CAP medical support staff

[usafcap1]

what does medical support staff do?

[Eclipse]

Nothing beyond what anyone with basic First Aid training could do.

[PHall]

CAPR 160-1 will answer all.

[usafcap1]

Nothing beyond what anyone with basic First Aid training could do.

If i were to be an EMT could I do more?

[Eclipse]

Nothing beyond what anyone with basic First Aid training could do.

If i were to be an EMT could I do more?

No.

[NCRblues]

CAP SM with EMT-B -  "oh no, someone is hurt! I shall call 911"

CAP SM with EMT-I - "Oh no, someone is hurt! I shall call 911"

CAP SM with Paramedic - "oh no, someone is hurt! I shall call 911"

CAP SM with an M.D./D.O - Oh no, someone is hurt! I shall call 911"

CAP random SM with no med quals at all - "oh no, someone is hurt! I shall call 911"

^ That's about it.

[Spaceman3750]

Nothing beyond what anyone with basic First Aid training could do.

If i were to be an EMT could I do more?

No.

Except in a life-threatening emergency, and when you are doing an activity where 60-3 applies (ES). In that case, you may provide care up to your level of certification/licensure.

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.

Emphasis mine.

[Fubar]

I've been to a number of cadet activities that involve a "medical staff" who seem pretty busy working on feet, cadets that "don't feel well" and even the occasional sprained ankle. None of the things seem to reach the level of life-saving care, yet nearly every activity has them. Their argument is that they can't call 911 every time a cadet has an upset tummy, and I agree. Yet, providing this basic "care" doesn't seem to mesh with our regulations.

[NCRblues]

I've been to a number of cadet activities that involve a "medical staff" who seem pretty busy working on feet, cadets that "don't feel well" and even the occasional sprained ankle. None of the things seem to reach the level of life-saving care, yet nearly every activity has them. Their argument is that they can't call 911 every time a cadet has an upset tummy, and I agree. Yet, providing this basic "care" doesn't seem to mesh with our regulations.

It does not mesh at all. The following instance JUST happened at a unit Saturday activity in my area. A cadet reported into the "medical officer" for the day (an EMT-B fresh out of school) with an "upset stomach". The "medic" looked the kid over and said he needed to drink more water and take a TUMS. The kid felt better so returns to the activity. Later that day the kid goes home, collapses and is rushed to the hospital with an internal GI bleed. Kid is fine now after emergency surgery. The surgeon told the parents that "if someone competent was in charge medically than they would have know the symptoms" (I disagree with this particular MD, but whatever). Now the parents are in an uproar over this.

IMHO, the regulations are written like they are so WE (as in ANY cap member) does not make that "sick/not sick" call. It is a classic CYA. Someone does not feel good? Call the parents let them be on the hook if the kid kicks the bucket (heaven forbid) later.

[CAP4117]

^ I don't think anyone should expect an EMT-B to make a diagnosis like that. We're not even really supposed to make the "sick/not sick" call. It makes me question the use of EMTs as "medical officers" to begin with, because under whose medical direction are they practicing (legally)? As someone who is about to be a fresh out of school EMT-B, I would be very nervous about being put in that position. If there was an emergency I would of course do everything I could to help, but this seems like it was outside the EMT's scope of practice.

[ol'fido]

My .02. YMMV....

At an encampment, cadets often come up with minor medical complaints. These are usually the normal complaints that befall any normal teenager on a day to day basis plus the usual "ouchies" associated with encampments such as blisters, upset stomachs, etc. There needs to be some mechanism for dealing with these that falls between the two extremes of "well, Cadet Smith has a nickel size hotspot on his heel. We better take him to the ER." and "There's a bandaid Cadet Smith. You can judge for yourself whether you have a hotspot. I'm not going to tell you to put the band aid on but I'm going to go get a soda and what you do while I'm out of the room is up to you." There need to be a common sense middle ground there where minor medical problems can be judged to be minor or major and the appropriate action taken.

Also, the fact that an EMT-B missed a call is one anecdotal instance and not "proof of theory". The St. Louis Post Dispatch had been covering a story for the last week or so about a homeless woman who died in jail after having been arrested for trespassing in a hospital ER. She had gone to three different hospitals in the days before her death complaining of pain in her legs. The doctors at each place could find no cause for her symptoms and sent her away. She refused to leave the last place and was arrested. An autopsy later revealed blood clots in her legs that had traveled to her heart killing her. So even the MDs can get it wrong.

[CAP4117]

It's not so much that the EMT-B "missed a call," it's more that the entire situation (IMHO) was out of his scope of practice. I agree that it would be ridiculous to send a cadet to the ER every time they have an upset stomach, but a new EMT-B should not be the one in charge of that decision. They (we) simply don't have enough training right out of school. I agree with you that there should be a sensible middle ground - something like a nurse-on-call system? I have no idea if that would work for CAP. Unfortunately, as with so many things, the lawsuit potential here is so great that it can really complicate the common sense of the matter.

[NCRblues]

I am not saying the EMT-B should have been or should not have been able to make that call.

