 2010

Keystone Colorado

November 13, 2010

11/13/2010 © 2010 James H. Moss

© 2010 Summit Magic Publishing

LLC

11/13/2010

© 2010 James H. Moss

Contact Info

• www.recreation-law.com

• Twitter: RecreationLaw

• Facebook: Rec Law Now

• FB Page: Outdoor Recreation

11/13/2010 © 2010 James H. Moss

11/13/2010 © 2010 James H. Moss

Disclaimer:

All legal advice by it’s very nature is subject to change and the laws of each state. All legal advice requires a review by your

local attorney

11/13/2010 © 2010 James H. Moss

What you Learn

• My Purpose is to inform & Educate

• Your job is to apply information to your program

11/13/2010 © 2010 James H. Moss

10 First Aid Myths

11/13/2010© 2010 James H. Moss

Why Have We Gone So Far?

We want to keep people safe

We want to help people

We want to be heroes

11/13/2010 © 2010 James H. Moss

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Christopher Van Tilburg, M.D. First Aid Kit

1. Tape.

2. Compression wrap.

3. Communication device.

4. Pain medication.

5. CPR mask and nitrile gloves.

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Colorado

Only 1 Commercial SAR in Colorado in the last 3

years

1500 SARs each year

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Myth 1: What is first aid

What ever it takes

Do No Harm

Everything I know

Minimal care till qualified help arrives

11/13/2010 © 2010 James H. Moss

Myth 1: What is first aid

What ever it takes

Do No Harm

Everything I know

Minimal care till qualified help arrives

11/13/2010 © 2010 James H. Moss

First Aid Defined

First aid measures will be defined as temporary procedures necessary to relieve trauma or injury by applying dressing and/or band-aids.

Department of Human Services v. Berry, 297 Ark. 607; 764 S.W.2d 437; 1989 Ark. LEXIS 69

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…requiring the defendant merely to call for help and move the patron to a place where assistance could be provided.

Pacello et al. v. Wyndam International, Inc., 2006 Conn. Super. LEXIS 1042

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Federal

…defined first aid as "any one-time treatment, and any follow up visit for the purpose of observation, of minor scratches, cuts, burns, splinters, and so forth, which do not ordinarily require medical care….

29 CFR Parts 1904 and 1952

49 CFR Part 225

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First Aid Measures --Temporary interventions necessary to treat trauma or injury.

016 06 CARR 001 (2010)

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618.5506 "First aid" defined. (NRS 618.295)

"First aid" means a single treatment and any follow-up visit for the purpose of observation of minor scratches, cuts, burns, splinters and other injuries which do not ordinarily require medical care.

11/13/2010 © 2010 James H. Moss

First Aid, as defined by the American Red Cross

Tenn. Comp. R. & Regs. R. 1400-1-.13 (2010)

11/13/2010 © 2010 James H. Moss

Reality

What can you really do?

Minimum to keep Alive

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Myth 2: I can carry Epinephrine for my Guests

Yes

No

Maybe

11/13/2010 © 2010 James H. Moss

Myth 2: I can carry Epinephrine for my guests

Yes

No

Maybe

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Prescription Drug

Illegal to provide prescription drug to someone whose name is not on the prescription

Your name on Prescription

Only you can take

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Solution

• Have your guests bring their own prescriptions

–Saves you money

–Right drug for the right person

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Myth 3: A Physician can prescribe epinephrine for

my Guests

Yes

No

Maybe

Only Epinephrine

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Myth 3: A Physician can prescribe epinephrine for

my Guests

Yes

No

Maybe

Only Epinephrine

11/13/2010 © 2010 James H. Moss

Physician-Patient Relationship

• A physician can only prescribe to a patient

• Only prescribe to someone the physician has examined

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Solution 1

OTC Asthma Inhalers

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Benadryl

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Solution II

Have your Guests Bring their own

Epinephrine

Myth 4: The Good Samaritan law will protect me from anything I do to

help others

Yes

No

Maybe

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Myth 4: The Good Samaritan law will protect me from anything I do to

help others

Yes

No

Maybe

11/13/2010 © 2010 James H. Moss

Work

•No Good Samaritan Protection if you are a first aid provider

–Your job requires you to have a first aid card/training

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Cause

•No Good Samaritan Protection if you are the cause of the accident

–Guide on the trip

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Good Samaritan

All States you can only treat to your training

Maximum treatment covered by Good Sam is First Aid

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Good Samaritan Restrictions

• Several states only perform medical care

–No rescue is protected

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Good Samaritan

• Requires element of Good Faith

• No Compensation

• Care level of Ordinary & Prudent Person

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Myth 5: WFR are Protected by Good Sam

in All States

Yes

No

Maybe

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Myth 5: WFR are Protected by Good Sam

