See 9-Echo-1 for a must read post: Unacceptable Risks and Such…
The Paramedic Lawyer
Browsing the archives for the Paramedic category
No Comments I received an email from a fellow firefighter and EMT that asked me about South Carolina law concerning firefighters, EMT’s and paramedics arming themselves with either lethal and/or non-lethal weapons.
I will first discuss the applicable South Carolina law on this issue. Next, I will discuss fire and EMS departmental concerns on this issue. I will conclude with my personal thoughts.
N.B.: South Carolina has a number of public-safety departments whose members are both certified law enforcement officers and firefighters/emts/paramedics. The majority of the below will not apply to these departments and their members, as SC provides expressly for certified law enforcement offers the ability to carry openly and/or concealed just about everywhere in the State.
I. South Carolina Law
A. SC Authorization to Carry a Pistol
South Carolina law does not expressly provide for firefighters, EMTs, and paramedics to “carry about the person, any pistol whether concealed or not…”1
In South Carolina your occupational status as a firefighter, EMT, or paramedic does not provide you open-carry or concealed-carry rights in the performance of your fire and EMS duties.
In other words, in order for you to carry while on duty, and in the performance of your fire and EMS duties, you must possess a valid South Carolina Concealed Weapons Permit issued from the State Law Enforcement Division.
B. SC Prohibited Places for Concealed Carry
1. South Carolina law expressly forbids concealed weapons permit holders from carrying in the following places: “private or public school, college, university, technical college, other post‑secondary institution, or into any publicly‑owned building”2
Your fire station or EMS station is likely a publicly owned building, therefore should you carry there, you are committing a criminal offense.
If you work for a private fire or EMS agency that is not publicly-owned, mere carry into that building may not be a crime, but South Carolina sets forth other prohibited places for concealed carry.
2. South Carolina law expressly forbids concealed weapons permit holders from carrying “into the residence or dwelling place of another person without the express permission of the owner or person in legal control or possession.”3
The majority of fire and EMS calls are to “the residence or dwelling place of another person.” In order for you to legally carry concealed into someones house, you would have to get their permission first.
Asking for permission gives away the fact that you are carrying concealed, defeating the purpose. Additionally, since you arrive at their doorstep in an official capacity, any consent they do give would likely be determined to be invalid as being made under duress. The consent is likely invalid because they may reasonably believe should they deny your request it would prevent you from putting out their fire or rendering them medical assistance.
If you violate this provision you are guilty of a misdemeanor and, upon conviction, must be fined not less than one thousand dollars or imprisoned for not more than one year, or both, at the discretion of the court and have [your] permit revoked for five years.4
3. South Carolina law expressly forbids concealed weapons permit holders from carrying into a “hospital, medical clinic, doctor’s office, or any other facility where medical services or procedures are performed unless expressly authorized by the employer.”
This covers where we transport our patients, and sometimes where we pick them up.
If you violate this provision you are guilty of a misdemeanor and, upon conviction, must be fined not less than one thousand dollars or imprisoned for not more than one year, or both, at the discretion of the court and have [your] permit revoked for five years.5
C. Non-Lethal Self Defense Weapons
Self-defense weapons generally considered non-lethal, such as pepper spray, are not covered by the SC Concealed Weapons Permit law, and are not expressly forbidden for firefighters, EMTs or paramedics to carry.6
D. SC Law, Conclusion
There are other prohibitions on places of carry, however I feel these are the most applicable ones to the issue at hand. If you hold a valid South Carolina CWP, you should have been made aware of these prohibitions in your training class. If not, or if you have forgotten them, visit the SC Code sections referenced, or visit one of the many Concealed Carry advocacy groups.
It should be rather evident that from the above that South Carolina law is quite hostile to any firefighter, EMT, or paramedic that chooses to employ their Concealed Weapons Permit to carry concealed on-duty.
Self-defense weapons generally considered non-lethal, such as pepper spray, are not covered by the SC Concealed Weapons Permit law, and are not expressly forbidden for firefighters, EMTs or paramedics to carry.
