Welcome, Guest. Please login or register.
Did you miss your activation email?
August 24, 2019, 11:00:31 AM
Home Help Login Register
News:

CAP Talk  |  Operations  |  Safety  |  Topic: Medical Sections
0 Members and 1 Guest are viewing this topic.
Pages: 1 2 [3] 4 5 6 Send this topic Print
Author Topic: Medical Sections  (Read 30457 times)
SARMedTech
Salty & Seasoned Contributor

Posts: 798

« Reply #40 on: June 13, 2007, 02:55:30 PM »

Ummm...I thought I said they brought them to the hospital and he was admitted.  Sorry for not specifically saying..."the parents were notified, the seniors stayed until the parents arrived two days later and he went home..."

and just because a cadet needs to go to the hospital doesn't mean they need to go home.  They may have cut their finger or sprained an ankle, that sometimes requires a hospital visit, not necessarily a go home though. 

One encampment I was at had a cadet with epilepsy and mild retardation.  About three times a day he'd have a siezure, we didn't send him home and guess what, he actually completed the encampment.

These kinds of stories only serve to support the need for onsite medical personnel. If you had a cadet who was seizing three times a day and no one had the good sense to send him home, that proves that there was some skewed medical judgement, perhaps by someone not qualified to assess and make the stay or go situation. Seizures are not little things like hiccups that happen and then go away...there are lingering neuro effects some times for days and whoever decided that a cadet in a state of status epilepticus (periods of seizures with no significant recovery post-ictal time) should stay made a very dangerous call. Firefighters and lots of other occupations have medical parameters and if you fall outside of them, you are done until you are stable. A cadet seizing three times a day at an encampment is NOT stable. Was he medically checked out each time he had a seizure for things like a lacerated tongue or contusions? Was he given a neurological assessment each time he seized? Im guessing not. All of these stories only serve to make my point for the necessity of liability covered, medically directed EMS in CAP. Im pretty sure that a cadet seizing three times a day could have wound up costing CAP alot of money if any one of this 3 a day seizures had had long lasting effects. You dont mention if he had his meds (usually dilantin and barbituates), if its was insured that he was taking them properly, etc. You also dont say who decided he should stay until the end. I would have sent him home on a medical "discharge" for the duration of the event.
Report to moderator   Logged
"Corpsman Up!"

"...The distinct possibility of dying slow, cold and alone...but you also get the chance to save lives, and there is no greater calling in the world than that."
capchiro
Salty & Seasoned Contributor

Posts: 579

« Reply #41 on: June 13, 2007, 03:28:27 PM »

Steven, this is the problem for commanders with the current system.  I may trust you, as I have come to know a little about your medical background and depth of knowledge, but another EMT or medical person of some type comes to a Georgia encampment from Florida and becomes the "medical person" and then tells the commander that a cadet with multiple seizures is okay to stay at encampment.  This creates a liability for the sick cadet, for other cadets around him, for the "medical person" if something happens and a big problem for the commander if something happens.  nothing like having a cadet on an orientation flight on a Blackhawk or climbing a rope bridge and having a seizure.  The stress and dehydration that accompanies encampments can only exacerbate any epileptic type disorder.  We need the "proper" medical personnel at CAP stuff and until we can insure that we have it, it's almost better to err on the side of caution. JMHO
Report to moderator   Logged
Lt. Col. Harry E. Siegrist III, CAP
Commander
Sweetwater Comp. Sqdn.
GA154
jimmydeanno
Salty & Seasoned Contributor

Posts: 4,155
Unit: ǝnƃoɹ

« Reply #42 on: June 13, 2007, 03:31:37 PM »

I don't know all the details of this specific cadet as I was not privvy to all his medical needs, not being someone who would have been able to meet them.

We had a RN and licensed physician on site.  As a staff member we were told that the cadet has seizures several times a day normally and to just make sure the nurse was present when they occured.  We were told of the signs to watch for when they are about to occur.  The nurse just made sure the cadet didn't hurt himself, gave him time to recover and he went on his merry way.

