Walking/Jogging

[EMT-83]

I don't know if they even teach medical/legal issues in the military, but trust me; it's a big deal in the civilian world. We've had the discussion many times here, but don't count on Good Samaritan laws to cover your butt.

It's very simple; provide medical care while working for CAP and no one has your back. You're on your own. Do you really want to risk your house, car, job, or whatever, just to thumb your nose at the rules?

[Walkman]

As a Paramedic at the end of the day I do first aid and cpr and nothing else. Without the toys its A,B,C. A good lawyer will also hang both you and CAP out to dry by arguing that the Good Samartian law does not apply because although you were not being paid for your services and you had no duty to act you chose to and received compensation through being provided federal insurance coverage on approved AF missions. Bottom line is A,B,C is where lives are saved and what keeps you safe. 

That clears it up for me. Thanks!

[Devil Doc]

In a Sue Sue Sue Country, that is the way this country works its a shame that people with adequate training, and skills have a fear of Legal Ramifications.

If you can leave a Legal Aspects out of Medical Care, Especially when it comes to Emergency Medicine and SAR, CAP could function alot better. However, because of the mentallity of Liability, Insurance and Malpractice, why should one want to stop and Help. Goom Samaratan law should a ground to stand on when it comes to Life or Death. CAP should have precedence over you basic first aid since we are a Government Entity.

I am not sure what equipment people are reffering to carrying on a ground team, but I do carry military style medical equipment.

IMO legal issues should have no leg to stand on when the person willing to save a ife, risk there own life and time to do it.

[Eclipse]

But you can't remove the legal aspects, because in theory they are there to protect you and the victims / patients.  Those cadets with stethoscopes I referred to earlier
are just the tip of what we would see if CAP allowed any sort of ALS or similar.  The only think more dangerous then ignorance is a "little" knowledge - someone who
thinks they have a clue and makes things worse because they don't.

I am not sure what equipment people are reffering to carrying on a ground team, but I do carry military style medical equipment.

I have had members show up with backboards, oxygen, C-Collars to name a few.  I've seen a couple other things not for air as well.

[Devil Doc]

Backboard and C-Collars is First Aid. Oxygen is Not. Stethoscopes can be used to find Ascultation on the Internal Sounds of the Body.

Its not like im Carrying Combi-Tubes or Intubating people.

I do however, Carry Tourniquets, Kerlix, Stethoscope, BP Cuff, Cravats, Gloves, 4 x 4 Bandages, etc. Im trying to get a C-Collar, Cloth Litter, and other random medical supplies.

I am not doing I.Vs, Pushing Meds, Intubating, Crics etc.

I may do a Need Thornetesis if need be, and Sucking chest wounds etc.

[Jaison009]

Lets thank about this logically. The life safety issues that kill most people are strokes, cancer, cardiac arrest, and respiratory arrest.

In a stroke early detection and early access to the appropriate facility is key.

Nothing you can do about cancer.

In a cardiac arrest situation, there is trouble with perfusion and/or the pump. What can we do about it as prehospital providers? Check LOC, call EMS, open airway, look, listen, and feel for breath sounds, If none 2 rescue breaths, check a pulse or signs of circulation. If none, start CPR. Early un-interrupted CPR, defibrillation, and EMS access are the keys to survival. The out of hospital cardiac arrest survival rate is LOW. The key is non-stop compressions. Even if you do nothing else get on the chest, push hard, push fast. The science behind the new ARC and AHA standards prove that even if you do not stop for breaths, proper CPR generates 21% O2 (minimum necessary to sustain life).

In a respiratory arrest, proper basic airway management: positioning, opening/re-opening airway, airway visualization for foreign body objects, finger sweeps as appropriate, providing breathing using faceshield fixes most breathing problems.

With circulation issues such as life threatening bleeding: direct pressure, (no more pressure dressing or pressure points), and tourniquet if direct pressure does not stop it.

