CPR
- Thread starter cobraman
- Start date
Sure you can count AED's I am First Aid and CPr cetified. I worked as Lifeguard and a Lifeguard instructor through high school and college. At one time someone petitioned the Red Cross to include bottled oxygen and AED devices in the Lifeguard Training class. Sounding like a bad idea to me. Eventually they dropped the idea. Pool decks and Electic devices is not a good idea. Plus Chlorine gas and bottled O2 and Hcl acid did sound like a safe storage combination to me either.
David Schmidbauer
Retired Screen Name
OK... lets get this back on a firearm topic! 
Those of you that are certified/licenced in CPR and or EMT here is the question.
If you become involved in a defenseive situation and you fire on someone. You score a decisive hit which stops his aggression due to trama from the wound.
After securing the area (removing weapon from his reach) do you then start to administer first aid?!?
If you don't and he dies think of how his families lawyer(s) will use your unaction.
If you do and he dies you could be accused of not only shooting him but following up to cause his death.
Hmmmmmmm.... what to do? WHAT to do? Anyone?
------------------
Schmit, GySgt, USMC(Ret)
NRA Life, Lodge 1201-UOSSS
"Si vis Pacem Para Bellum"
Those of you that are certified/licenced in CPR and or EMT here is the question.
If you become involved in a defenseive situation and you fire on someone. You score a decisive hit which stops his aggression due to trama from the wound.
After securing the area (removing weapon from his reach) do you then start to administer first aid?!?
If you don't and he dies think of how his families lawyer(s) will use your unaction.
If you do and he dies you could be accused of not only shooting him but following up to cause his death.
Hmmmmmmm.... what to do? WHAT to do? Anyone?
------------------
Schmit, GySgt, USMC(Ret)
NRA Life, Lodge 1201-UOSSS
"Si vis Pacem Para Bellum"
Hey guys, I got my EMT-B license/certificate thingy in 1996. I had planned to get on a service then, but plans changed a bit and I enrolled in RN school. Since I'm in school, I let the EMT-B lapse as it is hard to get recertified if you're not actively working with a service.
Currently still have CPR cert., but lost the AED cert when I let the EMT run out.
Knock on wood, I may graduate with my RN this summer.
I'm guessing that this question has an underlying issue of "duty to render aid".
As a medical professional the law requires you to render aid unless #1, there are already cops/medics on scene; and/or #2, if you reasonable believe that you would be at risk for injury or illness by having contact with the victim.
Well, like all good nurslings I've got a bandage kit and some gloves in my car at all times. And I've got a pair of gloves in my schoolbag, which is almost always with me.
If I have to shoot someone, I will not render aid (other than calling 911).
First, how do I know the guy doesn't have HIV/AIDS or Hepatitis? A pair of latex gloves are definitely not adequate barriers for dealing with an exsanginating HIV patient. Just look at any ER on TV (real or fictional). All the staff, when treating a major bleeder, are fully gowned with mask and face shield.
A victim who has taken multiple gunshots to the torso is likely to have fractures (and bone fragments) of the ribs, scapula, vertebrae, clavicle, sternum..... I said I carried latex gloves, not kevlar gloves.
This risk of punctured gloves (and subsequent exposure to blood) combined with an unknown disease status (of the victim) is plenty of reason to believe that you may be at risk for injury and illness by treating the victim.
Additionally, treatment is only indicated if the BG is still alive. Well, if he is alive and had previously attacked you, then how smart is it to reholster and come into close contact with him, exposing yourself to continued attack?
Basically, I don't think there is much legal or moral reason to render aid to an assailant you just shot.
$.02, -Kframe
-Kframe
Currently still have CPR cert., but lost the AED cert when I let the EMT run out.
Knock on wood, I may graduate with my RN this summer.
I'm guessing that this question has an underlying issue of "duty to render aid".
As a medical professional the law requires you to render aid unless #1, there are already cops/medics on scene; and/or #2, if you reasonable believe that you would be at risk for injury or illness by having contact with the victim.