Yes

No

Maybe

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California Good Sam

• § 50086. Voluntary emergency services; Immunity from liability

• who possesses first aid training equivalent to the Red Cross

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Connecticut

• § 52-557b. "Good Samaritan law". • who has completed a course in first aid

offered by the American Red Cross, the American Heart Association, the National Ski Patrol, the Department of Public Health or any director of health, as certified by the agency or director of health offering the course

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Illinois

• § 745 ILCS 49/67. First aid providers; exemption for first aid

• Any person who is currently certified in first aid by the American Red Cross, the American Heart Association, or the National Safety Council and who in good faith provides first aid without fee

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Kansas• 65-2891. Emergency care by health care

providers; liability; standards of care applicable.

• any person who holds a valid certificate for the successful completion of a course in first aid offered or approved by the American Red Cross, by the American Heart Association, by the Mining Enforcement and Safety Administration of the Bureau of Mines of the department of interior, by the National Safety Council or by any instructor-coordinator, as defined in K.S.A. 65-6112,

11/13/2010 © 2010 James H. Moss

Kentucky

• KRS § 311.667 (2009)• Expected AED users receive American Heart

Association or American Red Cross training in CPR and AED use, or an equivalent nationally recognized course in CPR and AED use;….

• …person certified by the American Heart Association or the American Red Cross to perform cardiopulmonary resuscitation….

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Louisiana

• § 9:2793.2. Gratuitous emergency services rendered by American Red Cross volunteers; limitation of liability

• The emergency service provided was inconsistent with or a breach of policies or procedures taught in the current and most advanced national American Red Cross First Aid Training Course or American Red Cross Disaster Nursing Course

• Volunteer" means a person who has successfully completed first aid training by the American Red Cross or other recognized emergency medical training program and whose certification is current.

11/13/2010 © 2010 James H. Moss

Maryland• § 5-603. Emergency medical care• (2) A member of any State, county, municipal, or

volunteer fire department, ambulance and rescue squad or law enforcement agency or of the National Ski Patrol System, or a corporate fire department responding to a call outside of its corporate premises, if the member:

• (i) Has completed an American Red Cross course in advanced first aid and has a current card showing that status;

• (ii) Has completed an equivalent of an American Red Cross course in advanced first aid, as determined by the Secretary of Health and Mental Hygiene; or

11/13/2010 © 2010 James H. Moss

Pennsylvania

• § 8331. Medical good Samaritan civil immunity

• by the American National Red Cross or the American Heart Association or an equivalent course of instruction approved by the Department of Health….

11/13/2010 © 2010 James H. Moss

AED Good Sam Protection

Every AED Good Samaritan statute is based on training from the American Red Cross or the American Heart Association

11/13/2010 © 2010 James H. Moss

Good Samaritan in all States for:

• American Red Cross

• American Heart Association

• National Ski Patrol

• Boy Scouts of America

• National Safety Council

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Solutions

• Provide American Red Cross

–No additional work

–Additional protection

–Internationally recognized first aid

11/13/2010 © 2010 James H. Moss

Better Solution• National Ski Patrol (NSP) Outdoor

Emergency Care (OEC)

–MD approved Curriculum

–Student and instructor manual

–PowerPoint presentation for each chapter

–Website for help (OECzone.com)

11/13/2010 © 2010 James H. Moss

Myth 6: My physician can write prescriptions

for my Guests

Yes

No

Maybe

Only Epinephrine

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Myth 6: My physician can write prescriptions

for my Guests

Yes

No

Maybe

Only Epinephrine

11/13/2010 © 2010 James H. Moss

Remember: Physician-Patient Relationship

• A physician can only prescribe to a patient

• Only prescribe to someone the physician has examined

11/13/2010 © 2010 James H. Moss

11/13/2010© 2010 James H. Moss

11/13/2010© 2010 James H. Moss

11/13/2010© 2010 James H. Moss

Section 2242 Business and Professions Code

§ 2242. Furnishing dangerous drugs without examination

(a) Prescribing, dispensing, or furnishing dangerous drugs as defined in Section 4022 without an appropriate prior examination and a medical indication, constitutes unprofessional conduct.