The carry of non-lethal self defense weapons will likely be determined by individual department or service policy, and is what we will discuss next.
II. Fire and EMS Department Policy on Lethal and Non-lethal Weapons
A. Policy on Concealed Weapons
If your fire or EMS department does not have a policy forbidding the concealed carry of weapons into the stations, and forbidding the concealed carry of weapons while on duty, it should. Immediately.
My discussion of the applicable South Carolina law above should be all that is required to support such a policy, aside from the liability implications of an employee discharging a firearm on duty.
B. Volunteers and Concealed Carry
Volunteers are a valuable resource to lots of departments across this State. If your fire or EMS department utilizes volunteers who respond POV from various locations, you need to be aware that your members may be carrying concealed weapons and bringing them to your scene.
While it may have been legal for them to carry where they were prior to their response, it may not be legal for them to carry into your scene, your station, and the hospital.
Your department should have a policy in place that deals specifically with volunteers responding with concealed weapons. An easy solution would be to have your members secure their weapons in a locked glove box or console within their vehicle prior to exiting and performing their duties.
C. Sign Requirements for Prohibiting Concealed Carry
Even though SC law expressly forbids carry into publicly-owned buildings, your department needs to reference SC Code Section 23-31-235, on the proper signage requirements required by law designating the station or other facilities as a prohibited place for concealed carry.
If you are a private fire or EMS agency, then you definitely need to reference this code section. The stickers you buy at Staples to stick on the door likely fail to meet the legal signage requirements for legally prohibiting concealed carry.
D. Policy on Carry of Non-Lethal Self-Defense Weapons
If your fire or EMS department does not have a policy on the carry of non-lethal self defense weapons you may need to consider one. You need to be aware that your personnel may already be carrying a variety of such weapons on-duty without your knowledge.
If you lack any policy and your personnel carry non-lethal self defense weapons, you should know that your department is liable for any injury that results from their use of such weapons. Non-lethal does not mean non-injurious.
If your personnel are carrying non-lethal self defense weapons with your permission, hopefully you have considered the following:
- Does your department have a continuum of force protocol?
- Does your Medical Director approve of a Non-Lethal Self Defense protocol?
- Does your department train your personnel in the proper use of non-lethal self defense weapons?
- Does your department issue non-lethal self defense weapons?
These are just some basic questions, but you should get the idea. A plaintiff’s lawyer could have a field day with you on the stand over just these questions, and this is just the tip of the iceberg of considerations.
III. Personal Opinions on the Arming of Firefighters and EMTs
First off, I hunt, I shoot, and I own firearms, including firearms for self-defense. I am a firm believer in the Second Amendment imparting an individual right.
I cannot, however, support arming firefighters, EMTs or paramedics with lethal weapons. Ambulance Driver has a previous post on this as well. Further, I cannot imagine a department knowingly permitting their members to carry concealed weapons on duty. The potential liability and public relations implications are huge.
If the scene is not safe, stage and wait for law enforcement. Wait however long it takes.
If the scene deteriorates, retreat to a position of safety. If law enforcement is not already on scene, get them. Do not re-enter the scene until law enforcement has secured it and made it safe to re-enter.
If a patient attacks you or is uncontrollably combatative in the back of the ambulance, stop the ambulance in a safe place and retreat. Use only what force is required to retreat and get to a position of safety. It is not patient abandonment if you retreat for your own safety. Get law enforcement on scene and allow them to use their tools and training to handle the combatative patient.
Further, if you were assaulted then you will need them anyway to file charges on the patient. It is a crime in SC to assault a firefighter, EMT or paramedic in the performance of their duties.
Some may argue that pepper spray or other non-lethal weapons are needed to ensure that you can escape a situation. That may be true. It is a crazy and violent world. I have worked in Savannah with medics wearing body armor and carrying pepper spray. (Although I had neither!) I understand that fire and EMS departments are issuing body armor to their members.
However, I consider the carry and use of non-lethal weapons anathema to our mission and in violation of our hard earned status as non-combatants. We are not the police, and that affords us a level of patient trust and interaction that our LEO friends don’t receive.