Well, like all good nurslings I've got a bandage kit and some gloves in my car at all times. And I've got a pair of gloves in my schoolbag, which is almost always with me.
If I have to shoot someone, I will not render aid (other than calling 911).
First, how do I know the guy doesn't have HIV/AIDS or Hepatitis? A pair of latex gloves are definitely not adequate barriers for dealing with an exsanginating HIV patient. Just look at any ER on TV (real or fictional). All the staff, when treating a major bleeder, are fully gowned with mask and face shield.
A victim who has taken multiple gunshots to the torso is likely to have fractures (and bone fragments) of the ribs, scapula, vertebrae, clavicle, sternum..... I said I carried latex gloves, not kevlar gloves.
This risk of punctured gloves (and subsequent exposure to blood) combined with an unknown disease status (of the victim) is plenty of reason to believe that you may be at risk for injury and illness by treating the victim.
Additionally, treatment is only indicated if the BG is still alive. Well, if he is alive and had previously attacked you, then how smart is it to reholster and come into close contact with him, exposing yourself to continued attack?
Basically, I don't think there is much legal or moral reason to render aid to an assailant you just shot.
$.02, -Kframe
-Kframe
sectioneight
Inactive
Here in Georgia, ten years ago at least, you were only obligated to do more than any other good samartin if you were in uniform. I personally could not sit by and let someone die if I had the power to stop it. even if I was the person on the handle end of the weapon. One of those moral hangups that I have. go figure. Of course the laws may have changed now so this may need more investigation...
I am not an Attorney-at-Law. I am not qualified to interpret the law or to
give legal advice. Furthermore, I speak ONLY of Texas.
If you are on duty as a medical person you must follow the medical
protocols established as federal and state standards for your position and
situation. If you are off duty, the only law I have found applicable to Texas
and rendering aid is in the:
Transportation Code
Chapter 550. Accidents and Accident Reports
Subchapter B. Duties Following Accident
Paragraph 5650.023. Duty to give information and render aid
(Quote)
The operator of a vehicle involved in an accident resulting in the injury or
death of a person or damage to a vehicle that is driven or attended by a
person shall:
(1) give the operator’s name and address, the registration number of the
vehicle the operator was driving, and the name of the operator’s motor
vehicle liability insurer to any person injured or the operator or occupant of
or person attending a vehicle involved in the collision;
(2) if requested and available, show the operator’s driver’s license to a
person described by Subdivision (1); and
(3) provide any person injured in the accident reasonable assistance,
including transporting or making arrangements for transporting the person
to a physician or hospital for medical treatment if it is apparent that
treatment is necessary, or if the injured person request the transportation.
(Unquote)
As far as I can determine, as a legal layperson, “... making arrangements
for transporting...” can mean calling 9-1-1. Therefore, if I am off-duty, I
can satisfy all legal requirements by making arrangements for transporting
the patient.
As an additional point of contention, even if I *cause* the accident, if I am
the only able-bodied person at the scene, I can leave the scene of the
accident to get help (rather than render first aid) and be in full compliance
with the law so long as I do not delay reporting my involvement in the
accident. (In other words, I’d explain it all to the 9-1-1 operator.)
If someone in Texas can find a reference to “leaving the scene of an
accident”, please advise. I don’t believe it exists.
-----
If I shoot someone in my home, I will call 9-1-1 and not touch the intruder
or make an attempt to physically render aid to the intruder. My job is to
keep myself and my family safe until law enforcement arrives.
In EVERY medical emergency, the first and foremost question is scene
safety. It does NO good to try to become a hero, rush into an auto accident
scene, and have all of us killed by a speeding Peterbuilt!
Secure the scene so it doesn’t get worse, then evaluate what action must be taken.
Do you need HAZ MAT personnel, fire department, how many ambulances,
etc. etc.? Rushing instinctively into emergencies gets more people injured,
maimed, and killed. Dead heroes don’t save people and somebody
tomorrow might need your help every bit as much as these poor people in
front of you at the moment.
