App alerts you when someone in your neighborhood needs CPR. People make a difference not the government when people need help

Posted: February 26, 2014 | Author: Recreation Law | Filed under: First Aid, Medical | Tags: Arvada Fire Protection District, Cardiac Arrest, Cardiopulmonary resuscitation, CPR, first aid, Mobile app, PulsePoint | 1 Comment

You too can be a hero and save a life. The app PulsePoint will notify you when someone near year need’s CPR.

I’ve written about the need and benefits for people to respond to medical and first aid emergencies. See You don’t need an engine to get to the hospital, and you may live if you don’t rely on one. Getting help may be better than getting there. Now there is an App to do that. PulsePoint is an app that does that; it notifies you if someone needs CPR that is close to you.

After downloading the app to your phone you pick the fire district where you live. The biggest issue is the few numbers of fire districts that have signed on; only one in Colorado. Once you have signed on, you will be notified if you are within a close area where someone needs CPR in any of the districts that have signed up.

Even if you don’t live anywhere near a fire district that is signed up, if you travel, you should still download the app. I’ll be in three of the fire districts that are available in the next couple of months.

Read the article In one Colorado community, a smartphone app might save a life. Then contact your fire-protection district and community leaders and encourage them to become part of the program.

There are thousands of you out there who have the training, have the experience and have the desire to help. Get the app, PulsePoint, and get involved. You too can save a life.

To learn how one community jumped on board see In one Colorado community, a smartphone app might save a life

What do you think? Leave a comment.

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The Wilderness Medical Society has issued new practice guidelines for Treatment of Exercise-Associated Hyponatremia and Spine Immobilization in the Austere Environment

Posted: January 23, 2014 | Author: Recreation Law | Filed under: First Aid, Medical | Tags: Exercise-Associated Hyponatremia, first aid, Good Samaritan, Medical guideline, Medical Protocols, Medicine, Practice Guidelines, Recreation, Samaritan, SAR, Spine Immobilization, Spine Immobilization in the Austere Environment, Treatment, Wilderness Medical Society, Wilderness Medicine, WMS | Leave a comment

The Wilderness Medical Society has issued new practice guidelines for Treatment of Exercise-Associated Hyponatremia and Spine Immobilization in the Austere Environment

If you have medical protocols (and why would you?) they just changed. If you run wilderness programs, a new guideline that you will be judged against has been created.

The Wilderness Medicine Society is the organization for writing guidelines for outdoor recreation and SAR community, besides being a great organization for meeting the experts in the field of wilderness medicine. If you are involved in the outdoors you should be a member! Join today.

The Wilderness Medicine Society is the First Aid Organization

The new guidelines have been developed over years of research by experts in the field. These experts include both the SAR personnel who find people and the physicians who treat the injured victims once they arrive at a hospital.

Join today and find out what these new guidelines are and how to implement them in your program.

Every legal problem does not have to have a legal solution. Sometimes you can just think!

Posted: January 8, 2014 | Author: Recreation Law | Filed under: First Aid | Tags: Education and Training, Emergency medical technician, EMT, first aid, First Aid Training, Guides, Marketing, Occupational Health & Safety, Outfitters, Risk Management, Standard of Care, Standards, training | 1 Comment

Damned if you do, Damned if you don’t really means you need to think

harder. Don’t make a rule or requirement; create a solution, solve the problem. Incentivize your employees to get training, advanced first aid training, and you avoid the legal problems and create a better work environment. Make a rule live and die by it. Provide training, incentive’s hire right and you don’t need the rule.

An article was posted recently about how outfitters and guides are damned if they do and damned if they don’t. The issue was whether the outfitter should require their employee/guides to have first aid training. Legally, the answer was a mixed bag; whatever decision you the outfitter made would both increase and decrease your risk. The article was 100% correct………legally.

However, that is not the end of the discussion (it was the end of the article). There are several ways you could have guides who have first aid training without making a rule.

1. The easiest way is to hire guides with first aid training. It does not have to be a requirement; it is just something you look for in an employee.

2. You could provide incentives to your employees to go get first aid training. You could provide paid study time, study help or even pay for successfully passing a first aid training course. All are relatively cheap, provide a great benefit to both the guide and the employee, provide your guests with first aid trained guides and not put your neck in a noose.

3. You can pay guides more who are first aid trained. Simply, the more training you have the more money you can make. Basic first aid provider with an eight-hour card is paid less than an EMT.

4. You can make first aid training a requirement for promotions or pay raises. If you say that your chances of getting a pay raise or a promotion is greater with first aid training do you think your employees will go get trained?

5. You can do the training yourself. One ski area I worked at became an EMT instructional organization and twice a week provided free EMT classes to its employees. By the end of the ski season, the number of EMT’s doubled on the ski patrol.

You can take a Red Cross Instructor course and the required first aid courses and quite soon become a Red Cross first aid instructor.

Teaching your guide’s first aid is the best first aid training your guests could ever hope for. Your guides will be trained in the problems your business sees. They will be trained with the equipment you carry and use. (I can’t tell you how many times I’ve come across a problem and dug through someone else’s first-aid kit hoping they had a particular item.)

English: First aid training dummies. (Photo credit: Wikipedia)

Your guides trained by you in the real problems they may face with the equipment they will be

using.

Here are five simple solutions to the problem. All solve the problem without creating a damned if you do, damned if you don’t situation. More importantly you have created an incentive in your employees without making rules, to help your employees and your business get better!

Do Something

Remember Marketing makes promises that Risk Management has to pay for? Man times outfitters advertise the first aid training of their guides; that is Marketing. What if you have made the promise that your guides do have first aid training? What if they don’t?

An example of how that could occur?

You advertise that each trip will have at least one EMT on the trip. The trip has four guides; one EMT and three basic first aiders. Halfway through the trip the EMT is evacuated. The trip can go on with three guides. However, what is going to have if someone is injured after the EMT has left the trip?

Have you not broken one of your own marketing rules? Have you not breached the standard of care you advertised to your guests?

You can always answer your quest’s questions. “Yes, we try to have an EMT on every trip, and all of our guides have first aid training.” Answering a question is not something on your website or brochure that will come back to haunt you.

Solve the problem; don’t legally put yourself in a box to become a target.