In my opinion carrying weapons and deploying weapons on our patients (or bystanders) revokes our non-combatant status and places us in greater danger.
These are just my personal thoughts on the matter.
Each jurisdiction is different, and may determine that their members need these tools. I just hope that those of us in the streets and those in administration take the time to answer the tough questions and perform the proper risk-benefit analysis in making a decision on this topic.
I would enjoy hearing why you agree or disagree.
- SC Code of Laws, Section 16-23-20. See also, SC Code of Laws, Section 23-31-240. [↩]
- SC Code of Laws, Section 16-23-420. [↩]
- SC Code of Laws, Section 23-31-225 [↩]
- Id. [↩]
- SC Code of Laws, Section 23-31-215. [↩]
- Id. [↩]
Allegedly1 a Firefighter/EMT with the Keene (N.H) Fire Department was being videotaped during a call. The resulting videotape has been published on YouTube and shows the Firefighter/EMT striking the video camera held by one photographer and confiscating a camera-equipped cell phone from another bystander.
Here is the video (H/T STATter911):
Here is an article describing the events surrounding the scene.2 The notable portion of the article is this:
Aubern Goodwin was able to stay with Kurt for a short while when he was placed into a holding area. She reportedly witnessed Mr. Rivera violently attack the handcuffed Mr. Hoffman. A call was put out to the Keene Fire/EMS for an ambulance as the attack injured Kurt’s neck. The EMS and sheriffs arrived and started ordering cameras turned off and areas cleared of people, all while spouting irrelevant HIPAA regulations in a blatant attempt to assert authority. One of the EMS workers, Captain Ronald Leslie, even stole a camera, directly snatching it out of a videographer’s hand.
Here is a letter written by the person who had their cell phone confiscated directed toward the Firefighter/EMT.
In this day and age cameras are everywhere. If you haven’t yet been photographed or filmed, you will be.
Let’s discuss some important topics so that you won’t be immortalized on YouTube and have the Fire and EMS blogs replaying your 15-minutes of infamy.
1. Smile: A Picture is Worth a Thousand Words
People can photograph and film you performing your firefighting and/or EMS duties. The general rule is that anyone may take photographs of whatever they want when they are in a public place or places where they have permission to take photographs.3 Streets, sidewalks, and public parks are examples of places that are traditionally considered public.
Property owners may legally prohibit photography on their premises but have no right to prohibit others from photographing their property from other locations.4
There are some exceptions though. You can’t be photographed or filmed where it is specifically prohibited by law. By law, I mean there must be a specific local ordinance or state law that prohibits photography in that specific location. Private ‘No Photography’ signs not backed by a local ordinance or state law likely are worthless.
The take away: you can legally be photographed or filmed without your consent when you are in a public place where you have no reasonable expectation of privacy. 5
2. Film, Memory Cards, Video Tape: It’s Not Yours To Take
You cannot confiscate cameras, film, memory cards or video tape. That’s theft.
You cannot demand film, memory cards or video tape be erased. That’s theft, too.
You cannot physically threaten a photographer. That’s assault.
You cannot prevent a photographer from leaving the scene unless they comply with your unlawful confiscation or erasure demands. That’s false imprisonment or kidnapping.
Got it? Good.
3. Camera Grabbing: Relax, Don’t Do It
Battery is both a criminal act and a civil tort. At common law, simple battery is an unlawful application of force to the person of another resulting in either bodily injury or an offensive touching. The common-law elements serve as a basic template; but individual jurisdictions may alter them, and they may vary slightly from state to state.
Importantly here, battery need not require body-to-body contact. Touching an object “intimately connected” to a person (such as an object he or she is holding) can also be battery.6
Grabbing, striking or hitting a camera, camera-phone, or video camera held by a photographer is likely battery. The photographer can file criminal battery charges against you and the photographer can sue you civilly for battery.
It’s simple. Don’t touch the camera.
4. Three’s a Crowd: Properly Making a Safe Work Space
If you find yourself crowded by a gaggle of paparazzi or even an overzealous single photographer, they may be interfering with your ability to do your job. In this case there is a right way and a wrong way to create a proper and safe working environment. As we discussed above, grabbing cameras or physically pushing photographers is the wrong way.
