First Aid Responder

[Ned]

Guys,

This isn't some sort of evil decision by the CAP Tri-Lateral Commission to diss you personally.

It's a pretty simple financial decision.

Go ahead and call a med mal carrier and get them to quote an errors and omissions policy for CAP.  Be sure to tell them that the licensed folks will be engaging in high-risk emergency procedures in SAR situations in potentially all 50 states (with differing scope of practice restrictions) and the odd Commonwealth or two.  Tell them we need coverage for MDs, RNs, DCs, DOs, PAs, LVNs, and various flavors of paramedics and EMTs.  Remind them that none of CAP folks will be covered by Good Samaritan exemptions.

Tell us what they quote you.

Any bets as to what the amount would be?  Hundreds of thousands of dollars, maybe?

For an organization with 60,000 members (in a good year.)

How much are you willing to raise the dues to cover the policy?

Which programs are you willing to eliminate to fund this?

If you want to blame someone, don't blame CAP, inc.

Blame the lawyers.  And their clients.  And the judicial system.

But don't go looking for some "secret" reason why CAP doesn't include EMS as part of our Missions for America.  It's as plain as it can be.

[SARMedTech]

On the Yahoo CAP Health Services site we have been discussing training as medics.  Hawk mountin already offers this training, but we have no recognition as a medic for cadets or non medical personell.

Since we already have the authorization of a CPR/first aid patch for the BDU uniform I am proposing we have an ES tital of First Aid responder FAR , or EFAR Emergency First Aid Responder, and IFAR instructor First Aid Responder.  This would allow wing to know who all has had first aid training and who is current.  This would be helpful on missions, Sarex, encampments etc..  Afterall on missions the most we would normaly do is firt aid response and not much more.  We don't need a new badge or tital, or ribbon.  We already have the patch.  All we need to add is the ES qualification in the NiMMS.

How do you all feel about this.  It gives us medical officers some training to administer and helps take the load off us for encampments, missions etc.  It also helps to encourage youth to explore medical fields.

I would like to have a west coast version of Hawk Mountin Medic training to get cadets and seniors qualified as First Aid Responder or instructors.  I would be happy with the help of others at setting this up in Nevada or Northern AZ.  We could also look into getting medical professionals to discuss their professions at the training as well.

The problem here is that the Hawk Mountain program offers no licensure-meeting requirement for their "medics" nor do they provide many of the requirements necessary to sit for the various state and National Registy Examination. I think it would be great if they did, but they dont, so if a person goes through HM training and then tries to get their medics license, all they will have done is waste alot of time. And from what I have seen from the HM site, they dont make that really clear. It would be a great program to train CAP Medics, but it just doesnt get it done and even if it did, CAP is not willing to even investigate the idea. They do not yet grasp the idea that SAR missions often entail the need for emergency ground care beyond bandaides and iodine and that when we find a person it may be an hour or more (sometimes much more) away from the nearest EMS provider. Fact is, that the GS/EMS situation is broken and needs to be fixed. There will be those here that will tell you that CAP isnt in the business of providing EMS....I disagree. If you are in the business of finding people, often in downed planes, you need to be able to tend to them immediately and not wait for another asset to arrive. Im on your side here, but im nowhere near high enough up in CAP to make this change.

[ELTHunter]

Remind them that none of CAP folks will be covered by Good Samaritan exemptions.

CAP members aren't cover by Good Samaritan exemptions?  Is that true?  I have always been lead to believe we were, as long as we stayed within the bounds of our training.

[SARMedTech]

Guys,

This isn't some sort of evil decision by the CAP Tri-Lateral Commission to diss you personally.

It's a pretty simple financial decision.

Go ahead and call a med mal carrier and get them to quote an errors and omissions policy for CAP.  Be sure to tell them that the licensed folks will be engaging in high-risk emergency procedures in SAR situations in potentially all 50 states (with differing scope of practice restrictions) and the odd Commonwealth or two.  Tell them we need coverage for MDs, RNs, DCs, DOs, PAs, LVNs, and various flavors of paramedics and EMTs.  Remind them that none of CAP folks will be covered by Good Samaritan exemptions.

Tell us what they quote you.

Any bets as to what the amount would be?  Hundreds of thousands of dollars, maybe?

For an organization with 60,000 members (in a good year.)