What do you think? Leave a comment.

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You don’t need an engine to get to the hospital, and you may live if you don’t rely on one. Getting help may be better than getting there.

Posted: December 18, 2013 | Author: Recreation Law | Filed under: First Aid | Tags: Bicycles, first aid, Good Samaritan, Samaritan, TED, Ted Talks, United Hatzlah, Urgent Care, Zambikes | Leave a comment

These two different first aid services are saving lives. One because traffic jams in a crowded city and one because nothing else is available. A rescue maybe your neighbor and a ride may be from a stranger. Both may save your life. Check out The Zambulance and United Hatzlah

United Hatzlah

I was impressed and motivated when I watched this TED Talk called Eli Beer: The fastest ambulance? A motorcycle. Here is how TED describes the talk.

As a young EMT on a Jerusalem ambulance, Eli Beer realized that, stuck in brutal urban traffic, they often arrived too late to help. So he organized a group of volunteer EMTs — many on foot — ready to drop everything and dash to save lives in their neighborhood. Today, United Hatzlah uses a smart phone app and a fleet of “ambucycles” to help nearby patients until an ambulance arrives. With an average response time of 3 minutes, last year, they treated 207,000 people in Israel. And the idea is going global.

The basis of the success is not the training or equipment. It is an app and the desire to help. The app notifies everyone who is signed up of an emergency in their area. They can respond 15-20 minutes faster than an ambulance can in normal traffic.

Mr. Beer ends the talk telling about a neighbor; a Palestinian saved his father’s life because he was trained, he volunteered, and he responded.

Zambikes

The second organization is called Zambikes Team. I met a volunteer of Zambikes at Interbike this past fall. Zambikes creates ambulances. By ambulances, I mean trailers that a sick or injured person can ride in pulled by a bicycle.

Zambikes says it is not saving someone’s life every two weeks. That is remarkable in a country were seeing a doctor may mean a 3-4-day walk.

Both are seeking contributions. If you so feel, please do.

However, both represent some things are I feel are a little greater.

United Hatzlah is not based on equipment but neighbors. How many people within a few blocks of you have first aid training and are willing to help if they are notified. Even if there is nothing they can do, having someone there to comfort an injured or dying person has unbelievable power and value.

How many Medical Exploring Posts, Girl Scout Units, Volunteer Ski Patrollers could respond to assist someone if they only knew they were needed.

Zambikes is taking the money and solving a problem in their country with their resources. It is not a situation where we are exporting American ideas and saving lives today to create a bigger problem tomorrow. Zambikes hires locals, (now 35 people) to build the bikes and trailers. It solves a problem with local resources without creating pollution, over-population or changing the local residents.

First aid without an ambulance is still first aid.

What do you think? Leave a comment.

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Wilderness First Aid

Posted: June 19, 2013 | Author: Recreation Law | Filed under: First Aid | Tags: 1st Aid, American Red Cross, Automated external defibrillator, Cardiopulmonary resuscitation, CPR, Emergency Medical Services, first aid, Good Samaritan, Outdoor recreation, Outdoors, PowerPoint, Presentation, Recreation, Schools and Courses, Survival and Primitive Technology, Wilderness First Aid, Wilderness First Responder | Leave a comment

Legally what is important about First Aid when you are away from EMS, what is not…………and what is just sleight of hand

Audience: Association of Outdoor Recreation and Education

Location: Keystone, Colorado

Date: 2010

Presentation: Wilderness First Aid http://rec-law.us/17L6pQB

This presentation looked at myths and realities of first aid and the special issues of wilderness first aid. It also examined the various state Good Samaritan statutes and why some first aid “designations” might now qualify under the act.

For additional articles on the subject see:

10 First Aid Myths http://rec-law.us/ySaAwO

Another Way to Teach CPR http://rec-law.us/xEEaRo

CPR is not fool proof http://rec-law.us/w4PrpE

Everyone should write first aid protocols…. Or you could just buy a first aid book!http://rec-law.us/wguXEW

First Aid has its Limits. By law! http://rec-law.us/xS1IEk

Letter to the Editor: Wilderness and Environmental Medicine http://rec-law.us/AjxzNj

Not a final decision, but I believe an indication of where the law of AED’s is heading however the basis for the decision is nuts! http://rec-law.us/yKC5te

Seriously, you have to send a memo about this, the issue is not what they are doing, it is who you are allowing to instruct. http://rec-law.us/Ap1bRu

Stopping a rescue when someone is willing to perform may create liability http://rec-law.us/xuMtOt

Remember the law changes constantly, this presentation may be out of date. Check back at www.recreation-law.com and with your attorney to make sure the information is still valid.

What do you think? Leave a comment.

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Email: Rec-law@recreation-law.com

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Facebook Page: Outdoor Recreation & Adventure Travel Law

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Mobile Site: http://m.recreation-law.com

By Recreation Law Rec-law@recreation-law.com James H. Moss #Authorrank

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Articles for OR Pros in the latest Wilderness & Environmental Medicine Vol. 23, No. 4 Winter 2012

Posted: December 27, 2012 | Author: Recreation Law | Filed under: First Aid, Medical | Tags: #HAPE, Accute Mountain Sickness, Altitude Illness, Altitude sickness, AMS, Autoinjector, Epinephrine, Ibuprofen, Wilderness Medical Society, WMS | Leave a comment

There are several critical articles here for OR Pros!

· Editorial: Does Ibuprofen Prevent Acute Mountain Sickness

· Altitude Sickness in Climbers and Efficacy of NSAID’s Trial (ASCENT):

· Placebo for Prevention of Altitude Illness

· Predictive Value of Basal Exhaled Nitric Oxide and Carbon Monoxide for Acute Mountain Sickness

· Wilderness Medical Society Practice Guidelines for Treatment of Eye Injuries and Illnesses in the Wilderness

· Use of Human Remains Detection for Dogs for Wide Area Search after Wildfire:

· Fifty-Three Hours of Total Sleep Deprivation has no Effect on Rewarming from Cold Air Exposure

· Injury and Illness in Mountain Bike Stage Racing:

· Letters to the Editor:

· Epinephrine Autoinjector Warning

· Using the 6-Minute Walk Test for Screening Summit Success on Mount Aconcagua

· Assessing Travelers’ Knowledge and Use of Coca for Altitude Sickness

· Possible Association with Amphetamine Usage and Development of High Altitude Pulmonary Edema

You can become a member of the Wilderness Medical Society by going HERE. Sign up today and learn for the rest of the year. Be on the knowledgeable end of wilderness medicine and able to offer your clients the latest in prevention and first aid.