Utilize the available law enforcement on scene or get them on scene to assist you. All jurisdictions have disorderly conduct laws that the LEO’s can enforce. Disorderly conduct laws prohibit people from engaging in behavior that causes inconvenience, annoyance or alarm through disruptive behavior. Interfering with a firefighter or paramedic in the performance of their duties is likely to constitute extreme behavior rising to disorderly conduct.
Additionally, most jurisdictions have specific laws against interfering with police, fire or EMS workers in the performance of their official duties.
However, as an EMT or Paramedic your job is patient care, not law enforcement. Let the experts handle it. Get law enforcement on scene to assist you and allow them to handle the situation while you focus on the patient.
5. Silence: It’s Not Just for Mimes
The initial mistake I see from the video above is that the FF/EMT acknowledged and responded to the verbal taunts from the photographer. The photographer appears to be purposefully taunting and berating in order to elicit a response to capture on film. In this case he succeeded.
There appears to be an increasing trend of citizen journalists and shock journalists that seek to provoke confrontation to record. By responding verbally to these photographers they are only encouraged and emboldened.
You do not have to talk to anyone but your patient or someone directly related to the patient so you can properly assess your patient.
Focus on the patient. Ignore the photographers.
Conclusion
With the increasing prevelance of cameras, camera phones, and small video cameras, it is only a matter of time before you encounter being photographed or filmed on scene. You need to understand the basics of photographer’s rights and more importantly you need to know what not to do.
By following the 5 simple tips outlined above you can avoid an embarrassment on YouTube, save yourself the trouble of a criminal or civil complaint, and serve your patient by focusing on them rather than the circus around you.
- The word ‘allegedly’ is used here as a hedge, as I have not been able to locate a reliable source that details the actual sequence of events and actions. The posted video and statements from the links provided herein is all that I have presently located. [↩]
- It is unclear from reading this if the author was shooting the video in the above clip, was the person who had his camera confiscated, or was an uninvolved witness. [↩]
- The Photographer’s Right, Bert P. Krages, 2009. http://www.krages.com/ThePhotographersRight.pdf [↩]
- Id. [↩]
- You have a reasonable expectation of privacy only in places like dressing rooms, restrooms, inside your home, etc. In these instances, the photograph or film is not illegal, rather the invasion of privacy is illegal. In most jurisdictions invasion of privacy is a civil claim, not a criminal act. [↩]
- See Fisher v Carrousel Motor Hotel, Inc., 424 S.W.2d 627 (1967 [↩]
You and your partner Sam are dispatched to one of the areas of town that fail to make the shiny travel brochures for a 20 year old male with a chief complaint of leg pain. Upon your arrival you find the patient sitting on the living room couch with a bloody towel around his calf.
Your assessment reveals that he is stable with no other injuries or complaints other than his bloody calf. In response to your questioning the patient merely states that he fell. As you remove the towel from the calf to inspect the wound, you discover that there are two wounds, nearly identical in size on opposite sides of the calf. You attempt to further question the patient about how he fell, what he fell into, and what object went through his calf. Your patient fails to provide an answer requesting simply that you “wrap it up.”
At this point your paramedic spidey sense kicks in. You realize that you are looking at a gun shot wound. And you are in their crowded living room with just your partner, Sam, who is too busy dutifully digging out 4×4’s and Kling to appreciate your moment of clarity.
You quickly dress the wound and ask if your patient wishes to go to the ER. Your patient colorfully replies in the negative. You have your patient sign the refusal forms, politely bid your patient farewell, and beat feet to the rig.
“Central, 515.”
“Go ahead, 515.”
“515 requesting a Sheriff’s deputy meet us at the Piggly Wiggly on Devine.”
“Copy, 515. Stand by.”
“What are you calling the cops to the Pig for?”, Sam asks.
You explain that you have a duty to report treatment for a gun shot wound.
