EMS Protocols

[Major Lord]

There are lots of reasons you might have a conflict with CAP in either a moral or legal sense. 900-3 for instance, prohibits CAP members from being deputized. Unfortunately, (or fortunately, depending upon your perspective I suppose)  this law has no actual  legal effect, and if you refuse to join the Posse Comitatus, being a CAP member is not going to be a valid legal defense. One school of thought is that if you are not prepared to watch someone die a slow agonizing death in order to fulfill your oath of membership, you should not in good conscience join CAP. The other school of thought is that you give the Corporate regulations due regard, and if you are called upon to arrest a bad guy or start an IV as a necessary measure in the preservation of life, you weigh the legal and membership consequences against your own conscience, and do the right thing. Once again, CAP has made its position abundantly clear over a very long period of time, so no one should be surprised, outraged, or even frustrated by the Reg's and policies of CAP, Inc.

Major Lord

[cap235629]

or sign you out of the mission on the spot if you start doing something beyond the scope of CAP's mandate and authorization.

Is this one of those Eclipse regulations that aren't really there?  Where does a GTL get the authority to sign anyone but him/her self in or out of a mission?

GTL's are the final authority in the field for a ground team - they aren't there just to "drive the cadets".  You obey them or you go home.

Show me where ANYONE but the member who signed themselves in to a mission has the AUTHORITY to sign them out of a mission.  You have a great theory but it is not backed up by regulation.  And I would refute the GTL being the final authority.  Ever here of a GBD? OSC? IC?.  GTL's are the FRONT LINE LOWEST LEVEL OF SUPERVISION, not the "final authority".

Please educate me on the regulation you base your assertions on....

[cap235629]

The state of Wisconsin may set care levels for professionals they license,
but they literally have no say about what CAP will do.

Tell that to California.  Also, whoever pays the bills calls the shots.  Are you sure you are in the same CAP I am?

[Eclipse]

or sign you out of the mission on the spot if you start doing something beyond the scope of CAP's mandate and authorization.

Is this one of those Eclipse regulations that aren't really there?  Where does a GTL get the authority to sign anyone but him/her self in or out of a mission?

GTL's are the final authority in the field for a ground team - they aren't there just to "drive the cadets".  You obey them or you go home.

Show me where ANYONE but the member who signed themselves in to a mission has the AUTHORITY to sign them out of a mission.  You have a great theory but it is not backed up by regulation.  And I would refute the GTL being the final authority.  Ever here of a GBD? OSC? IC?.  GTL's are the FRONT LINE LOWEST LEVEL OF SUPERVISION, not the "final authority".

Please educate me on the regulation you base your assertions on....

If the GTL of the team you are on decides you are done, you are done.  Period.  That's how it works.  For the purposes of the team and that sortie, he is your direct commander.

[PHall]

or sign you out of the mission on the spot if you start doing something beyond the scope of CAP's mandate and authorization.

Is this one of those Eclipse regulations that aren't really there?  Where does a GTL get the authority to sign anyone but him/her self in or out of a mission?

GTL's are the final authority in the field for a ground team - they aren't there just to "drive the cadets".  You obey them or you go home.

Show me where ANYONE but the member who signed themselves in to a mission has the AUTHORITY to sign them out of a mission.  You have a great theory but it is not backed up by regulation.  And I would refute the GTL being the final authority.  Ever here of a GBD? OSC? IC?.  GTL's are the FRONT LINE LOWEST LEVEL OF SUPERVISION, not the "final authority".

Please educate me on the regulation you base your assertions on....

The IC can do it.

[sarmed1]

....Also, whoever pays the bills calls the shots

I think thats more the bottom line.  Technically no one but CAP dictates what CAP members will or wont do.  Look at 60-3 (please correct me if I am wrong, but as I remember) on multi juristictional missions CAP assets remian under the control of CAP; a CAP incident commander will report thru the overall incident commander. (or some such verbage)
The only time those type of things change (ie caltrans uniform, or over 18 only etc etc) is when someone (the bill payer basically) says "...in order for you to play; you will do this....." CAP still says yes or no. I am sure if down the road if someone says your people will have XYZ medical capability or training CAP will way the benefit's of that mission package and mandate the requirement (even if its only locally) or say sorry we wont play.

as far as your emt at the football game expample....first thats a really bonehead sto atement to make...I'd try to screw....err have his cert reclaimed too; but if he was working as the janitor at the game he is no position to provide emergency care because the school says as a representtive of the district thats the school nurse, athletic trainer etc etc not the janitor's  otherwise he's there as a private citizen....the whole good samaritan thing (barring if your state, locality or agency says you are on duty all the time such as some law enforcement agencies....but in that case they agree to back you.) 