As a Medic I can intubate, start IV/IOs, provide cardiac monitoring, provide injections, provide 12 lead ECG diagnosis, airway management both basic and advanced, fracture care, handle burns, trauma, ob-gyn, cardiac, diabetic, respiratory, and hundreds of other types of issues, etc, etc as long as I have the tools. No matter what I do it starts Level of Consciousness, Circulation, Airway, Breathing, advanced stuff. Most of the advanced stuff with toys is necessary because the basics weren't done or failed.

So in the above I used first aid and CPR with minimal equipment (gloves, 4x4s (gauze pads), personal face shield,  Israeli or military compression bandage, and my mini first aid kit (bandaids, safety pins, tape, space blanket, etc) and handled 90% of the true life threatening emergencies. The items I use most are ibuprofen, lomotil, and moleskin. No reason to have or carry anything else. Even in true wilderness medicine, advanced procedures are discouraged due to the risk of infection from the environment and further injury from moving the patient. Carrying all of the stuff that is in my Northface backpack is not only impractical but kills me as a responder. Carrying around an extra 20 lbs of crap I'll never be able to use that will expire sucks.

I think this is where you will see a challenge in the civilian EMS world also.

As an EMT you will not be starting IVs, intubating, darting chests, or any of the other stuff that you learned and did in the military. An EMT-B is limited in their skill to assessment, taking vital signs, basic airway management, bleeding control, spinal immobilization, lifting patients, doing CPR, assisting patients with their own medications, and assisting your medic by setting up for advanced skills. Driving is almost a 100% gurantee.   


There is not a lot there that doesn't use basic FA.

In a Sue Sue Sue Country, that is the way this country works its a shame that people with adequate training, and skills have a fear of Legal Ramifications.

If you can leave a Legal Aspects out of Medical Care, Especially when it comes to Emergency Medicine and SAR, CAP could function alot better. However, because of the mentallity of Liability, Insurance and Malpractice, why should one want to stop and Help. Goom Samaratan law should a ground to stand on when it comes to Life or Death. CAP should have precedence over you basic first aid since we are a Government Entity.

I am not sure what equipment people are reffering to carrying on a ground team, but I do carry military style medical equipment.

IMO legal issues should have no leg to stand on when the person willing to save a ife, risk there own life and time to do it.

[Jaison009]

It sucks carrying a backboard around the back country. A stethoscope can be shoved into a first aid kit and not be in the way along with a bp cuff but I don't recommend it. The cravats, 4x4s, gloves, banadges, etc are all part of a basic first aid kit. Cloth litter and other "random medical supplies" I would avoid. Treating a sucking or flail segment are often taught as part of wilderness FA. Darting a chest will open you to a lot of issues.   

Backboard and C-Collars is First Aid. Oxygen is Not. Stethoscopes can be used to find Ascultation on the Internal Sounds of the Body.

Its not like im Carrying Combi-Tubes or Intubating people.

I do however, Carry Tourniquets, Kerlix, Stethoscope, BP Cuff, Cravats, Gloves, 4 x 4 Bandages, etc. Im trying to get a C-Collar, Cloth Litter, and other random medical supplies.

I am not doing I.Vs, Pushing Meds, Intubating, Crics etc.

I may do a Need Thornetesis if need be, and Sucking chest wounds etc.

[Devil Doc]

LOL, I should change the name of this thread.


I do Agree 100% with Basics. Basics are 90% of the work you do. LOC, A&O, ABC, Etc. I did not know EMT-B cannot Dart Chest. It would make since now that i think of it. I do have to remember that Military Medicine and Civilian Medicine is Different.

A Wildness FA Class is fine, I do not think they have any around here. The backboard i would prolly leave in the CAP Van or POV, so i would not be carrying it around. Im still learning how CAP does stuff.

Thanks for the Advise guys, im not a Civilian Medic, so it is appreciated.  Hopefully i can get my EMT-B eventually, and learn what type of First Aid i can, and Cannot do.

[NM SAR]

The thing to keep in mind is that, if you're trained as an EMS provider at any level (CFR up through EMT-P), you can't perform any invasive skills or administer medications, even if in your scope of practice, without medical direction. This means a physician who is taking responsibility for the care that medical providers in your agency provide. My team, Cibola SAR, has a medical director. CAP does not, and most likely never will. Hence, you're pretty well down to basic first aid. No invasive airways (including OPAs and NPAs), no drugs, nothing sharp.