Also, I was witness to a few of these seizures, and from what I understand there are different "types" of seizures that range from violent twitching and spasming to what appears to be a loss of conciousness with little movement.  His were the latter.

The decision to even allow him to come was made by the Wing Commander and Encampment Commander, above my paygrade.

So I really don't see it as an issue since the cadet was aware of how to take care of himself on the onset and recovery of his seizures, the parents were aware of the medical capabilities of the staff, the nurse and doctor were aware of and had experience in handling this disability and all were willing to attend to the needs of the cadet when they arose.

Some may call it a liabilty, I call it a success story.
Report to moderator   Logged
If you have ten thousand regulations you destroy all respect for the law. - Winston Churchill
Ned
Resident Philosopher

Posts: 2,233

« Reply #43 on: June 13, 2007, 08:57:51 PM »

Here's the lowdown from my experience with medical staff at encampments.

(. . .)
3) Encampment Nurse: Licensed nurse, ran the medical bay in day to day operations.  Maintained a good supply of Gatorade powder, glucose tabs, simple OTC medications (Tylenol, aspirin, Advil, alka-seltzer, pepto, etc) as well as a more complex first aid kit with bandages, dressings, compression bandages, etc.  She also maintained prescription medications and ensured the cadets got them every time they were supposed to.  She treated blisters, headaches, dehydration, and other simple 'first aid' type injuries.

4) DOCTOR: The last encampment I went to had all the above as well as a licensed orthopedic surgeon.  He aided the nurse when nothing was going on, but handled more complicated injuries.  Sprains, twists, etc.  He was vital in determining if something needed to go to the hospital or could be handled at the encampment.  In a pinch, if a cadets medication ran out or treatment needed a prescription medication, after consultation with the parents and consent- BAM prescription written and filled.  He carried his own liability and malpractice insurance.

There was never in the last 10 encampments I've been to a need for any true 'emergency' care at encampment, and things that merited a hospital visit were brought and someone else dealt with it. What I have seen the need for is someone trained to recognize the symptoms of things and the proper course of action to take.


I'm certainly glad that everything went well at these activities and that cadets and seniors had access to professional care.

But in telling us the staff coverage I wish you had mentioned that the nurse and the doctor were not CAP members (or that the encampments occurred a long time ago before the current restrictions on our HSOs were enacted.)

Because if they were members, then the set-up you described would not be permissible under current regulations.  Because, according to your description, both the doctor and the nurse engaged in prohibited "routine care" including administering medications, diagnosis of injuries and illnesses, and prescribing medications.

Similarly, I am hopeful that  the non-member doctor treating cadets (with parental permission, of course) had placed CAP, Inc as a named insured on his malpractice/liability insurance.   Otherwise, the corporation would have had horrific exposure in the event of a bad healthcare outcome.

Again, I'm glad it went well, but we should make sure that we provide complete descriptions to ensure that other activity commanders do not mistakenly allow CAP HSOs to perform any medical care beyone first aid in true emergencies.

Ned Lee
Encampment Guy
Former CAP Legal Officer
Report to moderator   Logged
SARMedTech
Salty & Seasoned Contributor

Posts: 798

« Reply #44 on: June 14, 2007, 01:09:12 AM »

Steven, this is the problem for commanders with the current system.  I may trust you, as I have come to know a little about your medical background and depth of knowledge, but another EMT or medical person of some type comes to a Georgia encampment from Florida and becomes the "medical person" and then tells the commander that a cadet with multiple seizures is okay to stay at encampment.  This creates a liability for the sick cadet, for other cadets around him, for the "medical person" if something happens and a big problem for the commander if something happens.  nothing like having a cadet on an orientation flight on a Blackhawk or climbing a rope bridge and having a seizure.  The stress and dehydration that accompanies encampments can only exacerbate any epileptic type disorder.  We need the "proper" medical personnel at CAP stuff and until we can insure that we have it, it's almost better to err on the side of caution. JMHO