How much are you willing to raise the dues to cover the policy?

Which programs are you willing to eliminate to fund this?

If you want to blame someone, don't blame CAP, inc.

Blame the lawyers.  And their clients.  And the judicial system.

But don't go looking for some "secret" reason why CAP doesn't include EMS as part of our Missions for America.  It's as plain as it can be.

There are many flaws in your argument.

1. You are trying to quote a number that would include every single member of CAP being covered by liability insurance as an EMT/Medic. I doubt that every member has an interest in EMS. What most of those of us who desire to see this change are proposing is a CAP medical corp.

2. There are EMS malpractice insurers who operate in all 50 states. The cover EMTs of all sorts based on the protocols in those different states.

3. All EMTs and Medics provide high risk procedures. I have done riskier things in the back of a moving ambulance than I would ever do in the field and quite frankly, having a patient on a drag stretcher and trying to drop and breathing tube is much easier

4. The "dues" you might need to raise to cover what we will for now call the CAP medical corps would not have to be paid by everyone, just those who wished to provide emergency medical care in the field.

5. Any doctor that would be involved (say as a remote medical director) would have his own insurance and I seriously doubt that we need chiropractors in the field, so that particular argument is moot. We're not talking about treating people for sciatica here, we are talking about saving lives through EMS. Youre comparing apples and oranges. Also, while perhaps their might be a need for an RN in the field, LVNs are not the most common practitioners of emergency medicine.

6. If it wished to do so, the USAF could cover CAP EMTs and Medics during the time that we are operational for them.

So here is your scenario...You are say 60 miles away from a hospital when you discover the downed plane you have been looking for. One passenger is dead. The other passenger and the pilot are in schock from broken bones and burns and the pilot can barely protect his own airway. What do you do? First aide isnt going to cut it. They are going to need airways and fluids, two things not covered by first aid.

Its not lawyers fault that we dont have these kinds of Corpsman in the field. That rest squarely with CAP. They are not willing to form an investigative committee to even examine this situation and the need for EMS personnel in the field. We train cadets how to splint legs and given then wire or SAM splints. Do you know what happens if you splint a femur fracture improperly, you either tear or occlude the femoral artery. Now the EMS help you need is still 60 miles away and then they have to find you and your downed aircraft once they get that 60 miles covered. You know what you have if you have two people in non-compensating shock for 60 minutes....Two dead people. All EMS is high risk. It developed from the same military model that CAP did. The only argument you make that rings true is cost. Im not meaning to jump down your throat but these are the same arguements that everyone who says that CAP-EMS cannot work and they simply dont hold water.

[SARMedTech]

Remind them that none of CAP folks will be covered by Good Samaritan exemptions.

CAP members aren't cover by Good Samaritan exemptions?  Is that true?  I have always been lead to believe we were, as long as we stayed within the bounds of our training.

Good samaritan laws cover those people who assist in accidents, etc but have no medical training. On its face, the Good Samaritan Law, which doesnt exist in all states, is not intended to cover EMS personnel.

[ELTHunter]

Remind them that none of CAP folks will be covered by Good Samaritan exemptions.

CAP members aren't cover by Good Samaritan exemptions?  Is that true?  I have always been lead to believe we were, as long as we stayed within the bounds of our training.

Good samaritan laws cover those people who assist in accidents, etc but have no medical training. On its face, the Good Samaritan Law, which doesnt exist in all states, is not intended to cover EMS personnel.

If you're a GTL with Wilderness First Aid, not ant EMT, I wouldn't think you would be considered "EMS" personnel.  I think in every Red Cross class I have had, the instructor has told me that we would be covered (In Tennessee) as long as we are performing within the scope of our training.

[sarmed1]

Good samaritan laws do not apply to profesional responders.  They cover you primarily whie out and about helping of your own good neighborly type of behavior.
CAP SAR personnel are looked at as proffesional responders.

On insurance.  Any proffesional providing medical care would need to be covered.  Unless CAP writes things as inclusive only to EMT and  Paramedice.....which would be dissing a be excluding a big part of our community.

An average 3mil/4 mil liability for an EMT or Paramedic runs about $100 per year.  That is for an individual, I imagine even with that coverage the corporation would require its own coverage also.