-----
The term “certified” has two distinct meanings.
1) This evening I certified two ladies in First Aid. Tomorrow I will certify
five students in CPR. The ONLY thing I am certifying is that these students
successfully completed the academic and/or practical requirements of the
course. Such certifications provide no warranty or guarantee of future
performance or proficiency.
2) Certifications issued by a “certifying agency” indicate proficiency and
capability above the layman level. EMTs, RMT, LVNs, RNs, Doctors of every
kind, and a host of “certified”, “registered”, and/or “licensed” professionals
are expected to perform at a level commensurate with their certification.
However, as I stated above, in Texas nobody has a “duty to act” by
rendering first aid, if they are off-duty. That is true even for doctors.
Rumors and misinformation abound and the following is another such
rumor. I am told only the state of Vermont required off-duty healthcare
personnel to render first aid (or better) at the scene of an accident. That
was taken from a National Safety Council pamphlet but I have no legal
source to prove/disprove that comment. Can anyone please provide such a
source?
Before rendering opinions otherwise, please quote “chapter and verse” of
any law which requires otherwise. I don’t think it can be done. I stand
ready to be proven wrong.
Please remember my disclaimer. I am not an Attorney-at-Law. See an
Attorney for advice you can rely upon.
[This message has been edited by Dennis (edited December 16, 1999).]
give legal advice. Furthermore, I speak ONLY of Texas.
If you are on duty as a medical person you must follow the medical
protocols established as federal and state standards for your position and
situation. If you are off duty, the only law I have found applicable to Texas
and rendering aid is in the:
Transportation Code
Chapter 550. Accidents and Accident Reports
Subchapter B. Duties Following Accident
Paragraph 5650.023. Duty to give information and render aid
(Quote)
The operator of a vehicle involved in an accident resulting in the injury or
death of a person or damage to a vehicle that is driven or attended by a
person shall:
(1) give the operator’s name and address, the registration number of the
vehicle the operator was driving, and the name of the operator’s motor
vehicle liability insurer to any person injured or the operator or occupant of
or person attending a vehicle involved in the collision;
(2) if requested and available, show the operator’s driver’s license to a
person described by Subdivision (1); and
(3) provide any person injured in the accident reasonable assistance,
including transporting or making arrangements for transporting the person
to a physician or hospital for medical treatment if it is apparent that
treatment is necessary, or if the injured person request the transportation.
(Unquote)
As far as I can determine, as a legal layperson, “... making arrangements
for transporting...” can mean calling 9-1-1. Therefore, if I am off-duty, I
can satisfy all legal requirements by making arrangements for transporting
the patient.
As an additional point of contention, even if I *cause* the accident, if I am
the only able-bodied person at the scene, I can leave the scene of the
accident to get help (rather than render first aid) and be in full compliance
with the law so long as I do not delay reporting my involvement in the
accident. (In other words, I’d explain it all to the 9-1-1 operator.)
If someone in Texas can find a reference to “leaving the scene of an
accident”, please advise. I don’t believe it exists.
-----
If I shoot someone in my home, I will call 9-1-1 and not touch the intruder
or make an attempt to physically render aid to the intruder. My job is to
keep myself and my family safe until law enforcement arrives.
In EVERY medical emergency, the first and foremost question is scene
safety. It does NO good to try to become a hero, rush into an auto accident
scene, and have all of us killed by a speeding Peterbuilt!
Secure the scene so it doesn’t get worse, then evaluate what action must be taken.
Do you need HAZ MAT personnel, fire department, how many ambulances,
etc. etc.? Rushing instinctively into emergencies gets more people injured,
maimed, and killed. Dead heroes don’t save people and somebody
tomorrow might need your help every bit as much as these poor people in
front of you at the moment.
-----
The term “certified” has two distinct meanings.
1) This evening I certified two ladies in First Aid. Tomorrow I will certify
five students in CPR. The ONLY thing I am certifying is that these students
successfully completed the academic and/or practical requirements of the
course. Such certifications provide no warranty or guarantee of future
performance or proficiency.