Harry-

I agree that a physician trumps an EMT in training and diagnostic as does a nurse (though nurses technically do not diagnose and EMT-Ps do regularly perform field diagnoses). I think my point was more that it was really completely reckless to allow a cadet who was seizing several times a day to remain at an encampment. Here is a situation where there were medical folks there, and they failed. All of the factors you mentioned (dehydration, fluctuating blood sugar, fatigue, the effects of strenuous activity in heat) can cause some with epilepsy to go into a period actively seizing. And while I think that the CAP cadet program should be kept open to all young folks who can and want to participate, a thorough look needs to be taken at that cadet's physical condition and quite frankly, I would question the wisdom, not of allowing anyone with epilepsy at an encampment, but rather a person who is prone to status epilepticus in the first place. Many epileptics go years between seizures and many have them each day and while this runs afield of the current topic, its a little (read alot) irresponsible to allow a cadet with that condition to be out on an encampment. I would love for all of them to be able to participate in all activities, but thats just not the way it goes. And I agree fully with what you say about the variance between qualifications and knowledge/skill set, so we do need to be careful in that regard. And in the situations you list above, the O-ride and climbing a rope bridge, even a petit mal seizure (of the sort described by the above poster) could be potentially very dangerous. While the last thread on this sort of topic got locked out, it is something that really needs to be worked on and talked about constructively.
« Last Edit: June 14, 2007, 01:32:12 AM by SARMedTech » Report to moderator   Logged
"Corpsman Up!"

"...The distinct possibility of dying slow, cold and alone...but you also get the chance to save lives, and there is no greater calling in the world than that."
Eclipse
Too Much Free Time With Silver Clasp
*
Posts: 30,143

« Reply #45 on: June 14, 2007, 02:48:56 AM »

To both of these, this is the problem with these topics - people ask / tell what they can do today under current regs, and people start discussing what SHOULD be done.

These are the times in which we live.  I have photos of ILWG members hanging IV's in the field.

That's not going to happen ever again...
Report to moderator   Logged


arajca
Salty & Seasoned Contributor

Posts: 4,391

« Reply #46 on: June 14, 2007, 02:54:30 AM »

While we may discuss it here, nothing will change until someone makes a proposal to the appropriate CAP authorities. There are many folks here with strong opinions about how things should be done, but, so it seems, few do more than argue here. If you really want change, do the research and submit a well developed, thought out proposal. Sending a note complaining will not change anything. Arguing here will not change anything. Do the work.
Report to moderator   Logged
SARMedTech
Salty & Seasoned Contributor

Posts: 798

« Reply #47 on: June 14, 2007, 03:26:15 AM »

To both of these, this is the problem with these topics - people ask / tell what they can do today under current regs, and people start discussing what SHOULD be done.

These are the times in which we live.  I have photos of ILWG members hanging IV's in the field.

That's not going to happen ever again...

I'd love to see those photos and know about when they were taken. And whether they were taken in the 1950's or the 1980's it shows at one point that CAP medical officers were trusted to do more than say "i think that cadet might be sick" and then stand around wringing their hands. I know, I know, we live in an era of frivolous law suits. I havent been with my squadron very long, but I am working to change the way the medical regs currently stand. Things take time to change and NEVER is a long time. Im sure there were those who thought a portable hospital would never be able to pull up in front of your house and begin treating you before you ever saw a doctor. And the fact that there are photographs of medical officers hanging IVs would seem to be documentation that CAP engages in activities in which field medical care could become necessary. Maybe the discussions of CAP medical regulations will bump uniform discussion out of the top three and could actually prove more productive.
« Last Edit: June 14, 2007, 03:34:05 AM by SARMedTech » Report to moderator   Logged
"Corpsman Up!"