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Online Heart Rescue Simulator

Posted: July 10, 2012 | Author: Recreation Law | Filed under: First Aid | Tags: AED, Cardiac Arrest, Cardiopulmonary resuscitation, CPR, first aid | Leave a comment

You can use this to learn to save a life or to test others in how they would respond.

Heart Rescue Project has created this internet based simulator to teach people how to respond to someone in a cardiac crisis. Click on the link and follow the instructions. It is pretty Amazing!

Click Here!

What do you think? Leave a comment.

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Latest edition of the WMS Wilderness & Environmental Medicine Journal is out.

Posted: April 5, 2012 | Author: Recreation Law | Filed under: First Aid, Medical | Tags: #Edema, #HAPE, #Nifedipine, Altitude, AltitudeSickness, health, High Altitude Pulmonary Edema, Journal, Medicine, Wilderness Medical Society, WMS | Leave a comment

If you work in the Outdoor Industry, you should be a member of the WMS.

The Articles in the Volume 23, Number 1, Spring 2012 edition of the Wilderness Medical Society (WMS) journal are great!

· Nifedipine for the Treatment of High Altitude Pulmonary Edema

· Background Rates of Acute Mountain Sickness-Like Symptoms at Low Altitude in Adolescents Using Lake Louise Score

· Peripheral Arterial Desaturation is Further Exacerbated by Exercise Adolescents with Acute Mountain Sickness

· Recombinant Angiotension-Converting Enzyme 2 Suppresses Pulmonary Vasoconstriction in Acute Hypoxia

· Physiological Bone Responses in the Fingers after More than 10 Years of High-Level Sport Climbing: Analysis of Cortical Parameters

· Medical Direction of Wilderness and Other Operational Emergency Medical Services Programs

· Novel Use of a Hemostatic Dressing in the Management of a Bleeding Leech Bite: A Case Report and Review of the Literature

· Wolf Spider Envenomation

· Managing Anaphylaxis in a Jungle Environment

· Increasing Creating Kinase Concentrations at the 161-km Western States Endurance Run

· Improvised Traction Splints: A Wilderness Medicine Tool or Hindrance?

· Animal-related Motorcycle Collisions in North Dakota

You are going to get great information by reading the newsletter, website and journal of the WMS. More importantly, I find the information is just as critical in telling you what not to do.

You can become a member of the WMS by going here. Sign up today and learn for the rest of the year.

What do you think? Leave a comment.

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WMS Trailblazer – January 2012

Posted: January 17, 2012 | Author: Recreation Law | Filed under: First Aid, Utah | Tags: Conference, first aid, Medical, Physcian, Recreation, Wilderness Medical Society (WMS), WMS | Leave a comment

[Wilderness Medical Society (WMS) Updates]

Leading the worldwide community of Wilderness Medicine

Trailblazer – January 2012

The WMS Staff would like to wish each of you a happy and healthy new year!Remember, we’re here for you. So, if there’s anything we can do to help you, please let us know.Loren Greenway | <a href=”mailto:teri | Jonna Barry | <a href=”mailto:jim

Announcements

Wilderness & Mountain Medicine Conference

February 4-8, 2012

Park City, Utah

If you are a physician, spend part of spring on Mt Everest learning!

Posted: October 14, 2011 | Author: Recreation Law | Filed under: First Aid | Leave a comment

Having trouble viewing this email? Click here

CME in a Winter Wonderland - The Canyons Resort

The Wilderness Medical Society and our prestigious Nepal partner, Peak Promotion, invite you to join us for the ultimate CME* adventure during the April-May 2012 climbing season. Together, we are able to offer you a well-priced, educational, all encompassing Khumbu Valley-Everest experience!
We’re rolling out this advanced notice now so you can plan ahead for this active CME adventure!
Everyone welcome!
All who participate in this WMS experience are required to join or be members of the WMS. Also, every participant must carry Evacuation and Medical coverage.
Due to the on-going demand for “adventure
and hands-on” wilderness medicine training
and experience, the WMS has put together
this world-class program.
This course offers the opportunity for continuing medical education while on an Everest base camp (EBC) trek, plus for those more climbing oriented, we offer a Camp 2, Camp 4 or full summit opportunity. WMS CME credit is available from Kathmandu to Everest base camp, and we are planning on two nights at EBC (not normally offered for Everest treks) in cooperation with Everest ER.

When:
	The Camp 4 and summit bid experience will begin March 22, 2012. For the standard EBC trek or Camp 2, four various start dates are available in April and May, so check the Everest Experience Calendar on the WMS website to decide which dates work best for you.
Where:
	Khumbu Valley, Nepal
Why:
	Because you asked for it! An amazing, once-in-a-lifetime wilderness travel adventure

Contact person:
Dr. Eric L. Johnson
eluthjohn@aol.com
Our partners:
Everest ER: everester.org
Peak Promotions: Mr.Wongchu Sherpa, owner info@peakpromotionnepal.com http://www.peakpromotionnepal.com/

Visit the WMS website wms.org/conferences/everest12 for details, complete schedule and cost breakdown.

*The Wilderness Medical Society (WMS) is accredited by the Accreditation
Council for Continuing Medical Education to provide continuing medical
education for physicians. The WMS designates this educational activity for
a maximum of 22AMA PRA Category 1 Credits™. Each physician should
only claim credit commensurate with the extent of their participation in the
activity.

If you know someone who might be interested, please forward!

This email was sent to jhmoss@gmail.com by info@wms.org \| Update Profile/Email Address \| Instant removal with SafeUnsubscribe™ \| Privacy Policy.
Wilderness Medical Society \| 2150 S 1300 E \| Suite 500 \| Salt Lake City \| UT \| 84106

Seriously, you have to send a memo about this, the issue is not what they are doing, it is who you are allowing to instruct.