I doubt coverage for all 50 states would be needed.  In my 17 years of CAP I have operated outside of my home state maybe 2 or 3 times  The complexities of operating outside of your primary state of licensure or certification are even more complicated than the insurance requirements.

On HMRS what exactly do you expect out of an 8 day course?  The shortest paramedic class I have seen is 6 months, as a Full time student.  First Responder is the best you could pull out of that, and when we did run that program they were eligible for state reciprocity.  Currently the course provides Wilderness first aid certification, CPR certification.  Students are also trained in field sanitation and preventitive medicine as it relates to the wilderness/remote environment.  That level of training is more useful to a CAP GT and more in line with the current standing on medical care.

mk

[arajca]

There are many flaws in your argument.

1. You are trying to quote a number that would include every single member of CAP being covered by liability insurance as an EMT/Medic. I doubt that every member has an interest in EMS. What most of those of us who desire to see this change are proposing is a CAP medical corp.

Actually, most of us desire to see CAP accepted as true player in the SAR field. It's a matter of priorities. First and foremost, get accepted and established at a basic level - WHICH DOES NOT INCLUDE BECOMING AN EMS PROVIDER. Visit the several threads here discussing the National Incident Management System (NIMS). That is where emergency services - including SAR, EMS, Fire, LE, etc. are going. CAP hasn't found the turn yet, let alone started down the road. After becoming established and credentialed, then we can look at adding EMS to our services.

2. There are EMS malpractice insurers who operate in all 50 states. The cover EMTs of all sorts based on the protocols in those different states.

True, and they have differing rates depending on the state and level of coverage. Most large multistate companies are self insured. Meaning they have a multi million dollar fund sitting to cover incidents. They usually have an underwriter to back them up and they pay for that as well.

3. All EMTs and Medics provide high risk procedures. I have done riskier things in the back of a moving ambulance than I would ever do in the field and quite frankly, having a patient on a drag stretcher and trying to drop and breathing tube is much easier

It's a matter of environment. If I have someone collapse with a heart attack in the middle of the wilderness, and EMS is more than 30 minutes away, they're dead. If the same person collapses in the middle of town, they have a much better chance of survival. It may sound callous, but that's life.

4. The "dues" you might need to raise to cover what we will for now call the CAP medical corps would not have to be paid by everyone, just those who wished to provide emergency medical care in the field.

And if I, as an EMT elect not to provide my services to CAP, do I still have to pay the extra dues? CAP is already an expensive activity. Increasing dues on those few members that are EMT's, etc will most likely end in no EMT's in CAP. Or no EMT's willing to contribute their skills to CAP.

5. Any doctor that would be involved (say as a remote medical director) would have his own insurance and I seriously doubt that we need chiropractors in the field, so that particular argument is moot. We're not talking about treating people for sciatica here, we are talking about saving lives through EMS. Youre comparing apples and oranges. Also, while perhaps their might be a need for an RN in the field, LVNs are not the most common practitioners of emergency medicine.

Insurance rates are also based on where you practice. If you are serving as a PA, you get hit with additional charges to cover the EMT's under your license. When an EMT makes a mistake - or not - the PA gets sued since he is the 'supervisor' of the EMT.

6. If it wished to do so, the USAF could cover CAP EMTs and Medics during the time that we are operational for them.[/qoute]
True, but to date it hasn't wished to do so.

So here is your scenario...You are say 60 miles away from a hospital when you discover the downed plane you have been looking for. One passenger is dead. The other passenger and the pilot are in schock from broken bones and burns and the pilot can barely protect his own airway. What do you do? First aide isnt going to cut it. They are going to need airways and fluids, two things not covered by first aid.[/quote]
1. The SAR medics I know carry some of these things. If it's going to be a long evac, they'll play God.
2. The SAR medics are not part of any SAR team, they are part of the ambulance service. When they're needed, they get called out. Which is not on every SAR mission.
3. Change the plane to a cliff and the injuries to trauma, and you've described a typical SAR mission in the mountains of CO, except the hospital is usually 100+miles away.
4. CAP is usually not the lead agency on searches. The lead agency typically has the local medical helicopter service on stand by.
5. I'm one person. Who lives and dies depends on the extent of their injuries. I've dealt with this in haz-mat (15 years).