"...The distinct possibility of dying slow, cold and alone...but you also get the chance to save lives, and there is no greater calling in the world than that."
SAR-EMT1
Salty & Seasoned Contributor

Posts: 1,502
Unit: GLR-IL-328

« Reply #48 on: June 14, 2007, 04:20:09 AM »

When I was in AZ they had a huge problem they year before with medical problems.  They did like many people here advocate, they called 911 for everything.  The base EMS got real tired real fast for showing up 2 or 3 times a day for a week for what we in EMS kindly term "BS" calls.  As a paramedic they wanted me to help them solve their problem.  My solution was in place medical support (the same as the military does) Citing CAPs restricvtive regs and the lack of medical direction or insurance we were at a little bit of an impass.  The solution we came up with was military medical personnel (myself as a NG medic) and an actiuve duty RN I conned into going permisive TDY. (I had one or two other nurses and techs come down and help out during some busier times)  We had established assessment guidelines, routine and emergency treatment protocols approved by and signed off by a base physician.  ( Limited ALS level care and the usual tums, motrins and benadryls etc) We coordinated with their clinic (non emergency room) for duty hours evaluation and follow up and with an off base urgent care for after hours.  We provided our own transport via military ambualnce for routine and used 911 for ALS level emergencies. 
We did all of the other expected mecical support stuff, monitor water intake, ensure extra water at outdoor activites on site standby for things like PIR and obstacle and Land Nav course.  We went from something like 2 dozen transported cadets with a similar number sent home the previous year  to only 2 patients sent for serious care (spider bite & ear infection) and none sent home.  The biggest argument I hear is the liability CAP would have, either in the outlay for insuracne or the cost of lawsuit payment if something goes wrong.  Look at the amount of money we potentially saved the corportation with our medical support operation.  The average EMS ride costs about $500-$700 (theres $12000 to $17000 right off the bat), and whats the average doc in the box visit cost $100-$300 ish? (so another 3 or 4 grand) The only outlay they had was for the limited amount of supplies we used...maybe $50 to $100 in over the counter meds and some other boo boo supplies. 

In my CAP time I have seen more serious illness and injuries at encampment type activites than I have ever seen doing SAR missions.  This is definetly one area that CAP needs to get its head above water in regards to medical support.  Be it an internal exception or a requirement for some type of military support.  Most encampment activities are held on a military base of some kind (they usually have some kind of medical support or a higher headquarters that has it) and somewhere in a wing there is at least one active duty, guard or reserve medical type person who is also a CAP member.  It takes more work than your state director asking for a medic or a nurse or even a PA but if you are serious about solving the problem and staying legal about it the resources are out there.

mk

If it is at all possible could you PM me with the details of how you worked this thing out and what your treatment plans etc were like?
Report to moderator   Logged
C. A. Edgar
AUX USCG Flotilla 8-8
Former CC / GLR-IL-328
Firefighter, Paramedic, Grad Student
SAR-EMT1
Salty & Seasoned Contributor

Posts: 1,502
Unit: GLR-IL-328

« Reply #49 on: June 14, 2007, 04:47:25 AM »

To both of these, this is the problem with these topics - people ask / tell what they can do today under current regs, and people start discussing what SHOULD be done.

These are the times in which we live.  I have photos of ILWG members hanging IV's in the field.

That's not going to happen ever again...

Would you mind posting those pics? As a historical reference.

... Once upon a time, California and several other states even had MASH units under the Control of WING.

They are discussed briefly in several books about CAP. One by C.A. Mobley -sp?- comes to mind.
Report to moderator   Logged
C. A. Edgar
AUX USCG Flotilla 8-8
Former CC / GLR-IL-328
Firefighter, Paramedic, Grad Student
Eclipse
Too Much Free Time With Silver Clasp
*
Posts: 30,143

« Reply #50 on: June 14, 2007, 01:57:48 PM »

To both of these, this is the problem with these topics - people ask / tell what they can do today under current regs, and people start discussing what SHOULD be done.