Posted: October 4, 2011 | Author: Recreation Law | Filed under: First Aid | Leave a comment

To: All OEC Instructors
From: Nat OEC Program Director
Subject: Training Practices
Date: 9/19/11
It has been brought to my attention that during some of the refreshers Being held this year, individuals are being injured as a result of two much enthusiasm being projected during practical exercises. This is not acceptable. We need to insure that during the practical exercises, the students demonstrate that they know how to perform the skills but not to the extent that their volunteer patients sustain real life injuries.
A few examples would be:
Don’t perform real CPR on a pretend patient
Don’t tighten a tourniquet on a pretend patient
Don’t apply tension when demonstrating the Posterior SV dislocation reduction on a pretend patient.
Don’t apply traction when applying a traction splint on a pretend patient.
Don’t apply AED pads to a pretend patient.
Don’t give an Epi pen to a pretend patient.
I know these appear to be common sense but again we have already had some complaints of injuries during refresher training this year. It is incumbent on you as the OEC Instructor to insure safety for your patrollers during this training.

Thanks for your cooperation.

Besides, you are teaching illegal acts if you are teaching EPI use. See 10 First Aid Myths

What do you think? Leave a comment.

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Everyone should write first aid protocols…. Or you could just buy a first aid book!

Posted: May 11, 2011 | Author: Recreation Law | Filed under: First Aid | Leave a comment

Why does everyone in the outdoor industry continuously want to reinvent the wheel?

I received an email asking if they should write first aid protocols for the program. I answered no; it is a violation of someone’s copyright!

Everything you need has been written down by someone, why start from scratch. There are dozens of books on Amazon, that talk/teach/explain first aid. Don’t write first aid rules, buy a book. Buy several books and hand them out to your staff.

The books are written correctly most of the time and don’t violate the law, most protocols, I’ve seen if they do not violate the law, they march through the gray area.

On top of that remember, there are no first aid protocols in most states, unless you are a licensed health care provider, and in communication with a physician. Protocols do not exist, unless you are licensed and have no legal or medical value.

See: Letter to the editor: Camp Business to understand the first aid protocols issue.

What do you think? Leave a comment.

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Wilderness Medicine Journal for spring 2011 has some great articles you should know about

Posted: April 29, 2011 | Author: Recreation Law | Filed under: First Aid | Leave a comment

If you are in the outdoor industry you should be a member of the WMS.

The Wilderness Medical Society (WMS) Journal for Spring 2011 is available. Some of the articles include:

How Deep is your wallet? Dealing with injury, illness or death abroad
All Aboard! Cheap Options for Travel
10 Tips for Enjoying Tempting Food in Exotic Countries and Not Regretting it Later.
Call to Action/Response/Do Something

Read now and Join Now.

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Stopping a rescue when someone is willing to perform may create liability

Posted: April 25, 2011 | Author: Recreation Law | Filed under: First Aid | Leave a comment

Barnes v. Dungan et al., 261 A.D.2d 797; 690 N.Y.S.2d 338; 1999 N.Y. App. Div. LEXIS 5556

Supervisor prevented an employee from performing CPR on co-employee having a heart attack.

This is an odd and disturbing case. On top of that we never really learn all the facts. The appellate Court opinion stated the following facts.

An employee of the defendant Peace Plantation Animal Sanctuary suffered a heart attack while working. Another employee who was certified in CPR responded and offered to perform CPR. The responding employee’s supervisor, the defendant Dungan prevented her from performing CPR. The employee suffering the heart attack died.

The surviving spouse of the deceased sued Dungan, Peace Plantation Animal Sanctuary and the National Humane Education Society over the death of his wife. The last two defendants were never clearly articulated as to their relationship with the Peace Plantation, but appear to be associations affiliated somehow with the defendant plantation. The lawsuit was based on a claim of intentional interference with lifesaving medical assistance. The theory was if the CPR has been performed the decedent would still be alive.

The defendants filed a motion to dismiss claiming:

“no legal duty existed which required them to render emergency medical assistance; that workers’ compensation provided the exclusive remedy for decedent’s injuries…”

The trial court denied the motions to dismiss and the issues were immediately appealed. The appellate court looked at the issues and based its decision supporting the trial court on two issues.

The first was the Restatement Second of Torts §326 which states:

One who intentionally prevents a third person from giving to another aid necessary to prevent physical harm to him, is subject to liability for physical harm caused to the other by the absence of the aid which he has prevented the third person from giving

The second is a decision from Idaho, Riggs v Colis (107 Idaho 1028, 695 P2d 413) which held that for a viable claim to be proved there must be three people: “the victim, a rescuer, and on
e who prevents or interferes with the rescuer–and the aid must have been actually prevented.”

The court applying the Restatement and the analysis of Riggs, id., that the three “parties” were present and the rescue was denied.

The court sent the case back to the lower court for trial.

So?

None of the cases quoted by the court in this case had the clear facts which allow such an easy analysis. However, after reading the case, you are dying to find out what happened after the case was sent back. The case also is just disturbing to people who have continually trained and studied to render aid such as the people working in the outdoor recreation community.

Now we will never find out why the defendant Dungan prevented the rescue.
However, it is easy and clear that if you prevent someone from offering or rendering first aid, without a valid reason, you may be liable.

This case will not apply for lapses in time to survey the scene or to stabilize the scene. Valid arguments on why rescue was delayed or not provided should always protect the rescuer. The issue will be if someone has the skills to save someone and those skills are prevented from being used by another person.

This is very different from the issue that there is no duty to rescue. Unless you placed the victim in the peril from which the victim now needs rescued, there is no duty to rescue anyone. This is a basic tenant of US law and has been this way for centuries. Even a physician or EMT is allowed to drive past a car accident with no liability, unless they caused or where part of the accident.

That was an issue in this case. If there was no duty to rescue, the defendants argued there could be no liability for preventing the rescue. However, the court stated that having no duty to rescue was different and not a defense to preventing rescue.

So Now What?

This is a rare case; in fact, I’ve found no other case like it. To some extent, it is bothersome in that it creates another way to litigate in the US. To a major extent, it is comforting to know that people are willing to try and keep each other alive. There is some comfort in knowing that if someone prevents someone from rescuing you, saving your life, then at least their life will be miserable for a while.