What I am saying is the regulations prevent CAP from providing medical care BECAUSE of something just like this situation.

[Eclipse]

The issue is that any member who is not a medical professional has the same expectation of care as any parent - do their best,
band-aid the scratches, and call 911 when things get "exciting".  No parent, absent some history or advance knowledge, is going to
assume internal bleeding because of the symptoms of dehydration.  Most non-medical professionals would have done the exact same thing
with the exact same result, and had "we're not Dr's" to fall back on.

But a medical professional would potentially know the difference, which means he puts himself at risk unnecessarily when he sets himself
up as a triage in situations like these. 

I've been there myself.  As a parent, you want the guy with the field hospital in his trunk around 24x7 to save your child in the rare case something
happens, but as a commander you have to also consider the corporation's rules and regs, not to mention the post-crisis career of the member.

This is the exact situation that CAP warns us about all the time.

I'd be willing to bet a Venti that this cadet hid a known medical history, this kind of thing does not come on suddenly, though sadly that may not
change the dynamics of any lawsuit that may be filed.

[whatevah]

With the only symptoms of "upset stomach" and the kid felt better after some Tums and water, nobody would have called 911 or gone to the local ER to spend 4+ hours waiting to be seen.  At the ER I work at, on a Saturday he probably would have been in the waiting room until he passed out with generic symptoms like that, even if he was taken in by ambulance.  A GI bleed is near impossible to diagnose without seriously abnormal vitals and/or the blood becomes visible after a trip to the bathroom or threw up blood.   So, lets not jump on the EMT for doing something that any of us (95% likely even the parents) would have done.

[CAP4117]

If you're referring to what I was saying, I wasn't trying to criticize the EMT. He did the best he could with his level of experience. Like I said, it shouldn't be on him to make that kind of diagnosis, especially when, as you say, the symptoms aren't really obvious. I was more expressing concern about his being put in that situation in the first place. I guess I was just trying to say that if CAP wants to have "medical officers," and go that route with all its liability, we should have more specific protocol about who a medical officer can be and, IMHO, EMT-Bs with no experience do not have enough training.

[manfredvonrichthofen]

Even as someone who is about finished with EMTB class, I would never want to be put in that situation and I don't think any should. You shouldn't even market yourself outside of your job as an EMT until you have about three years of actual experience. There is just way too much that comes in to understanding after you are doing the job, I know this and I have only done my clinicals, and worked it in the Army. But at the same time as an emergency prehospital caregiver, I would never want to be in that situation if I were a Paramedic with 20+ years. There are just too many Potential signs and symptoms that overlap to be confidIdent in your care when you are working with cadets. You have no heart monitor or 12 lead to help with any heart problems, nothing to help with any gastrointestinal issues, you just don't have enough for that. But helping with your mission subject, you can do a lot more confidently when you know how many potential patients you have and you know what your course of action should be, treat their presentations and you know then you are going to get them to further care immediately.  Just toooooo many variables to work on cadets.

[Major Lord]

Hopefully, someone remembered to mention to the EMT in his training that abdominal pain of unknown etiology is a direct turf to the ER. Unfortunately, cadets at every high intensity ( Note I did not use the word stress: we are not allowed to have any stress in cadet activities) activity, manifest every stress related symptom known to man. Besides asthma attacks, which a cadet either put on his form 31 ( or the nearest metric equivalent in your jurisdiction) or it does not really exist, here are a few of my favorite complaints:

1) "When I run long distances, I become short of breath and my legs began to hurt"......This one an EMT can diagnose!

2) "I get headaches when I stand in formation and people yell at me".......You and everybody else!

3) "When I am exposed to direct sunlight for long periods I become overly warm and perspire excessively"..........A sure sign of impending death

4) These are brand new boots, but they hurt my feet!..........Self Critiquing

I would always carry lots of Glucose tablets ( The type runners carry in little tubes) in my medical bag. Since most high energy cadet activities are stressful, I find that a little there-there therapy ( which is accompanied by patting the back, but only if you have ten Senior Member witnesses) and a glucose tablet can cure anything from Asthma to fractured femurs, to East Australian Wombat Death Syndrome. My best guess of real injuries at encampments are that 95% are feet and knee problems, and in CAWG, its nice to have a Podiatrist nearby to turf the badgers off to.

I have had only one really scary cadet activity illness, and this was a female cadet having first-time,  prolonged seizures. I believe she had a brain tumor, and not even a glucose tab will help that out. I never heard her long term outcome either, so if anyone knows who I am talking about, please let me know if she is okay ( off-list) Even in Cadet Survival School, the only real medical problem we had was a cadet who passed out from not hydrating while doing a little nature jog through the woods one beautiful morning. Turf'ed to 911, rehydrated via I.V., and back in service in two hours. While we waited for an ambulance, two EMT's and a nurse essentially did nothing: God knows what CAP would do if we gave a cadet rehydration fluids to drink!

Major Lord
EMT, etc.

[usafcap1]

Are the medical support staff working with the public or are we working with CAP members?

[Extremepredjudice]

Only members. And only stuff that is like blisters, sprains, and other exceedingly minor injuries.