But let's be honest. in wilderness SAR, the patient is gonna be stable when you find him or her, hours or days after the call came in. He or she will either be stable in a good way (alive, with a reasonable BP, HR and RR), or stable in a bad way (assuming ambient temperature), but stable nonetheless. Honestly, not much of a need in wildland SAR for anything more than basic first aid. Argument can be made for Certified First Responder (enlightened first aid). Wilderness First Responder would be nice.

if your medkit weighs more than your lunch, you're doin' it wrong.

[Stonewall]

As for walking and/or jogging, checkout the UP by Jawbone.  I won one last week and think it could help someone trying to walk/exercise more.

[JayT]

I do Agree 100% with Basics. Basics are 90% of the work you do. LOC, A&O, ABC, Etc. I did not know EMT-B cannot Dart Chest. It would make since now that i think of it. I do have to remember that Military Medicine and Civilian Medicine is Different.

It depends on the juristdiction.

[capgirl]

Whoa, now! How'd we get so off topic?  This happens so often. I guess it's a casualty of CAPTalk.

Today was officially the last day of MY walk/jog beginner program. I'm hoping that I'll be able to do the mile run right (and fast enough) next week for PT! For the readers who are wondering what in the world this is, here is the program - taken from a CAP draft called Cadets Take Off (http://www.capmembers.com/media/cms/Cadets_TakeOff_0CC0C01D61E3E_8FFE3E801A864.pdf).



After PT, I'll try to get on and tell you guys if it worked. 

[CAP4117]

I don't know if they even teach medical/legal issues in the military, but trust me; it's a big deal in the civilian world. We've had the discussion many times here, but don't count on Good Samaritan laws to cover your butt.

It's very simple; provide medical care while working for CAP and no one has your back. You're on your own. Do you really want to risk your house, car, job, or whatever, just to thumb your nose at the rules?

I tried to explain this to a young senior member (EMT-Basic) in my squadron after he told me he was trying to get some oxygen tanks to carry with him on GT stuff. 
We have a word for the overenthusiastic volunteer phenomenon in EMS.

[JayT]

I don't know if they even teach medical/legal issues in the military, but trust me; it's a big deal in the civilian world. We've had the discussion many times here, but don't count on Good Samaritan laws to cover your butt.

It's very simple; provide medical care while working for CAP and no one has your back. You're on your own. Do you really want to risk your house, car, job, or whatever, just to thumb your nose at the rules?

I tried to explain this to a young senior member (EMT-Basic) in my squadron after he told me he was trying to get some oxygen tanks to carry with him on GT stuff. 
We have a word for the overenthusiastic volunteer phenomenon in EMS.

But, but, but! O2 is the most important medication ever in history. It's the cure-all for everything!

[Sapper168]

But, but, but! O2 is the most important medication ever in history. It's the cure-all for everything!

I thought the cure all was a healthy dose of motrin and an IV?

[PHall]

I don't know if they even teach medical/legal issues in the military, but trust me; it's a big deal in the civilian world. We've had the discussion many times here, but don't count on Good Samaritan laws to cover your butt.

It's very simple; provide medical care while working for CAP and no one has your back. You're on your own. Do you really want to risk your house, car, job, or whatever, just to thumb your nose at the rules?

I tried to explain this to a young senior member (EMT-Basic) in my squadron after he told me he was trying to get some oxygen tanks to carry with him on GT stuff. 
We have a word for the overenthusiastic volunteer phenomenon in EMS.

But, but, but! O2 is the most important medication ever in history. It's the cure-all for everything!

Yeah, O2 will cure a hangover. You still hurt, but at least you can function.
Done more then a couple aircraft pre-flights carrying a yellow O2 bottle and wearing an quick-don oxygen mask on my face!