For the outdoor industry, there is really nothing to learn from this case; however, it is one you should know about, to use when you are elbowing your way through a crowd to provide first aid to someone who needs it.
Remember unless you are the reason why the rescue is needed you have no duty to rescue. Once you start you cannot stop until you are relieved by a higher medical authority.

Jim Moss is an attorney specializing in the legal issues of the outdoor recreation community. He represents guides, guide services, outfitters both as businesses and individuals and the products they use for their business. He has defended Mt. Everest guide services, summer camps, climbing rope manufacturers; avalanche beacon manufactures and many more manufacturers and outdoor industries. Contact Jim at Jim@Rec-Law.us

Jim is the author or co-author of six books about the legal issues in the outdoor recreation world; the latest is Outdoor Recreation Insurance, Risk Management and Law.

To see Jim’s complete bio go here and to see his CV you can find it here. To find out the purpose of this website go here.

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Barnes v. Dungan et al., 261 A.D.2d 797; 690 N.Y.S.2d 338; 1999 N.Y. App. Div. LEXIS 5556

Posted: April 25, 2011 | Author: Recreation Law | Filed under: First Aid, Legal Case | Tags: CPR, first aid, Rescue | Leave a comment

To Read an Analysis of this decision see: Stopping a rescue when someone is willing to perform may create liability

Barnes v. Dungan et al., 261 A.D.2d 797; 690 N.Y.S.2d 338; 1999 N.Y. App. Div. LEXIS 5556
Donald R. Barnes, Individually and as Administrator of the Estate of Sharon L. Barnes, Deceased, Respondent, v. Earl Dungan et al., Appellants.
83597
SUPREME COURT OF NEW YORK, APPELLATE DIVISION, THIRD DEPARTMENT
261 A.D.2d 797; 690 N.Y.S.2d 338; 1999 N.Y. App. Div. LEXIS 5556
May 20, 1999, Decided
May 20, 1999, Entered

PRIOR HISTORY: [***1] Appeal from an order of the Supreme Court (Mugglin, J.), entered June 1, 1998 in Delaware County, which denied defendants’ motions to dismiss the complaint for failure to state a cause of action.
DISPOSITION: The order is affirmed, with costs.
COUNSEL: Coughlin & Gerhart LLP (Joseph J. Steflik Jr. of counsel), Binghamton, for Earl Dungan, appellant.
Ryan, Orlando & Smallacombe (Melissa J. Smallacombe of counsel), Albany, for National Humane Education Society, appellant.
Garufi & Garufy (Sandra J. Garufy of counsel), Binghamton, for Peace Plantation Animal Sanctuary, appellant.
Thomas E. Schimmerling, Delhi, for respondent.
JUDGES: Cardona, P. J., Crew III, Carpinello and Graffeo, JJ., concur.
OPINION BY: Peters
OPINION
[*797] [**339] Peters, J.
Sharon L. Barnes (hereinafter decedent) was an employee at defendant Peace Plantation Animal Sanctuary in October 1996 when she suffered a heart attack while on duty. Co-worker Jodi Seeley, certified to perform cardiopulmonary resuscitation (hereinafter CPR), immediately responded and offered to resuscitate decedent but was prohibited from doing so by defendant Earl Dungan, her supervisor at Peace Plantation. Plaintiff (decedent’s husband) [***2] contends that had Seeley been permitted to perform CPR, decedent would have survived the heart attack.
Plaintiff commenced this action, individually and as administrator of decedent’s estate, against Dungan, Peace Plantation and its parent organization, National Humane Education Society (hereinafter the Society), alleging, inter alia, an intentional interference with lifesaving medical assistance. Prior to answering, defendants each moved to dismiss the complaint pursuant to CPLR 3211 (a) (7), alleging that no legal duty existed which required them to render emergency medical assistance; that workers’ compensation provided the exclusive remedy for decedent’s injuries; and that as to the Society, there existed no legal relationship which would make it responsible for the action of either Peace Plantation or Dungan. Supreme Court denied defendants’ motions in their entirety, prompting this appeal.
[HN1] Our review, on a motion of this kind, requires that we liberally construe [**340] the pleadings and accept the allegations as true, yielding every possible inference [***3] in plaintiff’s favor (see, Leon v Martinez, 84 NY2d 83; Parker v State of New York, 242 AD2d 785; MacFawn v Kresler, 214 AD2d 925, affd 88 NY2d 859). From this procedural vantage, we find that Supreme Court properly denied the motions.
[*798] Notably, the complaint alleges that defendants affirmatively prevented Seeley, a co-employee, from administering CPR as opposed to a failure to provide or procure emergency medical assistance (compare, Herman v Lancaster Homes, 145 AD2d 926, lv denied 74 NY2d 601). Upon that basis, plaintiff contends that there existed a legal duty to refrain from interfering with Seeley, a third party, who was willing and able to render necessary medical assistance. The Restatement of Torts so defines that duty: ” [HN2] One who intentionally prevents a third person from giving to another aid necessary to prevent physical harm to him, is subject to liability for physical harm caused to the other by the absence of the aid which he has prevented the third person from [***4] giving” (Restatement [Second] of Torts § 326).
Although no New York court has been directly confronted with this issue and we make no comment as to whether the allegations, taken as true, will ultimately be proven, we acknowledge the standard enunciated by Riggs v Colis (107 Idaho 1028, 695 P2d 413), which addressed this issue in a motion for summary judgment. There, in analyzing whether there was a breach of the aforementioned duty when the defendant prevented a bystander from providing emergency aid to the plaintiff while she was under attack, the court instructed that [HN3] a viable claim must show “the necessary fact situation of three parties–the victim, a rescuer, and one who prevents or interferes with the rescuer–and the aid must have been actually prevented” (id., at 1030, at 415; see, Soldano v O’Daniels, 141 Cal App 3d 443, 190 Cal Rptr 310).
Here, notwithstanding the fact that both Dungan and Seeley were both employees of Peace Plantation at the time that Dungan ordered Seeley not to render aid to the decedent, we find that [***5] upon a liberal viewing of the complaint and an analysis of the claim upon the Riggs v Colis (supra) standard, Seeley may be found to have volunteered emergency medical care outside the scope of her employment, thereby constituting the “rescuer” who was prevented or interfered with by Dungan from rendering needed medical aid to decedent (see, id.).
As to defendant’s remaining contention that workers’ compensation is the exclusive remedy available to plaintiff, we find that such issue is not only an affirmative defense and does not address the sufficiency of the complaint, but [HN4] there also exists an exception to the exclusivity provisions of the Workers’ Compensation Law if the acts can be found to constitute an intentional tort as plaintiff alleges (see, Workers’ Compensation Law § 11; Matter of Blanchard v Integrated Food Sys., 220 AD2d 895; Acevedo v Consolidated Edison Co., 189 AD2d 497, lv dismissed 82 NY2d 748).
[*799] Finally, addressing the Society’s contention that there [***6] exists no relationship between it and decedent, we find that in accepting the allegations in the complaint as true, a cause of action is sufficiently pleaded. Whether there is actual control by the Society over the actions of Peace Plantation will be a question of fact to be determined at trial (see, Pebble Cove Homeowners’ Assn. v Fidelity N. Y., 153 AD2d 843).
Accordingly, we affirm Supreme Court’s order.
[**341] Cardona, P. J., Crew III, Carpinello and Graffeo, JJ., concur.
Ordered that the order is affirmed, with costs.