2) Certifications issued by a “certifying agency” indicate proficiency and
capability above the layman level. EMTs, RMT, LVNs, RNs, Doctors of every
kind, and a host of “certified”, “registered”, and/or “licensed” professionals
are expected to perform at a level commensurate with their certification.
However, as I stated above, in Texas nobody has a “duty to act” by
rendering first aid, if they are off-duty. That is true even for doctors.
Rumors and misinformation abound and the following is another such
rumor. I am told only the state of Vermont required off-duty healthcare
personnel to render first aid (or better) at the scene of an accident. That
was taken from a National Safety Council pamphlet but I have no legal
source to prove/disprove that comment. Can anyone please provide such a
source?
Before rendering opinions otherwise, please quote “chapter and verse” of
any law which requires otherwise. I don’t think it can be done. I stand
ready to be proven wrong.
Please remember my disclaimer. I am not an Attorney-at-Law. See an
Attorney for advice you can rely upon.
[This message has been edited by Dennis (edited December 16, 1999).]
(It's ME again, Margaret...)
One dangerous legal/medical aspect seldom gets the attention it deserves -
the “rescuer-patient relationship” and the charge of “abandonment”.
I’m posting this separately because I can find NOTHING in the laws of Texas
pertaining to this subject. (I’ll bet it’s in the Health and Safety Code
somewhere, but I can’t find it. Therefore, consider the following VERY
tentative. I’m open to suggestions/corrections, etc.
If a person renders aid or medical advice to (or for) a person who is ill or
injured, a “rescuer-patient relationship” has been established. To the best
of my knowledge, the rescuer shall not leave or otherwise abandon his
patient unless and until one or more of the following becomes true.
1) The rescuer can turn the patient over to anyone with equal or higher
medical qualifications.
2) The rescuer can cease medical care if so directed
a) by a doctor or someone legitimately speaking for a doctor for medical
reasons, or
b) by a commissioned peace officer for reasons of the rescuer’s safety.
3) The patient can terminate his medical care unless over-ruled by a
medical doctor or commissioned peace officer who states the patient is a
threat or danger to himself or others.
4) The rescuer can terminate care if:
a) he becomes exhausted (physically unable to continue), or
b) he is incapacitated due to injury or serious illness, or
c) he becomes endangered (burning building or car, drunks with guns, etc.
etc.)
Note that a Justice of the Peace can not terminate medical care in progress.
The Justice of the Peace should not even be called until a doctor (or his
representative) declares formally that the patient is dead.
Note that a police officer can not terminate medical care for medical
reasons.
Whether or not an off-duty EMS person represents his medical director (a
doctor) is determined by the medical director.
All the above is further reasoning why I would not touch a person I've shot intentionally. (And God forbid I should hurt someone negligently or by accident.)
[This message has been edited by Dennis (edited December 16, 1999).]
One dangerous legal/medical aspect seldom gets the attention it deserves -
the “rescuer-patient relationship” and the charge of “abandonment”.
I’m posting this separately because I can find NOTHING in the laws of Texas
pertaining to this subject. (I’ll bet it’s in the Health and Safety Code
somewhere, but I can’t find it. Therefore, consider the following VERY
tentative. I’m open to suggestions/corrections, etc.
If a person renders aid or medical advice to (or for) a person who is ill or
injured, a “rescuer-patient relationship” has been established. To the best
of my knowledge, the rescuer shall not leave or otherwise abandon his
patient unless and until one or more of the following becomes true.
1) The rescuer can turn the patient over to anyone with equal or higher
medical qualifications.
2) The rescuer can cease medical care if so directed
a) by a doctor or someone legitimately speaking for a doctor for medical
reasons, or
b) by a commissioned peace officer for reasons of the rescuer’s safety.
3) The patient can terminate his medical care unless over-ruled by a
medical doctor or commissioned peace officer who states the patient is a
threat or danger to himself or others.