Its not lawyers fault that we dont have these kinds of Corpsman in the field. That rest squarely with CAP. They are not willing to form an investigative committee to even examine this situation and the need for EMS personnel in the field. We train cadets how to splint legs and given then wire or SAM splints. Do you know what happens if you splint a femur fracture improperly, you either tear or occlude the femoral artery. Now the EMS help you need is still 60 miles away and then they have to find you and your downed aircraft once they get that 60 miles covered. You know what you have if you have two people in non-compensating shock for 60 minutes....Two dead people. All EMS is high risk. It developed from the same military model that CAP did. The only argument you make that rings true is cost. Im not meaning to jump down your throat but these are the same arguements that everyone who says that CAP-EMS cannot work and they simply dont hold water.

Actually, CAP used by an ambulance provider service, but that went away after some lawyers got involved. So, yes, it is the lawyers fault. Before you start claiming CAP isn't willing to investigate this, I suggest you contact Lt Col Kay McLaughlin, CAP HSD. Currently, we can't even establish a specialty track for HSO's because the lawyers won't let us. That project has been in the works for several years now. For more info, see the CAP Health Services Yahoo Group. How do propose getting something that involves real patient care past the lawyers?

On the Good Sam laws topic, in some states, you can be covered if you are not serving in an EMS organization at the time you render aid. However, if you are outside of your PA's area, you can loose your certs. Seen it happen. EMT did everything right but the patient died anyway, but the incident was outside of his PA's area. He survived the lawsuit - the judge ruled the Good Sam applied because, in this state, the EMT did not have a duty to act. The state reviewed the case and pulled his cert because he was practicing without PA guidance because the EMT was outside the PA's area. Are you willing to put your livelihood on the line like that?

[SARMedTech]

Here are some other things to think about:

Even at the first responder level:  a person must be 18 to get this level of certification. Thats DOT/DHTSA regs.

So out of the 60k members, you could elminate those cadets who are too young. The you can eliminate those that have no interest in EMS. Then you can elminate those that for whatever reason cannot meet the physical requirements necessary for an EMS license (generally being able to lift 150 pounds by youself). The you can eliminate those folks who are not ground pounders, IE those who work in misson bases.  So the 60k number (IE certifying and insuring the entire membership) is a falacy. Also, as I say, MDs have their own malpractice which covers them when they are working as medical directors and medical directors are not generally in the field. Many RN's work under the liability of whatever organization, hospital, hospice they work for and quite frankly, other than flight nurses (CAP has no aircraft equipped for accute trauma transport that I know of) or nurses who are also EMTs of one level or another, this number is relatively small. As I also said, you can take Chiros out of the equation because i have yet to see a chiropractor work a trauma scene with me. Same the DO's. I could go on and on, but I think you are getting the point. Nobody is talking about making everyone in CAP an EMT, but rather  covering those who are and developing a "CAP Corpsman" program so that the badges and patches we wear actually mean something instead of just being more shiny bling.

How much are gliders and hot air balloons used for SAR activities or transport time sensitive materials? Perhaps there could be some cuts in those programs. I have nothing against either of them, I just wonder how practical they are.

[arajca]

Here is something else to think about - In most of the country CAP is not seen as a viable emergency services entity because CAP still insists on playing by its own rules and not the rule everyone else plays by.

Until that situation is fixed, CAP-EMS isn't a viable option.

The glider and hot air ballon programs serve the AE  and CP missions of CAP, not the ES mission. Contrary to what some members think, ES is not the end-all, be-all of CAP.

[SARMedTech]

Remind them that none of CAP folks will be covered by Good Samaritan exemptions.

CAP members aren't cover by Good Samaritan exemptions?  Is that true?  I have always been lead to believe we were, as long as we stayed within the bounds of our training.

Good samaritan laws cover those people who assist in accidents, etc but have no medical training. On its face, the Good Samaritan Law, which doesnt exist in all states, is not intended to cover EMS personnel.

If you're a GTL with Wilderness First Aid, not ant EMT, I wouldn't think you would be considered "EMS" personnel.  I think in every Red Cross class I have had, the instructor has told me that we would be covered (In Tennessee) as long as we are performing within the scope of our training.

Covered by whom for what? The problem is that Wilderness First Aide is a certification, not a licensure to practice.

[SARMedTech]

Here is something else to think about - In most of the country CAP is not seen as a viable emergency services entity because CAP still insists on playing by its own rules and not the rule everyone else plays by.