In your best Matlock voice you tell Sam, “In most all States any physician, nurse, or emergency medical services personnel who knowingly treats any person suffering from a gunshot wound or who receives a request for treatment of a gun shot wound shall report the existence of the gunshot wound to law enforcement in the city or county in which the treatment is administered or a request for treatment is received. However, no report is necessary if a law enforcement officer is present with the victim while treatment is being administered.1
“Then why didn’t you just ask Central to send you a deputy while we were on scene?”, quizzes Sam.
“Because people who tend to get shot at typically have their own devices that return fire. And I didn’t want to be between them and the cops. You know what I mean?”
“Besides,” you say, “my report to law enforcement may be made orally, but I will still document it on my PCR.”2
Crossing his arms, Sam retorts, “I just wouldn’t get involved. I mean what if they arrest the guy? His lawyer is gonna find out you ratted him out and sue your for a HIPAA violation!”
“Dude, you really need to read HIPAA. Not everything is a damn HIPAA violation. Anyway, since I am required to make a report to law enforcement, if I have to participate in judicial proceedings resulting from the report, I am immune from civil and criminal liability which might result as long as I act in good faith. Oh, and in all such civil and criminal proceedings, my acting in good faith is presumed.3
“And on top of that,” you continue, “my duty to report supercedes patient-provider confidentiality. In fact, patient-provider confidentiality does not constitute grounds for failing to report.”4
“Well, Perry Mason, what happens if you don’t report it?”, Sam jabs.
“If I knowingly didn’t report it I am guilty of a misdemeanor and, if convicted, must be fined not more than five hundred dollars.”5
“Oh,” says Sam.
“Hey, there’s the deputy.”
“Yeah, they always get here quick when you don’t need’em, huh.”
- South Carolina Code of Laws, Section 16-3-1072 (A [↩]
- South Carolina Code of Laws, Section 16-3-1072 (B [↩]
- South Carolina Code of Laws, Section 16-3-1072 (C [↩]
- South Carolina Code of Laws, Section 16-3-1072 (D [↩]
- South Carolina Code of Laws, Section 16-3-1072 (E [↩]
Epi who writes a great blog at Pink Warm and Dry needs your help in fulfilling her dream to be a paramedic. Bernice explains why you should chip in 5 bucks, and she also has the PayPal link on her site.
*cue violins* For the cost of an overpriced, oversugared, frapped, whipped and syruped Starbucks, you can help send Epi to medic school.*/smash violins*
Well, go on already and visit Bernice’s and chip in 5 bucks for Epi. I did, and you probably need to refill the karma bank as much me.
Good Luck, Epi! Don’t screw up.
Aug 11, 2009 Also posted at Paramedicine 101. Check out what else is there.
This post was generated from an email I received from Mark over at Medic999. One of Mark’s readers posted the details of a call he ran wherein the patient had a valid DNR order, and he was uncomfortable with the way the the DNR limited the available treatment options. You can visit Mark’s blog for a full run down of the opinions there.
For the readers outside of the United States, you should be aware that each State sets its own laws and regulations regarding DNR orders; there is no nationwide standard. Each State’s law may be different.
First a bit of a disclaimer: I am educated in United States common law and most specifically educated in the law of South Carolina, the State of my bar admission. I am also registered as a NREMT-P in South Carolina so I am most familiar with South Carolina’s laws on DNR orders.
I will focus first on the law within the jurisdiction I practice law and ride an ALS truck. I will then discuss my thoughts as to the call posted by Matt, and will end with a sampling of DNR regulations from other States for comparison.
Here in South Carolina we have the Emergency Medical Services Do Not Resuscitate Order Act. To establish a DNR order in South Carolina, the patient must: (1) have a terminal condition; and (2) the terminal condition must have been diagnosed by a health care provider and the health care provider’s record establishes the time, date, and medical condition which gives rise to the diagnosis of a terminal condition. Thus, it is a pre-requisite to have a physician established terminal condition.
When EMS personnel are presented with a valid DNR order EMS personnel must not use any resuscitative treatment. EMS personnel must provide that degree of palliative care called for under the circumstances which exist at the time treatment is rendered.