These are the times in which we live.  I have photos of ILWG members hanging IV's in the field.

That's not going to happen ever again...

Would you mind posting those pics? As a historical reference.

... Once upon a time, California and several other states even had MASH units under the Control of WING.

They are discussed briefly in several books about CAP. One by C.A. Mobley -sp?- comes to mind.

50's - 1956, I believe. 

The pics are from the infamous National Geographic article I keep threatening to scan and post.  I'm going to have to wreck my copy to scan, so I have been debating.

Looking again, and based on the terrain, they probably aren't from ILWG, but they are absolutley CAP, in the old green fatigues.  Show CAP frogmen as well.
Report to moderator   Logged


SARMedTech
Salty & Seasoned Contributor

Posts: 798

« Reply #51 on: June 14, 2007, 04:00:45 PM »

Ah the good old days of frogmen and field medicine. Makes one long for a by-gone era.
Report to moderator   Logged
"Corpsman Up!"

"...The distinct possibility of dying slow, cold and alone...but you also get the chance to save lives, and there is no greater calling in the world than that."
isuhawkeye
Salty & Seasoned Contributor

Posts: 1,311

John's web site
« Reply #52 on: June 26, 2007, 02:27:30 AM »

I'm sorry but I did not read all three pages of the thread.  I thought I would add Iowa's 2 cents worth

At each Iowa WTA we set up a first aid station. 

a "Medic" (I know the term is controversial) staffs the station.  they are responsible for having a plan for medical emergencies, and for assisting the safety officer with hydration, and other health services needs.

Report to moderator   Logged
SARMedTech
Salty & Seasoned Contributor

Posts: 798

« Reply #53 on: June 26, 2007, 03:19:37 AM »

Yeah...funny about the word "medic."  If youre out on a SAR or SARex or some other CAP activity and know you have an EMS responder with you, hollering "Medic!" is probably going to bring any level of responder running. Its just most EMS folks, I must admit myself included, are touchy about the term medic because it indicates a whole different level of licensure and about 1000 hours of clinical and classroom. I may be old-fashioned but as you can see from my signature line, I am a fan of "Corpsman." In the early days of field medicine, a corpsman could be anything from a stretcher bearer to an ambulance driver to the unit's "medic." If Iowa and Illinois ever work together and I am there, if you yell "Corpsman Up!" youre guaranteed to get my attention. Ive often thought that perhaps Corpsman is a term that could be used by CAP but then i think that maybe the Navy's medicos might take offense.
Report to moderator   Logged
"Corpsman Up!"

"...The distinct possibility of dying slow, cold and alone...but you also get the chance to save lives, and there is no greater calling in the world than that."
SARMedTech
Salty & Seasoned Contributor

Posts: 798

« Reply #54 on: June 26, 2007, 03:33:28 AM »

Here's the lowdown from my experience with medical staff at encampments.

(. . .)
3) Encampment Nurse: Licensed nurse, ran the medical bay in day to day operations.  Maintained a good supply of Gatorade powder, glucose tabs, simple OTC medications (Tylenol, aspirin, Advil, alka-seltzer, pepto, etc) as well as a more complex first aid kit with bandages, dressings, compression bandages, etc.  She also maintained prescription medications and ensured the cadets got them every time they were supposed to.  She treated blisters, headaches, dehydration, and other simple 'first aid' type injuries.

4) DOCTOR: The last encampment I went to had all the above as well as a licensed orthopedic surgeon.  He aided the nurse when nothing was going on, but handled more complicated injuries.  Sprains, twists, etc.  He was vital in determining if something needed to go to the hospital or could be handled at the encampment.  In a pinch, if a cadets medication ran out or treatment needed a prescription medication, after consultation with the parents and consent- BAM prescription written and filled.  He carried his own liability and malpractice insurance.