[68w20]

Um, no. It's very black and very white. No gray

I think I didn't phrase that quite correctly. I mean that the line about "within their skill level" leaves a little opening for CAP members that have advanced certs. It doesn't spell out which specific procedures you are allowed to perform. I had seen some debate about where those like EMTs draw the line at "reasonable treatment deemed necessary to save a life or prevent human suffering". That was the gray area I was thinking of. Am I completely off base with that?

Yes.  The regs you quoted are very clear.  CAP is not a medical responder and anything beyond basic first aid is supposed to be handled by other agencies.

Now, like all CAP regs, they do not trump the law, and if you are bound by "duty of care", etc., etc., then quoting a CAP reg is not going to protect you in
a civil or criminal case, but likewise neither will CAP be bound to provide you with any liability protection, etc., should you provide care beyond their authorization.

This puts many members into a precarious position - bound to provide care, but perhaps not covered by any angle of their insurance.

My advice to these member has been to simply not put themselves in situations where this might occur, and yes, that means some of our most highly motivated
ground types might not play.

This is a situation that has been hotly debated for at least a decade, and NHQ does not seem interested in changing things any time soon. 

Right, wrong, or otherwise, it simply "is".  Members need to accept that and act accordingly.

I respect that Eclipse, looking out for the people as a Whole. I understand fully what the consequences are. I do not see why NHQ does not want to change regs or mission, i guess there is bigger fish to fry.

Cool thing about NC HB 799, it states  Licensure for individuals with military training and experience; licensure by endorsement for military spouses; temporary license.

So im talking to the EMT board because my training is equivalent to an EMT-B. So North Carolina can license me as long as I have the Equivalent training. I think this is a plus for Military Medics Alike.

So I'm  asking this out of ignorance of the way USN does things: Were you not trained/certified as an EMT as part of post-BMT specialty training?  The way the Army does it is to certify all 68Ws through NREMT, and I was under the impression that both USAF and USN had similar programs.

[Devil Doc]

The USN when I went through did not train you to become a EMT through the NREMT. Now the AF, Army,  Navy and CG train at Fort Sam Houston and you get EMT-B Certified or you can chose to become an LPN. Its joint training then you go to your designated branch to learn that branches skills.

[Майор Хаткевич]

As for walking and/or jogging, checkout the UP by Jawbone.  I won one last week and think it could help someone trying to walk/exercise more.

Encampment!

[DocKibbey]

As a prior FMF "Doc" and EMT-B like the other "DevilDoc" on here I can relate to responding to incidents both in and out of the military.  It can become very problematic when dealing with laws for medical care whether you are in a duty position or in just in your car and responding to a car accident when off duty.  When I went through my "A" school for Corpsman in 2001 nobody really thought to ask about what do we do when we get out for work as we had just got into the military.  Even when I attended FMSS at Camp Pendleton in 2002 for my FMF rating there was not any talk about certifications outside of the military.  It was not until 2004 when I was overseas in Okinawa that I was able to get my NREMT certification on the side through our training company.  My understanding that nowadays corpsman are getting their NREMT certification which was a good move.  I worked as an EMT and volunteer firefighter when I got out of the military and felt lucky to get that job years ago as I continually was told that I was overqualified and it was very frustrating due to several other quals I had also.  It was frustrating to me at the time due to my training and experience that I had received to not be able to utilize them or have so little freedom to do what I was trained to do automatically.  In that regard I can understand why it can be frustrating for those with certain training in CAP to not be able to use it and for others with training but no experience to be overzealous.  As leaders it is our job to make sure the Cadets stay motivated about training and activities yet still remember that CAP has its limitations in regards to medical care.  I agree that Cadets whether "Master Medics" or not do not need to be trekking around O2 or any other advanced equipment.  Now at the same time those with training have a duty to act within their Standard of Care.  No one wants to have to watch someone suffer, of course the other side of things is that with the proper training you can also direct  someone what to do if they are injured to help themselves if you do not want to risk the lawsuit possibility if patients are conscious.  Also I know that those of us with the proper training understand what we are risking in certain medical situations and prefer to beg forgiveness then ask permission when it comes to saving a life