Okay, that is some great lawyer-speak, but what constitutes the “resuscitative treatment” we can’t give, and what does “that degree of palliative care called for under the circumstances which exist at the time treatment is rendered” mean for those of us in the street?
For that guidance we must consult South Carolina Department of Health and Environmental Control Regulation 61-7, Sections 1406 and 1407. In the event that the patient has a valid DNR order, the following procedures shall be withheld or withdrawn: (1) CPR; (2) Endotracheal intubation and other advanced airway management; (3) Artificial ventilation; (4) Defibrillation; (5) Cardiac resuscitation medication; and (6) Cardiac diagnostic monitoring. These 6 items are defined as prohibitive resuscitative treatment in the presence of a valid DNR order.
The following treatments may be provided as appropriate to patients who have executed a valid DNR order: (1) Suction; (2) Oxygen; (3) Pain medication; (4) Non-cardiac resuscitation medication; (5) Assistance in the maintenance of an open airway as long as such assistance does not include intubation or advanced airway management; (6) Control of bleeding; and (7) Comfort care. These 7 items are defined as the permissible palliative measures that can be given in the presence of a valid DNR order.
Okay, so that is what I can do and can’t do in the presence of a valid DNR order. But wait, there is more. When presented with a valid DNR order, I must honor it, regardless of the circumstances. If I can’t or won’t honor it, then I must immediately transfer patient care to another EMS provider or other health care provider who will honor it.
That is the law in the State I work.
Let’s restate Matt’s patient presentation: Elderly male, lungs full of fluid, SpO2 mid to high 60s on a nasal cannula, improved to about 69-70% with a non rebreather, respirations about 24, mental status , about a GCS 5. Nursing home staff states aspiration of vomitus, suction attempted with no relief. Valid DNR presented to EMS on arrival.
If I was presented with the above in my jurisdiction, right off the bat there are several things that I cannot do for this patient in the presence of the valid DNR order. I cannot drop an ET tube, King Airway or LMA. I cannot use a BVM to artificially ventilate. I cannot attach my LifePak 12 for cardiac monitoring.
My patient revoked my ability to use these tools, and I will respect their decision, but I won’t just watch them circle the drain. There are things I can do that may really help this patient. First, I will do my own assessment, as I do not trust NH assessments. I can still suction, so I would try to clear the airway as best I can. Here, an OPA is a basic skill, so dropping an OPA to maintain an open airway would be permitted. I can administer oxygen via non-rebreather over the OPA. (A tougher question would be whether CPAP or BiPAP is considered artificial respiration. I’ll punt on that one for now.)
I can also establish an IV and check a BGL. Who knows, maybe his blood glucose is 20 and an amp of D50 perks him up. I can…well, you get the idea. There are things we can do and should do to care for our patients.
I encourage you to become familiar with your State’s laws and regulations regarding DNR orders and your local protocols on DNR orders so that when presented with a valid DNR order you know what you can and can’t do to care for your patient.
These are tough situations for us because we are used to doing all we can with all we got. But we must remember that our primary purpose is quality patient care, and sometimes that means respecting our patient’s wishes regarding the end of life too.
Other State DNR order regulations for comparison:
Ambulance Driver and Rogue Medic have a really good multi-blog discussion going on stemming from an article by AD over at EMS1.com. Go read AD’s article, then the comments at his blog, then go read RM’s post and comments. Back already? OK.
I agree with both AD and RM that the mechanism of injury indicates your index of suspicion for certain injury types or patterns. In other words, the mechanism of injury should guide your patient assessment. The bottom line: You still have to assess the patient. Just because a patient experienced a mechanism of action that has an injury potential does not mean that the patient actually was injured. The MOI may raise or lower your index of suspicion for injury, but your assessment should rule in or rule out your suspicions, and you should treat based upon your assessment.
Treat the patient, not the MOI.
Let us examine the following comment excerpts and the EMT/Paramedic liability issues raised regarding patient assessment, over/under treatment, and over/under triage:
AD: But what about the restrained driver of a multiple rollover, who self-extricated from the vehicle, called the police himself to report the wreck, denies loss of consciousness, is totally lucid and oriented, denies any significant complaint, and whose NEXUS exam and other assessment findings are totally benign?