11/13/2010 © 2010 James H. Moss

Myth 7: Protocols Protect

Yes

No

Maybe

If Licensed

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Myth 7: Protocols Protect

Yes

No

Maybe

If Licensed

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Licensed Means

• State Exam, Curriculum & Program

–EMT

–Paramedic

–Nurse

–Physician Assistant

–Etc11/13/2010 © 2010 James H. Moss

Protocols

A physician cannot use protocols with a non-licensed person unless the person is under the supervision or supervision and control of the physician

11/13/2010 © 2010 James H. Moss

Supervision & Control

• Legal Definition

• Different in each state

• Requires Physician to–Train

–Supervise

–Track

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Supervision & Control

• Means in the Physician's Office or with the Phrygian if non-licensed

• Means actual communication contact if licensed

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Protocols Then Mean

• Dependent on license

–Must be in communication contact

• If not licensed

–Only First Aid can be performed

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Grounds for MD Discipline CA

§ 1320. Grounds(d) Permitting … unless under the

direct and responsible supervision of a person duly licensed under this chapter or physician and surgeon other than another licensed trainee.

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Supervision

(3) "Supervision" means the supervision of procedures authorized by this section by the following practitioners, within the scope of their respective practices, who shall be physically present in the treatment facility during the performance of those procedures:

11/13/2010 © 2010 James H. Moss

Myth 8: You have a duty to check your guests

health?

Yes

No

Maybe

If Licensed

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Myth 8: You have a duty to check your guests

health?

Yes

No

Maybe

If Licensed

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NO Duty to check health care

• No duty if licensed

• No duty if physician

• No duty if outdoor program

11/13/2010 © 2010 James H. Moss

Myth 9: Do I create liability if I check Guests

Health?

Yes

No

Maybe

If Licensed

11/13/2010 © 2010 James H. Moss

Myth 9: Do I create liability if I check Guests

Health?

Yes

No

Maybe

If Licensed

11/13/2010 © 2010 James H. Moss

If check Guest Health prior to trip…

• If you do are you making a diagnoses – Yes

• Can a first aider diagnose?

–If you make diagnoses do you have medical malpractice insurance?

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If you Don’t Check guests health and say you do…

Are you liable when someone dies on your trip that you should have spotted?

No, but liable for misrepresentation maybe

11/13/2010 © 2010 James H. Moss

If you do

• And someone dies you are liable because you did not catch and you said you would

• If you deny, you are diagnosing and liable to the state

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“Practice”§ 2052. Practice without certificate(a) Notwithstanding Section 146, any person who practices or attempts to practice, or who advertises or holds himself or herself out as practicing, any system or mode

of treating the sick or afflicted in this state, or who diagnoses, treats,

operates for, or prescribes for any ailment, blemish, deformity,

disease, disfigurement, disorder, injury, or other physical or mental condition of

any person, without having at the time of so doing a valid, unrevoked, or unsuspended certificate as provided in this chapter or without being authorized to perform the act pursuant to a certificate obtained in accordance with some other

provision of law is guilty of a public offense, punishable by a fine not exceeding ten thousand dollars ($10,000), by imprisonment in

the state prison, by imprisonment in a county jail not exceeding one year, or by both the fine and either imprisonment.(b) Any person who conspires with or aids or abets another to commit any act described in subdivision (a) is guilty of a public offense, subject to the punishment described in that subdivision.

• (c) The remedy provided in this section shall not preclude any other remedy provided by law.

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Whose Duty Is It?

Guest

Guest Physician

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Whose Duty Is It to check to see if a person

can do a trip?

Guest

Guest Physician

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Myth 10: A First Aider’s First Step is?

Airway

Breathing

Blood Flow

Get Help

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Myth 10: A First Aider’s First Step is?

Airway

Breathing

Blood Flow

Get Help

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Questions?

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Thank you

11/13/2010© 2010 James H. Moss