Until that situation is fixed, CAP-EMS isn't a viable option.

The glider and hot air ballon programs serve the AE  and CP missions of CAP, not the ES mission. Contrary to what some members think, ES is not the end-all, be-all of CAP.

Ive never said ES is the end-all, be all of CAP, but it is an important part and there is agaping hole in it without EMS. Ive done some searching of private, non-profit SAR organizations across the country and virtually all of them have liability covered EMS personnel. This is the problem with CAP being a non-profit and working for the AF at the same time. It wants what it sees as the best of both worlds and because of this, leaves gaping wholes in alot of the services it provides. The fact is that the ability to provide EMS is an intergral part of SAR and SAR is an integral part of CAP ES as stated by CAP itself. Perhaps its time to clear the decks and find some more progressive minded leadership.

[stillamarine]

Remind them that none of CAP folks will be covered by Good Samaritan exemptions.

CAP members aren't cover by Good Samaritan exemptions?  Is that true?  I have always been lead to believe we were, as long as we stayed within the bounds of our training.

Good samaritan laws cover those people who assist in accidents, etc but have no medical training. On its face, the Good Samaritan Law, which doesnt exist in all states, is not intended to cover EMS personnel.

If you're a GTL with Wilderness First Aid, not ant EMT, I wouldn't think you would be considered "EMS" personnel.  I think in every Red Cross class I have had, the instructor has told me that we would be covered (In Tennessee) as long as we are performing within the scope of our training.

Covered by whom for what? The problem is that Wilderness First Aide is a certification, not a licensure to practice.

I believe he would be refering to the Good Samaritan Act

[PA Guy]

Here are some other things to think about:

Even at the first responder level:  a person must be 18 to get this level of certification. Thats DOT/DHTSA regs.

So out of the 60k members, you could elminate those cadets who are too young. The you can eliminate those that have no interest in EMS. Then you can elminate those that for whatever reason cannot meet the physical requirements necessary for an EMS license (generally being able to lift 150 pounds by youself). The you can eliminate those folks who are not ground pounders, IE those who work in misson bases.  So the 60k number (IE certifying and insuring the entire membership) is a falacy. Also, as I say, MDs have their own malpractice which covers them when they are working as medical directors and medical directors are not generally in the field. Many RN's work under the liability of whatever organization, hospital, hospice they work for and quite frankly, other than flight nurses (CAP has no aircraft equipped for accute trauma transport that I know of) or nurses who are also EMTs of one level or another, this number is relatively small. As I also said, you can take Chiros out of the equation because i have yet to see a chiropractor work a trauma scene with me. Same the DO's. I could go on and on, but I think you are getting the point. Nobody is talking about making everyone in CAP an EMT, but rather  covering those who are and developing a "CAP Corpsman" program so that the badges and patches we wear actually mean something instead of just being more shiny bling.

How much are gliders and hot air balloons used for SAR activities or transport time sensitive materials? Perhaps there could be some cuts in those programs. I have nothing against either of them, I just wonder how practical they are.

No EMS Agency in CA has a physical capacity requirement for certification. Physicians in solo practice have their own malpractice but would have to add a rider for CAP that would drive up their premium. Physicians in group practices are generally covered by the group policy only while working directly for the group. This also applies to RNs, PAs etc. Their hospital, hospice or whatever only covers them when they are on the hospital, hospices clock. So to be covered those folks would need a seperate policy through CAP. Even if only 600 people in CAP wanted to participate in the program it would still be a sizeable chunk of change by the time all the EMTs, Physicians, Nurses and others were included. That would only include the personal liability it wouldn't include the corporate liability.  Remember, they aren't just going to sue you they will also go after CAP, Inc.

The only way CAP will ever be involved in EMS is if they are taken under the federal umbrella like the DMATs. And I don't see that happening anytime soon.

[SARMedTech]

Here are some other things to think about:

Even at the first responder level:  a person must be 18 to get this level of certification. Thats DOT/DHTSA regs.