But just like last months discussion on firearms carry; I think you would be hard pressed to find a lengthy list of agencies out there that will say you WILL do this on or off duty or suffer disciplinary action.  (if the opposite is true then a better and more likely succesful route would be to force a reg change that stipulates that as an exception rather than a "new reg")

mk

[Eclipse]

Tell that to California.  Also, whoever pays the bills calls the shots.  Are you sure you are in the same CAP I am?

It doesn't sound like it.

The state of California does not decide the capabilities or risk tolerance of CAP.  They "contract" (for want of a better term), the services offered within CAP's scope, and either take them or not.  You don't expect PD to put out fires or FD to enforce traffic laws.

Last I checked CAP was a National organization which is federalized in certain circumstances, which means states (or wings) don't extend the capabilities of the organization locally just because they feel like it.

We do what we do and nothing more - I 100% guarantee you no authorized mission in CAWG has ever gone beyond the reasonable scope of standard CAP capabilities and mission.

[cap235629]

or sign you out of the mission on the spot if you start doing something beyond the scope of CAP's mandate and authorization.

Is this one of those Eclipse regulations that aren't really there?  Where does a GTL get the authority to sign anyone but him/her self in or out of a mission?

GTL's are the final authority in the field for a ground team - they aren't there just to "drive the cadets".  You obey them or you go home.

Show me where ANYONE but the member who signed themselves in to a mission has the AUTHORITY to sign them out of a mission.  You have a great theory but it is not backed up by regulation.  And I would refute the GTL being the final authority.  Ever here of a GBD? OSC? IC?.  GTL's are the FRONT LINE LOWEST LEVEL OF SUPERVISION, not the "final authority".

Please educate me on the regulation you base your assertions on....

If the GTL of the team you are on decides you are done, you are done.  Period.  That's how it works.  For the purposes of the team and that sortie, he is your direct commander.

Again show me the reg!  I agree that if you don't play nice you go home, I am taking issue with your oppressive view of authority you tend to espouse.  YOU CAN'T DO HALF OF WHAT YOU SAY!

The IC can do it.

Show me where in the regs it says you even have to sign in?

[cap235629]

Tell that to California.  Also, whoever pays the bills calls the shots.  Are you sure you are in the same CAP I am?

It doesn't sound like it.

The state of California does not decide the capabilities or risk tolerance of CAP.  They "contract" (for want of a better term), the services offered within CAP's scope, and either take them or not.  You don't expect PD to put out fires or FD to enforce traffic laws.

Last I checked CAP was a National organization which is federalized in certain circumstances, which means states (or wings) don't extend the capabilities of the organization locally just because they feel like it.

We do what we do and nothing more - I 100% guarantee you no authorized mission in CAWG has ever gone beyond the reasonable scope of standard CAP capabilities and mission.

Since you can't apparently avail yourself to read the regulations let me post them the relevant sections for you with emphasis added for clarity:

From the latest rewrite of CAPR 60-3:

1-17. Ground Operations. Ground teams may be used in virtually all phases of a mission. Ground operations are governed by state and local laws as well as by CAP regulations and policies.

And specific to rendering aid:

f. First Aid and Emergency Medical Care. CAP is not an emergency medical care or paramedic organization and should not advertise itself as such. CAP will not be the primary provider of medical support on missions or training events though qualified personnel can be used to support such activities. The only type of medical aid that should be administered by CAP personnel or by any other person at CAP's request is reasonable treatment deemed necessary to save a life or prevent human suffering. This treatment must be executed by a person qualified to attempt such medical care within their skill level. When first aid or higher medical training is required for qualification in a particular specialty, the expectation is that the qualification course includes both knowledge and practical skills training; first aid courses taken on-line only are not acceptable; though members are not considered employees when supporting operations, courses are expected to meet the National Guidelines for First Aid in Occupational Settings available at http://www.ngfatos.net/ or ASTM F 2171-02, Standard Guide for Defining the Performance of First Aid Providers in Occupational Settings. CAP medical personnel are not provided supplemental malpractice insurance coverage, and any care provided is at the members own risk. Though medical supplies and equipment are not normally provided to responders, any reasonable supplies used on training or actual missions may be submitted for reimbursement as long as sufficient justification is provided.