There was never in the last 10 encampments I've been to a need for any true 'emergency' care at encampment, and things that merited a hospital visit were brought and someone else dealt with it. What I have seen the need for is someone trained to recognize the symptoms of things and the proper course of action to take.


I'm certainly glad that everything went well at these activities and that cadets and seniors had access to professional care.

But in telling us the staff coverage I wish you had mentioned that the nurse and the doctor were not CAP members (or that the encampments occurred a long time ago before the current restrictions on our HSOs were enacted.)

Because if they were members, then the set-up you described would not be permissible under current regulations.  Because, according to your description, both the doctor and the nurse engaged in prohibited "routine care" including administering medications, diagnosis of injuries and illnesses, and prescribing medications.

Similarly, I am hopeful that  the non-member doctor treating cadets (with parental permission, of course) had placed CAP, Inc as a named insured on his malpractice/liability insurance.   Otherwise, the corporation would have had horrific exposure in the event of a bad healthcare outcome.

Again, I'm glad it went well, but we should make sure that we provide complete descriptions to ensure that other activity commanders do not mistakenly allow CAP HSOs to perform any medical care beyone first aid in true emergencies.

Ned Lee
Encampment Guy
Former CAP Legal Officer

This post has some dust on it, but I thought it might be helpful to add one point about the treatment of cadets who have not reached the age of majority. Under the  laws which give a medical professional of whatever sort the authorization to treat a  minor, there is the issue of implied consent. It applies to people with altered mental status and also to children. If a cadet does something...say gets a nasty laceration and is taken to the nearest ER he can and will be treated under implied consent which essentially says that if his parents cannot be reached by phone or however else you might contact them, the ER doc essentially becomes the minor's guardian ad litem meaning that he has the authority to treat the child under the assumption that the cadet's parents or legal guardian would want him treated and cared for to the best extent possible. Its the same with EMS. If someone is not mentally capable of making to decision to accept or decline care or is a child who cant legally make that decision for themselves, we can report that we treated under implied consent and there is really very little concern about liability in such a situation.
Report to moderator   Logged
"Corpsman Up!"

"...The distinct possibility of dying slow, cold and alone...but you also get the chance to save lives, and there is no greater calling in the world than that."
Ned
Resident Philosopher

Posts: 2,233

« Reply #55 on: June 26, 2007, 05:06:05 AM »

This post has some dust on it, but I thought it might be helpful to add one point about the treatment of cadets who have not reached the age of majority. Under the  laws which give a medical professional of whatever sort the authorization to treat a  minor, there is the issue of implied consent. It applies to people with altered mental status and also to children. If a cadet does something...say gets a nasty laceration and is taken to the nearest ER he can and will be treated under implied consent which essentially says that if his parents cannot be reached by phone or however else you might contact them, the ER doc essentially becomes the minor's guardian ad litem meaning that he has the authority to treat the child under the assumption that the cadet's parents or legal guardian would want him treated and cared for to the best extent possible. Its the same with EMS. If someone is not mentally capable of making to decision to accept or decline care or is a child who cant legally make that decision for themselves, we can report that we treated under implied consent and there is really very little concern about liability in such a situation.

You may well be correct in your state.  But in most states (including my state of California) "implied consent" laws are designed for emergencies and situations where delay will entail substantial risk of permanent and substantial injuries.  Such laws do not apply to routine care.

As you undoubtedly know far better than I, most lacerations requriing  closure by stitches or staples have a window of several hours before the tough choices set in.  As a practical matter, any doc or emergency department will spend pretty much whatever time it takes to reach a legal guardian before suturing.

Again, these laws are very much a creature of state law, and vary somewhat across the 50 states, so you are probably correct for your state.  But that is also part of the problem.  Many CAP activities involve participants who cross state lines, and it becomes almost impossible for CAP, Inc to set out a uniform system of rules that could reasonably apply wherever we have members.