So out of the 60k members, you could eliminate those cadets who are too young. The you can eliminate those that have no interest in EMS. Then you can eliminate those that for whatever reason cannot meet the physical requirements necessary for an EMS license (generally being able to lift 150 pounds by youself). The you can eliminate those folks who are not ground pounders, IE those who work in misson bases.  So the 60k number (IE certifying and insuring the entire membership) is a fallacy. Also, as I say, MDs have their own malpractice which covers them when they are working as medical directors and medical directors are not generally in the field. Many RN's work under the liability of whatever organization, hospital, hospice they work for and quite frankly, other than flight nurses (CAP has no aircraft equipped for acute trauma transport that I know of) or nurses who are also EMTs of one level or another, this number is relatively small. As I also said, you can take Chiros out of the equation because i have yet to see a chiropractor work a trauma scene with me. Same the DO's. I could go on and on, but I think you are getting the point. Nobody is talking about making everyone in CAP an EMT, but rather  covering those who are and developing a "CAP Corpsman" program so that the badges and patches we wear actually mean something instead of just being more shiny bling.

How much are gliders and hot air balloons used for SAR activities or transport time sensitive materials? Perhaps there could be some cuts in those programs. I have nothing against either of them, I just wonder how practical they are.

No EMS Agency in CA has a physical capacity requirement for certification. Physicians in solo practice have their own malpractice but would have to add a rider for CAP that would drive up their premium. Physicians in group practices are generally covered by the group policy only while working directly for the group. This also applies to RNs, PAs etc. Their hospital, hospice or whatever only covers them when they are on the hospital, hospices clock. So to be covered those folks would need a separate policy through CAP. Even if only 600 people in CAP wanted to participate in the program it would still be a sizeable chunk of change by the time all the EMT, Physicians, Nurses and others were included. That would only include the personal liability it wouldn't include the corporate liability.  Remember, they aren't just going to sue you they will also go after CAP, Inc. The only way CAP will ever be involved in EMS is if they are taken under the federal umbrella like the DMATs. And I don't see that happening anytime soon.

Well, first off, at least one EMS provider in CA has a physical requirement...An agency called AMR. They require their EMTs to be able to lift 150 lbs by themselves and 225 with the aide of their partner. I also happen to know that the medics that work for LAFD have this requirement except I think their weight requirements are higher.

First off, doctors in hospices, etc are not going to be providing medical control for EMS providers. Each EMS region throughout the country has a Medical Director who supervises and shuffles the paper for what goes on in that EMS region. The medical control comes from doctors, often hospitalists, who work only in the emergency room and pick up the phone when a crew is coming to their facility and needs permission to push a certain drug, perform a certain procedure, etc...many of which are covered by standing orders and do not require permission. Physicians in group practices do not (read are not allowed in IL) to provide EMS medical control. The physician providing this assistance to the crews has to be board certified in Emergency/Trauma Medicine.

To give you an idea...we have a new ambulance company here in my home town that was started by two medics in an old airplane hanger. The got registered with dispatch and they get medical assistance by calling into the hospitals and saying "hey we need a doctor." I think one thing you fail to understand is that I am not talking about EMTs out their putting burr holes in peoples skulls, what I am talking about is EMTs on GTs performing within their scope of practice (actually no EMT or Medic has a scope of practice as this would indicate that they operate autonomously, which they do not...rather they have protocols.)  I'm talking about EMTs on GTs performing BLS/BTLS within their protocols to effectively AND safely stabilize a patient  and be able to monitor that patient and report findings ACCURATELY  until the main EMS agency arrives.

You say some people live and some people die...I am keenly aware of this. I had a patient die in my hands on March 24th. But that doesn't mean that when there is an option to prevent this from happening that there shouldn't be a system in place to stabilize that patient, which after all, is what EMS does in the first place. Its a fallacy that EMS practices emergency medicine. We provide emergency medical interventions and there is a huge difference. I'm talking about things like when a cadet goes into anaphylaxis from a bee sting, that we could start a nasal pharyngeal airway and give low does epinephrine.....both stabilizing measures which might save that patient until a full blown EMS crew gets there. Or the possibility of being able to place a dual lumen airway in the patients throat to provide them with an airway. I know money is a concern. Money is a concern in any situation. But do you think that SAR cant open CAP up to liability when someone says "Hey, why wasn't my wife put in a c-collar before you put her in that basket stretcher to carry her to the road?" See what we have here is a situation where CAP members are going to provide first aide that are not licensed to put their hands on patients, they're going to go too far and thats where CAP will get in trouble.