4) The rescuer can terminate care if:
a) he becomes exhausted (physically unable to continue), or
b) he is incapacitated due to injury or serious illness, or
c) he becomes endangered (burning building or car, drunks with guns, etc.
etc.)
Note that a Justice of the Peace can not terminate medical care in progress.
The Justice of the Peace should not even be called until a doctor (or his
representative) declares formally that the patient is dead.
Note that a police officer can not terminate medical care for medical
reasons.
Whether or not an off-duty EMS person represents his medical director (a
doctor) is determined by the medical director.
All the above is further reasoning why I would not touch a person I've shot intentionally. (And God forbid I should hurt someone negligently or by accident.)
[This message has been edited by Dennis (edited December 16, 1999).]
Hmmmm.... Well, I've been a volunteer EMT-B since 1982, and just this summer I quit working at Bushmaster Firearms to go to school and get a degree and license in Paramedicine. I have considered this problem before, and we kicked it around both at the station and in the shop, and while many people have differing opinions, this is what I came up with for my own situation.
I personally don't want to hurt anyone. I also personally don't want to be injured or killed by someone who does not share my pacifistic views, so I legally carry when I am not actually on duty or in school. If I was to have to fire on someone in self defense, I would feel an obligation to render all possible aid, the same way we work on drunk drivers, wife beaters, baby rapers, and assorted other wastes of protoplasm, and here's why.
It's not about them, it's about you. If you leave them lying there, you're no better than they are. Think about that for a minute. No matter what happened in court, no matter what happened in the hospital, no matter what all else, if you leave them lying there, you are just as bad as they are, and now you've got to live with that.
If you are trained, I feel you should render any aid possible without endangering yourself or others. Some people will feel this extends to bodily fluids, in the field we get it all over us anyway, so I don't usually worry about it too much. If the guy was still dangerous, I wouldn't get near him.
If I was wounded in the attack, I would concentrate on myself first, then him. I would prioritise any other wounded on scene and treat them in the usual order, worst injured first, reguardless of who's who.
This may not be the ideal answer for eveyone, but right now it's my contingency plan for just that type of situation. Hopefully I never have to put it into action.
------------------
With my shield or on it...
I personally don't want to hurt anyone. I also personally don't want to be injured or killed by someone who does not share my pacifistic views, so I legally carry when I am not actually on duty or in school. If I was to have to fire on someone in self defense, I would feel an obligation to render all possible aid, the same way we work on drunk drivers, wife beaters, baby rapers, and assorted other wastes of protoplasm, and here's why.
It's not about them, it's about you. If you leave them lying there, you're no better than they are. Think about that for a minute. No matter what happened in court, no matter what happened in the hospital, no matter what all else, if you leave them lying there, you are just as bad as they are, and now you've got to live with that.
If you are trained, I feel you should render any aid possible without endangering yourself or others. Some people will feel this extends to bodily fluids, in the field we get it all over us anyway, so I don't usually worry about it too much. If the guy was still dangerous, I wouldn't get near him.
If I was wounded in the attack, I would concentrate on myself first, then him. I would prioritise any other wounded on scene and treat them in the usual order, worst injured first, reguardless of who's who.
This may not be the ideal answer for eveyone, but right now it's my contingency plan for just that type of situation. Hopefully I never have to put it into action.
------------------
With my shield or on it...
Oh, and hey Dennis, the protocols vary by state so greatly that it's quite possible that no set standard for discontinuing care can exist at this time.
We've been exposed to different protocols from different states and even different regions within the same state in recent classes and almost none of them are consistent. Probably the best thing to do would be to look them up for your own area, mine here in Maine are as follows:
As an EMT-Basic, I can discontinue care only under the following circumstances- if a higher licensed person comes on scene to replace me in providing care, if the patient has not regained a pulse or vital signs during 20 minutes of constant CPR with AED and no ALS is available and if directed to stop by online medical control, or if a legal DNR order is presented to me after I have begun care.
For an EMT-B in Maine EMS Region One, that's it. Any other situation and you go on until you get to the hospital or tip over yourself, whichever happens first.