So I just don't see you getting away with all your Gung-Ho it's my way or the highway crap.  CAP does indeed fall under State and Local control as well as National regulations.

 
As far as giving care, treat at your own risk and CAP will take the credit and pay for your supplies.  WIN WIN!

[Eclipse]

^ Yes, of course, meaning CAP can't do something not allowed by the state, or the state may require extra licensing, etc., for CAP to operate.

It doesn't, however, dictate capabilities.  Period.

As to the other, no point in going there, if you're seriously asking us to quote chapter and verse on how CAP ES operates or who is in
command of what, there's no point to it on my side.

[cap235629]

Eclipse,

I have a profound respect for you as you make an excellent debate opponent.  Please understand that I am in no way trying to flame you, I enjoy the discourse.  We don't agree and that is OK.  The purpose of a debate is to get your opponent to rethink their position.  Not change it, just get them to think.

I know your interpretation of the regs wouldn't fly in Arkansas Wing so I am trying to point out some of the differences throughout all of CAP

I enjoy a good debate and unfortunately I am on medical leave and bored out of my mind so I find my self in many at the moment   Please just keep me engaged!
Hope you feel the same!

[Eclipse]

I know your interpretation of the regs wouldn't fly in Arkansas Wing so I am trying to point out some of the differences throughout all of CAP
just keep me engaged! Hope you feel the same!

Of course, I'm the same way in person, you can throw a coffee mug at me and I'll just throw it back...

OK, so on topic.

Are you saying you don't have to be signed into a mission in Arkansas (what about the 109?), or that neither the GTL or the IC can send you home?

[cap235629]

no I am saying that the 109 isn't mentioned in 60-3

[Short Field]

no I am saying that the 109 isn't mentioned in 60-3

Check here -

CAPR 60-3 para 1-17b(3). Ground Operations:  ...Ground resources will not self-dispatch; they must be properly released, even remotely via phone or other means if necessary, and noted appropriately on mission documents. Signatures are not required on the CAPF 109, Ground Team Clearance, but the CAPF 109 must note who briefed and released the crew accordingly.

As to who is in charge? 

CAPR 60-3 para 1-12. Organizing Resources.  ...The CAP IC exercises full authority over all CAP personnel for matters pertaining to the mission;...

While a GTL might not have the authority to sign a member off a mission, one radio call to the IC would take care of it.  Full authority is full authority.

Now for the requirement to sign-in. 

CAPR 60-3 para 1-13.  Common Responsibilities of all CAP Mission Personnel. There are certain common responsibilities or instructions associated with an incident assignment that everyone should follow. Following these simple guidelines will make your job easier and result in a more effective operation.  Checklists, forms and training materials are provided on the NHQ CAP/DOS website, and evaluation guides are provided in CAP-USAFI 10-2701.

CAP-USAFI 10-2701 Page 86, para 2. states: 

Were all personnel signed in and a method established to ensure that all personnel could be accounted for? Were the qualifications and credentials of all personnel checked and verified?

You can claim all you want that sign-in is not required but 60-3 specifically references 10-2701 as a guide.  The USAF also uses that guide to evaluate CAP and failure to sign-in members is a down-check.  That sort of makes it required as far as USAF is concerned.

[PHall]

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Waiting for the "AFI's do not govern CAP" arguement.

Because you just know somebody will try to use that arguement.

[Krapenhoeffer]

Yeah, unless the 900 series regs were changed really recently (i.e. within the last couple weeks), my understanding was that we didn't have injury coverage unless we were signed in. I know that WI requires members to be signed in, don't know if that is Nat'l policy.

Now, my understanding of 60-3, endorsed by everyone at home that I've asked is that CAP allows EMTs and whatnot to treat patients, as long as we stay within the law (duh), with the understanding that CAP will not provide liability coverage, but pay me back for my supplies that I expend. State Law says I can use my happy fun protocols when off duty (i.e. not near my ambulance), and to encourage bystander intervention, protects me by saying I can't be sued as long as I use good judgment, and stay within my protocols. Easy for me to do, as I have not the slightest idea how to do things outside of my scope of practice, and never would want to until I've been trained to do so. So I'm not going to break protocols.

Now, BLS protocols are almost universal throughout the state (with the slightly major controversy about Cardiocerebral resuscitation, but that's not going to be an issue for a CAP ground team). The problem is with Intermediate and Advanced Life Support protocols, which vary across counties.