Be Afraid, be very afraid of pre-printed forms for your recreation business

Posted: April 13, 2011 | Author: Recreation Law | Filed under: First Aid, Risk Management | Leave a comment

This form will tell the plaintiff you screwed up!

I love looking at “risk management” paperwork. At a recent conference where I was speaking, I stumbled across this form. The form was titled Accident/Incident Report Form.

Most incident or accident forms are created to track information and to be used to evaluate and correct problems. 99.95% of the time they are used to fill up file cabinets and kill trees. Think about the purpose of these forms as I work through this one.

These forms are created with the belief that they will help. They are created with good intentions.
However, I practice law and try to do so by dealing with the hard realities of how my clients actually run their programs or businesses.

The form is probably used by lots of people because it is easy, pre-printed and solves their problems. It may also be easy to help you lose a lawsuit if you use it. How?

1. Forms prove you have problems two different ways.

A. You have a stack of forms. You have a problem. You have a lot of people getting injured, and you are not doing anything about it. The stack alone proves you run a bad program.
B. If you sort your forms based on activity, location, etc. You have a problem if you have on item, location or activity that has a stack of forms. If your stack of forms identifies a location or activity, and the injured person was at “that location” then you knew of a problem and did nothing to solve it.

2. Forms eliminate foreseeability. Foreseeability is a defense that you could not have known that an accident could occur because it was not foreseeable. Foreseeability is defined, to some extent, as not something you would expect to happen. Here is the definition of foreseeability from the Colorado Jury Instructions.

CJI-Civ. 9.21 FORESEEABILITY LIMITATION
The negligence, if any, of the defendant, is not a cause of any (injuries) (damages) (losses) to the plaintiff, unless the injury to a person in the plaintiff’s situation was a reasonably foreseeable result of that negligence. The specific injury need not have been foreseeable. It is enough if a reasonably careful person, under the same or similar circumstances, would have anticipated that injury to a person in the plaintiff’s situation might result from the defendant’s conduct.

3. Forms indicate you are behind at best and possibly grossly poor in managing the problems of your program because you have a stack of forms. Everyone has incidents, accidents and injuries (unless you are dead). However, keeping track of them is an indication that you have them and do nothing about them in the mind of plaintiffs and possibly juries.

4. Incident forms, just kill trees, they don’t need to be filled out. First the definition of an incident will vary from a program to program and from day to day in one program. The idea that you would track something that did not happen is just odd.

Stupid Human Tricks in Writing

This particular form has additional issues. On page one the form asks the question: “What could the injured have done to prevent the injury.” Never, ever, never ever put opinions down on paper. Only put facts. Opinions are not information, not a way to evaluate. They are the result, and if you did not see the accident your opinion does not count.

The next issue is a question. After the line for information on where the parents notified there is a question “Parents Response?” What has that got to do with the way you are evaluating the accident or incident? If this is truly a report form, why is the response of a parent on the form? Did you call the parents and ask their response?

If the parent says something that may be of value to you, and there is any possibility of it being introduced at court, write it down on a message to your attorney or risk manager. That may protect the information until it is needed, and it will not show up as part of the report. You do not want to make someone madder when they are reading about what happened to their child and find out what they said on the form.

If the form is truly for gathering information and tracking incidents it does not matter how the parents responded. Besides, how do you expect them to respond? You just called to tell them their child was hurt or worse, and you expect them to be jubilant?

The next “smooth move” on the form is “Person’s notified such as camp owner/sponsor, board of directors, etc.” Why is this on the form? What has this information got to do with incident or accident evaluation?

More importantly how do you think this is going to look when it is provided to the plaintiff’s attorney during discovery? Well, this was bad enough they called the board of directors. Good to know. Alternatively, and even worse, my client has a broken arm, and they did not notify the board of directors?

You should have a plan in place on who to notify if there is a problem. Follow the plan; don’t put it on a form that may come back with a big question. Why did you call those people? Did you know you had screwed up and wanted them to know to prepare for the worse?

Third great line is “Describe any contact made with/by media regarding the situation.” Answer I wanted the local reporter’s opinion on broken arms at summer camps. What does this matter on a form reporting an incident?

Again the information may need to be something that is recorded but separate the information to the correct form.

It was easier to run around and scream in a panic.

One line asked if “Emergency Procedures followed at the time of an accident. If you write no here, how are you going to explain that? You better write yes and if you are always going to write yes, why have the question on a form?

If procedures were not followed there is usually a great reason why, the procedures did not fit the situation. (They never do.)

Now for the best “line” I’ve seen in decades on paper.

“Insurance Notification” Under that heading it has checked boxes if the following insurance companies were notified.

Parent’s Insurance
Camp Health Insurance
Worker’s Compensation
Camp Liability Insurance

The first three make sense to me. You want to write down a claim number for the insurance claim when the claim is based on a duty to provide in a personal health insurance policy or a WC policy. However, why in the world would you write on this form that you contacted the Liability Insurance Carrier of the program? Can you see what this means to the plaintiff’s attorney when he or she receives this from? From the date of the accident onward they knew they had screwed up!