Law enforcement is not mentioned anywhere in the protocols here, and this would lead to an interesting legal situation if you were the highest licensed person available in this situation, conceivably they might not be able to arrest you until you got to the hospital with the patient. This would not sit well with most of the cops I work with.
If they did arrest you on scene and restrained you from providing care, the resulting lawsuit on your behalf might just pay the settlement costs of your own lawsuit from the attack, or at least the abandonment lawsuit. It would really make for some intense legal negotiations in any case.
Anyway, that's how it stands up in my region. Again, hopefully I never have to put any of this to use, but hey, I buy lots of insurance, too.
------------------
With my shield or on it...
We've been exposed to different protocols from different states and even different regions within the same state in recent classes and almost none of them are consistent. Probably the best thing to do would be to look them up for your own area, mine here in Maine are as follows:
As an EMT-Basic, I can discontinue care only under the following circumstances- if a higher licensed person comes on scene to replace me in providing care, if the patient has not regained a pulse or vital signs during 20 minutes of constant CPR with AED and no ALS is available and if directed to stop by online medical control, or if a legal DNR order is presented to me after I have begun care.
For an EMT-B in Maine EMS Region One, that's it. Any other situation and you go on until you get to the hospital or tip over yourself, whichever happens first.
Law enforcement is not mentioned anywhere in the protocols here, and this would lead to an interesting legal situation if you were the highest licensed person available in this situation, conceivably they might not be able to arrest you until you got to the hospital with the patient. This would not sit well with most of the cops I work with.
If they did arrest you on scene and restrained you from providing care, the resulting lawsuit on your behalf might just pay the settlement costs of your own lawsuit from the attack, or at least the abandonment lawsuit. It would really make for some intense legal negotiations in any case.
Anyway, that's how it stands up in my region. Again, hopefully I never have to put any of this to use, but hey, I buy lots of insurance, too.
------------------
With my shield or on it...
Artech,
Thanks for the reply.
As I mentally pound on your reply I come to two conclusions.
1) I think my list includes what you stated, and
2) We seem to agree on everything you stated except for rendering aid to an intruder. I won't argue that point because when on-scene, I might agree with you.
What I find neat, is that EMS minimum standards are truly "standards" - established by the National Highway Traffic Safety Administration.
Each state can *add* to the standards so they may differ somewhat from state to state; but if I happen to be in Maine and you and I stop at a car wreck, I say, "I'm an EMT-Basic in Texas, how can I help?"
Without further conversation:
1) We know you're in charge because you are in your home state, and
2) We both know pretty well what each other knows!
I've helped local off-duty EMS bods in Michigan, Arizona, and Louisiana (as well as many "out of county experiences").
At one "major" (multi-patient) scene outside Tucson, I helped take vitals and set up IVs for one Paramedic while an out-of-state LVN did the same for the other Paramedic (until a second unit arrived). It was kinda neat!!
Here's hoping we only meet "socially"!
Thanks for the reply.
As I mentally pound on your reply I come to two conclusions.
1) I think my list includes what you stated, and
2) We seem to agree on everything you stated except for rendering aid to an intruder. I won't argue that point because when on-scene, I might agree with you.
What I find neat, is that EMS minimum standards are truly "standards" - established by the National Highway Traffic Safety Administration.
Each state can *add* to the standards so they may differ somewhat from state to state; but if I happen to be in Maine and you and I stop at a car wreck, I say, "I'm an EMT-Basic in Texas, how can I help?"
Without further conversation:
1) We know you're in charge because you are in your home state, and
2) We both know pretty well what each other knows!
I've helped local off-duty EMS bods in Michigan, Arizona, and Louisiana (as well as many "out of county experiences"
). At one "major" (multi-patient) scene outside Tucson, I helped take vitals and set up IVs for one Paramedic while an out-of-state LVN did the same for the other Paramedic (until a second unit arrived). It was kinda neat!!
Here's hoping we only meet "socially"!