As for NIMS/ICS...they have very little to do with the practice of EMS from a medical standpoint. They are designed as organizational systems in the event of a mass casualty incident. Very little of what NIMS does other than establishing triage, has anything to do with the actual medicine. And its not spreading at the rate you think it is because some agencies refuse to use it because it is still in its infancy and will probably take at least another 5-10 years before it is a viable management system. The fact remains that SAR agencies, like those that CAP worked along side of on Mt. Hood last Christmas are EMS capable and ready to go. They have to be. Its not a matter of people not wanting to pay more dues. Its a matter of SAR meaning Search and Rescue and Rescue inherently carries with it a medical component. If you have a patient in the wreckage or a plain, you better think twice about moving them without a EMS component on your GT. 

Your arguments are all over the place. All of CAPS literature says that CAP performs 85% of SAR missions for the Air Force on inland sorties. How can you say that CAP has yet to perfect their SAR capabilities. If they save 500 lives a year as its stands now, how many would they save if they could provide on scene stabilization. Lets here the statistics of how many people are reached by CAP GTs and then die before they can be gotten to a medical facility. The fact is that CAP touts medical as one of its specialties and doesn't deliver. Giving hygiene and anti-drug lectures to cadets and seniors isn't where the real medical dollars need to be spent.

[arajca]

For the sake or argument, let's assume that CAP develops an organic medical system for ground teams. CAP then advertises said capability. How do you ensure that each and every ground team has an EMT on it?

[SARMedTech]

For the sake or argument, let's assume that CAP develops an organic medical system for ground teams. CAP then advertises said capability. How do you ensure that each and every ground team has an EMT on it?

It has never been my contention that each and every GT has an EMT or Medic, only that those who already exist and may join in the future are covered by liability insurance and have medical direction so that they can do what they are trained to do. This has been brought up a few times and its not what I ever said. And Im not talking about ambulances and med-evac choppers and the like, Im simply talking about putting into place a program where those who have worked hard and trained to a level to be able to help those who are injured or experience sudden medical problems.

Im not saying that one day I hope to see ambulances going down the road in every state that say  "CAP EMS" on them. And as far as one of the other posters talking about NIMS and saying that CAP has to get that down first before it can even be a true SAR player, NIMS doesnt even have NIMS down yet. For proof of this, reference the days after hurricane Katrina. NIMS has nothing to do with there being one or two EMTs in a squadron in Minnesota and one in a squadron in Florida. Just as not all Squadrons deal with Cadets or even Seniors for that matter, every Squadron does not have to be able to do everything. Getting back to NIMS/ICS, this was a system developed in large part by FEMA and well, we can see how well they do at executing plans. NIMS isnt necessary for EMS when you arrive on a crash site and you have one person with a femur fracture and one person with eschar burns over 50% of their body. Here two EMS responders can manage this until private or municipal EMS arrives. The mistake that people often make is that NIMS=EMS. NIMS is being hammered out for situations like Katrina and 9/11 when the scale is so big that a command structure has to be set up. Of course you have to have a command   structure at a crash site and there is already in place within CAP Incident Commanders, etc, NIMS is designed for Mass Casualty Disasters and not everything that CAP will respond to fits that bill. And more than likely, if we show up on a system that requires NIMS to "kick in", the Air Force, National Guard, FEMA and Red Cross are going to be running the show and we will be taking orders from them.

Im talking about a system where when a person is found who hasnt had water for several days, someone can decide by examination whether they should be given a canteen to drink out of or should only have sips of water...should they be given any  food. You have a cadet with asthma and his albuterol isnt working...the next step is an airway adjunct of some kind or epinephrine.  Who's going to do that? Another cadet who's had a few hours of first aide and been shown how to make a tourniquet out of a stick? If CAP doesnt have a medical component, then it should stop recruiting saying that it does. If its not up to speed with the way that SAR operations are run, it shouldn't so  frequently say that it conducts 85% of the inland SARs for the USAF. Its time to live up to what we say we can do. If we say we can do it, the other organizations we work with will be expecting us to and relying on us for it and its going to be a big problem when we show up and dont have the slightest clue what to do.

[jimmydeanno]

Just out of curiosity, who would pay for all the equipment and meds that all of them are hauling around.  Even if stuff goes unused, a lot of it has shelf lives and need to be replaced "just because."  Add this maintenance cost onto the cost of insurance premiums, etc, and I think the cost would be rather substantial...