Finally, we again reach the problem that the emergency provider may well be covered for actions taken to ensure the good health of a minor patient, but even under optimum conditions, implied consent laws do not cover CAP, Inc for its decisions and actions.  Even if (and perhaps especially if) Mom and Dad cannot sue the doc or the EMS provider following a perceived bad outcome, they will surely come after the deep pocket; CAP, Inc.  Mom will argue that we delayed, or took the kid to the wrong facility, or lost the paperwork with their cell number on it so Mom could have been contacted before treatment, or whatever.

Bottom line is that implied consent laws -- however useful they are to ensure that patients are cared for and providers are relatively free of liability -- do not really help us in protecting CAP, Inc or somehow making it easier for HSOs to provide appropriate care within their scope of practice.

Ned Lee
Former Legal Officer
Report to moderator   Logged
SARMedTech
Salty & Seasoned Contributor

Posts: 798

« Reply #56 on: June 26, 2007, 06:19:47 AM »

I think there may have been some misunderstanding. I was only ever a paralegal and now do some medical-legal consulting on the side which basically involves interpretation of medical documents for lawyers and occasionally working as an expert witness in cases involving EMS. I didn't mean to indicate that it would be a CAP provider carrying for our hypothetical lacerated cadet. Here's my thinking: a cadet is climbing on something made of metal...I don't know what it would be...remember I am a nubie.  He slips and aside from destroying his brand new camos, he acquires a 10cm lac on his thigh. (we'll pretend that CAP wouldn't be liable for the injury because thats not what we're dealing with). This 10cm lac is bleeding severely. The sharp, eagle-eyed TAC officer calls 911. 911 arrives where the extraordinarily well trained and wise EMT assesses that this lac will have to be sutured. Now of course there is a window before the wound MUST be stitched. Based on experience thus far, I wouldn't say that I would like that window to remain open for hours. Perhaps and hour or two assuming that a health officer has controlled the bleeding with direct pressure from a fabulously well-stocked first aide kit. Now this laceration, because of its size, is considered a trauma which makes it emergent. Cadet gets to the ER, where every effort is made to contact the parents as the TAC officer is also trying to call the parents with his list of contact numbers. At this point, say 90 minutes post trauma the doctor will make the decision that he needs to close the wound because he is getting clotting where he doesn't want it and the tissue around the wound is looking quite pail. Here is the kind of thing I was talking about...the ER doc can make the decision (and I am keeping in mind that we are in different states) to go ahead and stitch because he rightly assesses that the parents would want their child to receive the best care he can. I have not been able to find any case law or statue through Find Law that says he cannot assume medical guardianship (ad litem) and treat the cadet. Further, if he didn't do this he could very well be deemed negligent by not meeting the mandated standard of medical care. Understand I'm not talking about a cadet getting something in his eye and going to the ER. I'm talking about a trauma. While California medical law has some twists and turns that don't exist in any other state, I cannot fathom that any court of compatent jurisdiction would day anything other than that the doc acted in the best interest of the child. So I'm not talking about about little injuries and not talking about a cadet that slips into a diabetic coma. I'm talking about the sort of thing that send young people to the ER everyday because, well, because they are kids and they get hurt. I do of course defer to an attorney's legal knowledge, but the National Registry of Emergency Medical Technicians which bases its protocol on California medical laws because they are some of the most stringent in the country, says that this would be a case of implied consent. You can tell I have worked in the legal field because I just typed forever and didn't say much. I would love to hear feedback because I appreciate "getting schooled" when it helps me be better at what I do. Honestly, I don't mind being proven wrong.
Report to moderator   Logged
"Corpsman Up!"

"...The distinct possibility of dying slow, cold and alone...but you also get the chance to save lives, and there is no greater calling in the world than that."
Ned
Resident Philosopher

Posts: 2,233

« Reply #57 on: June 26, 2007, 11:36:22 AM »

No, your scenario is almost certainly correct.  Under those circs the doc can and probably would treat and close because to do otherwise carries substantial risk of permanent scarring or worse.