However, even if the information that is being tracked makes sense, what is it doing on that form? That is an accident report form, not an insurance report form.

I saw this tack of forms on a table and just glanced at them, flipped them over and laughed out loud when I saw that last line!

However, these forms are worse than the information they collect. They are worse because the information is collected to begin with. The purpose, although thought to be great and altruistic when started never works and usually becomes a nightmare.

A. Never track incidents. An incident at worse is your good luck that it was not worse. You can never track all the incidents and the definition of an incident will cost you a day on the stand and in deposition as the opposing attorney attempts to understand why you track something’s and not others.

An incident is anything less than an accident. That is the best definition you can reasonably apply. Are these incidents?

I grabbed the salt rather than sugar shaker while making cookies, through the cookie dough out.
Johnny was doing his swim test and panicked. I grabbed him and pulled him to shore.
Suzy fell off the climbing wall but landed on the pads. She is fine.
Jerry, a staff member did not have his locking carabiner on correctly, and it had snagged open on his shirt. I noticed it from the ground and let him know.

All have the potential to be accidents or disasters. Even so, you or your staff corrected the problem before the accident occurred. Track them? Heck no. The staff did what you had trained them to do, prevent accidents.

So?

Don’t write forms worried about lawyers and lawsuits. Do create forms based on what is needed. This form is needed to track first aid and accidents. Nothing more should be on this form than to track first aid issues and accident issues.

Next only create a form to collect facts. Never Opinions. It is not your job to write down an opinion. As soon as you do, more information will surface that may change your opinion. There is nothing worse than a corrected form especially when the changes are in the “what happened” section.

All the problems I’ve listed above violate the above two rules.

No opinions, no information other than what was needed to record information for future use. Record nothing that can come back to haunt you in court or worse make you look foolish or stupid in court.

How should you do it?

If you do record information, for accidents only record what is necessary. One ski area in Colorado could track 80% of the medical calls on the front and back of 5” X 7” cards. Witness statements were on a separate 5” X 7”. Do not collect anything more; who was injured, and their contact information, where they were hurt and any other important information.

Determine what you need? Then collect that and only that information.

What do you think? Leave a comment.

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10 First Aid Myths

Posted: December 8, 2010 | Author: Recreation Law | Filed under: First Aid | Tags: Adventure travel, Epinephrine, first aid, James H. Moss, Myths, Recreation, Ski Resort | 3 Comments

This Presentation was given at the 2010 Association of Outdoor Recreation and Education Conference at Keystone Colorado.

10 First Aid Myths

http://static.slidesharecdn.com/swf/ssplayer2.swf?doc=aoremed-101126114719-phpapp01&stripped_title=10-first-aid-myths-5924402&userName=JHMoss

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Maine Supreme court applies a broad definition to a well worded Good Samaritan Statute.

Posted: November 8, 2010 | Author: Recreation Law | Filed under: First Aid, Maine | Tags: Good Samaritan, Good Samaritan law, Good Samaritan Statutes, Lost, MAINE, Snowmobile, Snowmobiler | Leave a comment

Campbell v. Schwartz, 47 Mass. App. Ct. 360; 712 N.E.2d 1196; 1999 Mass. App. LEXIS 795

The Maine Good Samaritan Statute uses the word “rescue” rather than the more limiting term “emergency care.”

This case is about friends who went searching for a lost snowmobiler. The deceased was the third snowmobiler of a party of three who were traveling late at night in below-freezing weather. When the deceased did not arrive with the other two snowmobilers, two people went back to search for him. They found the deceased with a snowmobile that was not working.

Based on the condition of the deceased, time of the night, and the 20-degree below zero the pair decided to have the deceased ride behind one of the rescuers. During the ride back the deceased fell off the snowmobile and was run over and killed by the following snowmobile. At the time of this death, the deceased had a blood alcohol level of .34, four times the Maine legal limit.

The deceased’s widow sued the two rescuers for the death of her husband. The defendants raised the defense of immunity because of the Maine Good Samaritan Statute.

The Maine Good Samaritan statue reads:

14 M.R.S. § 164 (2009)
§ 164. Immunity from civil liability
Notwithstanding any inconsistent provisions of any public or private and special law, any person who voluntarily, without the expectation of monetary or other compensation from the person aided or treated, renders first aid, emergency treatment or rescue assistance to a person who is unconscious, ill, injured or in need of rescue assistance, shall not be liable for damages for injuries alleged to have been sustained by such person nor for damages for the death of such person alleged to have occurred by reason of an act or omission in the rendering of such first aid, emergency treatment or rescue assistance, unless it is established that such injuries or such death were caused willfully, wantonly or recklessly or by gross negligence on the part of such person. This section shall apply to members or employees of nonprofit volunteer or governmental ambulance, rescue or emergency units, whether or not a user or service fee may be charged by the nonprofit unit or the governmental entity and whether or not the members or employees receive salaries or other compensation from the nonprofit unit or the governmental entity. This section shall not be construed to require a person who is ill or injured to be administered first aid or emergency treatment if such person objects thereto on religious grounds. This section shall not apply if such first aid or emergency treatment or assistance is rendered on the premises of a hospital or clinic.

The statute uses a very broad definition of what type of care will be protected by the act “renders first aid, emergency treatment or rescue assistance to a person who is unconscious, ill, injured or in need of rescue assistance.”

The court found the actions of the Good Samaritans when they started to search for the lost snowmobiler to the time they found him dead was a rescue. The time, the temperature, the distance from safety as well as the fact they knew he had been drinking added up to a rescue.

So?

Because the laws are so different from state to state, you cannot assume that the protection provided, or that you learned about in one state will be the same in another state. The Maine statute, thankfully, is broadly written and broadly interpreted by the courts. For two rescuers, it was fortunate that they were in a state that looked at rescue as a necessity for the residents of the state and chose to encourage it rather than discourage it.

:What do you think? Leave a comment.

Jim Moss is an attorney specializing in the legal issues of the outdoor recreation community. He represents guides, guide services, and outfitters both as businesses and individuals and the products they use for their business. He has defended Mt. Everest guide services, summer camps, climbing rope manufacturers; avalanche beacon manufacturers, and many more manufacturers and outdoor industries. Contact Jim at Jim@Rec-Law.us

Jim is the author or co-author of eight books about the legal issues in the outdoor recreation world; the latest is Outdoor Recreation Insurance, Risk

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To see Jim’s complete bio go here and to see his CV you can find it here. To find out the purpose of this website go here.