You gonna board and collar that guy, start two IVs, and fly him on the helicopter?
RM: It is appropriate to overtriage, rather than undertriage patients to trauma centers.
The patient in AD’s scenario has a high index of suspicion for a multitude of serious injuries. So, our assessment of this patient needs to be very thorough to either rule in, or rule out, our suspicions of obvious or hidden injuries. We ideally should triage and treat the patient based on our patient assessment and in accordance with our local protocols.
Does this mean if you don’t c-collar, long spine board, gain IV access, and fly him on the helicopter you are more likely to be sued for negligence? The likelihood of a suit usually depends on the patient outcome. The better questions to ask though are how thoroughly did I assess the patient, how well did I document my assessment, and did my assessment based treatment follow current protocols?
A plaintiff lawyer’s worst nightmare is the EMT or Paramedic who can recite in detail how they performed a thorough and professional assessment, how they treated the patient according to protocol based on that assessment, and have adequate documentation to support their assessment and treatment.
I would agree with RM that its is best to err on the side of over triage rather than under triage of your patients. A long term care facility manager told me once that they activate E911 for just about any resident complaint. His rationale: Families don’t get upset if you send Grandma to the ER when she doesn’t need to go, but they will definitely sue you if you don’t send her to the ER when she did need to go. I have heard and/or read this same statement elsewhere, so perhaps it is a training point of emphasis for nursing home managers and staff.
In any event, your triage and treatment should be based on your patient assessment, not merely on the mechanism of injury. I am not aware of any instances where an EMT or Paramedic was deemed negligent for the over triage of a patient, although that may change depending on the outcome of some of the recent helicopter EMS crash lawsuits.
From here, the comment discussion between AD, RM and commenter TED morph into a broader discussion on particular treatments and evidence based medical research supporting or not supporting particular treatments, leading to RM’s post linked above.
From my perspective this discussion raises four additional points for us to examine regarding EMT/Paramedic liability:
1. Spinal Immobilization vs. Spinal Immobilization Clearance;
2. Current Evidenced Based Research vs. Your Protocols and Treatment;
3. Present Mental Capacity; and
4. Informed Consent in EMS.
These four points and their associated liability issues are distinct enough to warrant their own posts. Stay tuned, as we will examine all four in turn.
Feb 17, 2009 Welcome to the Star of Life Law blog!
My name is Pete Reid. I am a Firefighter/Paramedic with the Town of Hilton Head Island Fire & Rescue Division. I am also a practicing Attorney in South Carolina.
Yes, you read that right! I am both a Firefighter/Paramedic and an Attorney. I get a lot of questions asking, ” Why on Earth would a lawyer become a firefighter and paramedic?” It is a story that I am happy to tell, and you can get the scoop on the ‘About Me’ page.
The Star of Life Law blog will focus on the legal issues involved in providing emergency medical services and rescue to patients in the field. I hope to accomplish this by examining old, yet persistant EMS problems, current EMS topics of interest, and through case studies. For example, we will be discussing proper EMS documentation on patient care reports, negligence, malpractice, and professional responsibility for starters.
This blog should be of interest to First Responders, Basic Emergency Medical Technicians (EMT’s), Paramedics, Firefighters, Medical Directors, EMS Administrators, and well, you get the idea. If you are involved anywhere in the EMS chain, this blog is for you. I take that back. This blog is actually for our patients, because they expect, demand and deserve quality patient care.
This blog is NOT about short-cuts or ends-around our responsibilities and obligations in providing quality patient care. This blog is about ensuring that your livelihood and reputation is not ruined by preventable mistakes in providing that care. No call is perfect, and we all make mistakes. We must, however, educate ourselves, learn from our mistakes, and learn from the mistakes of others.
I solicit and encourage your input and comments. I look forward to respectful debates in the comments, and hope that you will submit your questions or suggestions for posts on topics of interest and concern to you.
Let’s get started!