The problem from the point of the thread ("medical sections") is that it is not very helpful one way or another since neither the doc nor the EMT as you've described are CAP members and you have excluded CAP liability from the discussion by definition.

So, yeah, the doc and the ems provider would almost certainly be free and clear.  But I don't want anyone thinking that a CAP doc or a CAP medic would be free and clear under either CAP regulations or state law for doing what your independent doc and medic did.

Some of my scariest nightmares come from hearing about CAP "medical sections" where cadet "medics" carry gear around and treat various issues at encampments and/or CAP HSOs treat members for anything other than a bona fide emergency.

That is a unspeakable risk to the corporation.  Such scenarios threaten our very existence.

And they happen almost every summer at some wings' encampments.

It must stop.
Report to moderator   Logged
SARMedTech
Salty & Seasoned Contributor

Posts: 798

« Reply #58 on: June 26, 2007, 06:09:17 PM »

I agree with everything you said, and my saying that is something that has evolved over time. Until and unless CAP gets a Medical Corps, which I have to say I do want to see, we have to be mindful. Sure, Im gonna help that cadet out with tending to that monster blister because he didnt think to take off his boot when his heal started burning like it was on fire. And if someone burns themselves (or gets a sunburn) or has a minor laceration that needs no stitching, Im gonna help clean them up, make sure that lac isnt dirty, find out what they cut it on and think about whether we need to be thinking about a tetnus booster, put a 4x4 and some cling tape on that thing and send them back out. Im not going to let someone be in pain or sick if there is a one-shot way I can give them aide to help them. And I carry gear so that if there is a major trauma, we can go high speed. I dont carry anything I am not proficient in using or licensed to use and Im not gonna go berzerk and think I can fix anything in the field. But I will wade into a trauma up to my neck and take full responsibility for what happens if me not doing so means a very bad outcome. The basic thing, is that as HSOs or EMTs or whatever in CAP, we are there largely to monitor for dehydration, symptoms of exposure to heat and cold, etc. And in the absence of a full EMS team on standby, truth be told CAP wants me and people like us there.  Do I carry quite a bit of medical battle rattle? You bet your boots. But 99.5% of it is to keep people comfortable, healthy, hydrated and happy. If a handful of TUMS is going to keep an officer happy,Ive got him covered or if a cadet gets stung or sun burnt with blisters, Im your go-to guy. But the rest of my gig is to do what needs to be done to assess, triage and stabilize whatever might happen until we can evacuate the cadet or officer or until the lights and sirens come up the road. As a CAP newbie and a hardcore EMS junkie, its taken me a while to get the concept. But now that I have it, I can settle into what I am there to do, keep folks in one piece so we can carry on with the operation or exercise and if the spit hits the spam I hold things together as best I can until the ambulance or helo comes in.
Report to moderator   Logged
"Corpsman Up!"

"...The distinct possibility of dying slow, cold and alone...but you also get the chance to save lives, and there is no greater calling in the world than that."
isuhawkeye
Salty & Seasoned Contributor

Posts: 1,311

John's web site
« Reply #59 on: June 27, 2007, 05:59:57 PM »

this is why we get permission slips, and telephone numbers. 

In five years of being a "Medic" at CAP activities I have never had an issue with getting approval for emergency treatment

administering cadet's prescription/OTC meds is an entirely different story.
Report to moderator   Logged
Pages: 1 2 [3] 4 5 6 Send this topic Print 
CAP Talk  |  Operations  |  Safety  |  Topic: Medical Sections
 


Powered by MySQL Powered by PHP SMF 2.0.15 | SMF © 2017, Simple Machines Valid XHTML 1.0! Valid CSS!
Page created in 0.074 seconds with 26 queries.