Yes, I know that CAP isn't an EMS organization. I think the whole EFART thing in Voluntold was idiotic. But in WI, there are high schools, with EMTs on staff, that have their own protocols. One doesn't need to be an EMS organization to have EMS protocols. That's what I'm basing my idea off of. It wasn't too difficult to get an ER physician to review the protocols, and set things up with the local fire departments. Frankly, having our own protocols would allow someone above EMT-B access to their ILS and ALS protocols away from their home counties.

And yes, Basic First Aid is wonderful, and should be a requirement for all CAP members, but an 8 hour class cannot do the fundamentally necessary job of correcting human instincts for treatment. Human instinct tells me that when somebody pale in the face is crying out for water, I should give it to them. My brain tells me that the patient is in shock, and shouldn't be given anything to drink or eat. Back when I had only my basic first aid, I would have gone with my instinct.

The other important thing about having more advanced medical personnel in field, is that we speak the language, and we can do assessments. If I stumble upon a search target, who insists that they're fine, I'm still going to do an assessment, to include vitals. Yes, I carry around a BP cuff and a stethoscope, and if I see that this guy has a really low blood pressure, I'm not going to walk him out, I'm going to treat for shock and summon MedFlight.

If you stumble across a very lucky plane crash victim, the earlier splinting is performed, the less injury the patient is going to do to themselves.

[Short Field]

Waiting for the "AFI's do not govern CAP" arguement.
Because you just know somebody will try to use that arguement.

I guess that argument would work right up until you fail your USAF evaluation.

[RADIOMAN015]

Yes, I know that CAP isn't an EMS organization. I think the whole EFART thing in Voluntold was idiotic. But in WI, there are high schools, with EMTs on staff, that have their own protocols.

And yes, Basic First Aid is wonderful, and should be a requirement for all CAP members, but an 8 hour class cannot do the fundamentally necessary job of correcting human instincts for treatment.

The other important thing about having more advanced medical personnel in field, is that we speak the language, and we can do assessments. If I stumble upon a search target, who insists that they're fine, I'm still going to do an assessment, to include vitals. Yes, I carry around a BP cuff and a stethoscope, and if I see that this guy has a really low blood pressure, I'm not going to walk him out, I'm going to treat for shock and summon MedFlight.

If you stumble across a very lucky plane crash victim, the earlier splinting is performed, the less injury the patient is going to do to themselves.

The AF evaluation checklist item is "basic first aid" and call in EMS via 911 or via mission base (and we don't want to get into whether mission base really has a good phone number to contact EMS in the area the team is in and AF inspectors have not done a good job on following up/verifying on this ).   

Perhaps the best way to approach this is to look for qualified EMS folks that can work with you in a joint agency operation, rather than CAP doing it alone.   I think the old way  "we can do it all" is slowly transitioning to a joint operations.  This even includes things like snow mobile clubs, off road vehicle clubs,  friendly folks that have ATV's, etc.

Also with CAP IF you aren't using any skill very much (e.g. including radio ops, which is relatively easy; versus first first aid which is more difficult) you tend to loose proficiency. 

I'm sure your are frustrated by the regulation, but the bottom line is it is there to protect the average CAP'er GT members that has very little or no medical/first aid training, but are very skilled in wearing their BDU's & shining their black boots for show and tell back at mission base

RM

[RiverAux]

Now, my understanding of 60-3, endorsed by everyone at home that I've asked is that CAP allows EMTs and whatnot to treat patients, as long as we stay within the law (duh), with the understanding that CAP will not provide liability coverage, but pay me back for my supplies that I expend.

Good luck with getting paid back.

[EMT-83]

Now, my understanding of 60-3, endorsed by everyone at home that I've asked is that CAP allows EMTs and whatnot to treat patients, as long as we stay within the law (duh), with the understanding that CAP will not provide liability coverage, but pay me back for my supplies that I expend. State Law says I can use my happy fun protocols when off duty (i.e. not near my ambulance), and to encourage bystander intervention, protects me by saying I can't be sued as long as I use good judgment, and stay within my protocols. Easy for me to do, as I have not the slightest idea how to do things outside of my scope of practice, and never would want to until I've been trained to do so. So I'm not going to break protocols.

I don't know the exact wording of the Wisconsin statute, but as a general rule, you can be sued by anyone, at any time, for anything. Putting any faith in a Good Samaritan or similar law is risky business.