[SARMedTech]

Just out of curiosity, who would pay for all the equipment and meds that all of them are hauling around.  Even if stuff goes unused, a lot of it has shelf lives and need to be replaced "just because."  Add this maintenance cost onto the cost of insurance premiums, etc, and I think the cost would be rather substantial...

Not really a valid argument. My assumption would be that since CAP makes its members pay for so much of their own gear, equipment and uniforms now, including the contents of the little "1 gallon ziploc bags" it recommends for cadets, that it would probably expect the EMTs to pay for their own gear. Secondly, as far as equipment goes, it doesn't need to be replaced, just because: bandages, kurlex tape, cling tape, Israeli pressure bandages ,air splints, a pulse oximeter, a stethoscope, BP cuff, etc don't have expiration dates. As for the bandages I mentioned, they are good pretty much indefinitely unless they are opened. Things like 2x2s and 4x4s are good for a very long time unless they are just left rolling around loose in the EMTs pack.

As far as meds go, if we were talking about what an EMT would carry: Quik Clot has a very long shelf life as do instant cold packs, cold spray, aspirin is virtually indefinite  if its is stored properly. Nitro and Epi pens would need to be replaced about every 18 months, longer for the nitro if its in spray form since the liquid is more stable than the tablets. Glucagon is also good for 18 months to two years. Sealed activated charcoal is good until it is used as would be nasal and oral airways, combitubes, etc. You know its funny that I don't hear anyone asking how often and how expensive it is to maintain plane parts or the wings on gliders which have a "stress use life" measured in hours.

Lets get down to brass tacks: CAP isn't familiar with what it would take to have an EMT Corps...so because they don't have facts in front of them, they assume the worst and that it cant be done, as apparently, do alot of members of this board. I'm not trying to make enemies by pressing this issue, but hey, lets streamline the production of uniforms and patches and badges and other bling and see how much money that saves. This lack of understanding is shown by the very regs that govern health services. Health Services officers shall provide emergency medical care and stabilizing first aide to the extent of their training and licensure. First of all, I cant get my hands on things like epinephrine and glucagon unless they are supplied to me my an EMS agency or one sort or another. And even if I could, CAP doesn't provide the liability for me to operate the extent of my licensure and training so anything I do that is above what Joe Smith off the street could do is illegal and practicing without a license. CAP getting sued has been mentioned. The regs as they exist now would get CAP and me sued if I followed them. So if I happened to carry a nasal airway in my pack, if I put it down and tore the nasal mucosa, further compromising the airway, while CAP says it wants me to provide care to the extent of my training, I would lose my license and get sued and CAP would stand to lose alot more money than I would. While the CGAUX operates under largely these same policies, at least it would cover me if I functioned within my licensure protocols.

What CAP wants is for people with the license and training to stick their necks out to help someone in need, but doesn't want to take any responsibility. They cant have it both ways. They make it clear that they want EMTs in the field, but do nothing to back us up.

[ELTHunter]

If CAP doesn't have a medical component, then it should stop recruiting saying that it does. If its not up to speed with the way that SAR operations are run, it shouldn't so  frequently say that it conducts 85% of the inland SARs for the USAF. Its time to live up to what we say we can do. If we say we can do it, the other organizations we work with will be expecting us to and relying on us for it and its going to be a big problem when we show up and don't have the slightest clue what to do.

CAP doesn't say anything about having a medical component in any of the recruiting material that I can recall.  Maybe individual members or squadrons are saying such a thing, and if so they shouldn't.  What we do say, as you mentioned, is that we perform inland search & rescue for the USAF, and we do that.  How are we not living up to that commitment?  As far as I know, CAP has never declined to search for any missing aircraft when we have been requested through proper channels to do so.

What I do see is some people identifying an expertise that they have and wanting that expertise recognized and integrated into what CAP does.  EMS is only one area of emergency services that has been mentioned in the past.  Others have wanted to incorporate other skill sets into CAP ES.  There isn't anything wrong with having those discussions.  I think the question we need to ask ourselves is what are CAP's ES missions, what skill sets are required for those missions, and are those missions something CAP can do better than other organizations.  There are other specialties that CAP could integrate into our operations, the question is can the USAF be convinced that there is a need for CAP to perform them.