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New AHA guidelines for CPR are out.

Posted: November 2, 2010 | Author: Recreation Law | Filed under: First Aid | Leave a comment

American Heart Association has adopted the compression only CPR.

The major change from the old guidelines is compressions are now the first thing to be done. In the past breathing was more important and started first: CAB rather than ABC.

· Compressions
· Airway
· Breathing

The old order was ABC, Airway, Breathing, Compressions.

Compressions are supposed to be 100 per minute or the same beat as the Bee Gee’s Song Staying Alive.
An AHA video about the new guidelines can be found here. The video is excellent!

General information and news about the AHA and the guidelines can be found here at: 2010 AHA Guidelines for CPR and; ECC.

To see the complete guidelines go to: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science

Thanks to Dr. Christopher Van Tilburg for this head’s up on his blog Mountain Rescue Doctor.

What do you think? Leave a comment.

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Christopher Van Tilburg, M.D. is a well known and respected Wilderness Medicine Doc.

Posted: October 28, 2010 | Author: Recreation Law | Filed under: First Aid | Leave a comment

He also writes a great blog about the medical and first aid issues in the wilderness. And he writes in English.

Dr. van Tilburg’s post of October 7, 2010 is about altitude sickness. In a couple of paragraphs, Dr. van Tilburg has compiled research and solid information about AMS into a layman’s article.

The focus of his post was a study on Kilimanjaro that stated the standard tactics for fighting altitude sickness did not work. The study Incidence and predictors of acute mountain sickness among trekkers on Mount Kilimanjaro showed that neither a single rest day nor drugs stopped AMS.

The post The Golden Rules for Alitude Illness finishes with the Golden Rule for Altitude posted at the International Society for Mountain Medicine created by David Schlimn and Tom Dietz.

GOLDEN RULE I
If you feel unwell at altitude it is altitude illness until proven otherwise.
GOLDEN RULE II
Never ascend with symptoms of AMS.
GOLDEN RULE III
If you are getting worse (or have HACE or HAPE), go down at once.

A quote from Dr. van Tilburg’s website tells of his experience.

I work as a mountain doctor at a ski resort, as a mountain rescue volunteer, and in a local emergency room. In addition to writing seven books, I serve as Editor-in-Chief for Wilderness Medicine, the official magazine for Wilderness Medical Society, for which I write a column called “Great Gear for Work and Play.”

Dr. van Tilburg’s website can be found here. You should follow Dr. van Tilburg’s blog and read the study.

What do you think? Leave a comment.

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The Wilderness Medical Society Wilderness & Environmental Medicine Journal Vol 21 No 2 2010 Selected Table of Contents

Posted: October 15, 2010 | Author: Recreation Law | Filed under: First Aid | Leave a comment

If you are not a member of the Wilderness Medical Society, and you are in the field of Outdoor Recreation you should be.

Editorial: In Tribute to Charlie Houston
Editorial: Search and Rescue Activity on Denali, 1990 to 2008
Editorial: Sidecountry Rescue—Who Should Respond to Ski Resort Out-of-Bounds Rescues?
Original Research: Search and Rescue Activity on Denali, 1990 – 2008
Original Research: End-Tidal Partial Pressure of Carbon Dioxide and Acute Mountain Sickness in the First 24 Hours Upon Ascent to Cusco Peru (3326 meters)
Original Research: Large Snake Size Suggests Increased Snakebite Severity in Patients Bitten by Rattlesnakes in Southern California
Case Report: Frostbite in a Sherpa
Brief Report: Detection and Management of Hypothermia at a Large Outdoor Endurance Event in the United Kingdom
Review Article: Wilderness Medical Society Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness
Original Research: Adverse Encounters With Alligators in the United States: An Update
The Wilderness Instructor: Advanced Wilderness Life Support Education Using High-Technology Patient Simulation

The article Wilderness Medical Society Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness is very important to anyone working in any alpine environment. A new program, possibly a standard of care, has been developed, and you should know about it.

The same goes if you are an instructor in the wilderness medicine field and the article Advanced Wilderness Life Support Education Using High-Technology Patient Simulation.

For information on why a membership to the Wilderness Medical Society is a great idea go here. To subscribe go to the Wilderness Medical Society go here.

What do you think? Leave a comment.

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If you are out of shape, you face greater risk skiing…….

Posted: October 5, 2010 | Author: Recreation Law | Filed under: First Aid, Skiing / Snow Boarding | Leave a comment

A study out of Stockholm Sweden found that out of shape skiers faced a greater risk of heart attacks. Being out of shape combined with the altitude, and the cold weather increased the risks of medical problems.
Previous studies showed that 40% of all deaths on ski slopes were heart attacks. The study did find some interesting facts.

39% of the heart attacks occurred on the first day of skiing.
56% of the heart attacks occurred in the first two days of skiing.
50% of the heart attacks occurred within the first hour of activity.
The average time of suffering the first effects was within two hours of hitting the slopes.
50% of the people who suffered heart attacks had not done the recommended level of training before skiing. Patients who suffered heart attacks lived at an average elevation of 557 feet and suffered their attacks at an elevation of 4,429 feet.

The report recommended that skiers train by undertaking two hours of exercise each day before heading to the slopes.

One commentator described the exercise, elevation and cold as the perfect storm for heart attacks.

The article suggested that people going to high altitude to ski should:

Increase physical activity gradually.
If you’re going to a high-altitude resort, wait a day before hitting the slopes or engaging in other strenuous activities.
If it’s a very high altitude resort, ask your doctor about strategies for acclimatization.
Dress warmly, in layers.

See Physically Unprepared Skiers Face Heart Risk

What do you think? Leave a comment.

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Another Way to Teach CPR

Posted: July 15, 2010 | Author: Recreation Law | Filed under: First Aid | 1 Comment

When I was teaching knots to Scouts I used to use a Black Rat Snake. I made the knot, I just used the snake to explain the basics. Eleven year olds where 100% attentive and watched my hands while holding the snake.

This is a great way to teach CPR.

http://vimeo.com/11673844

What do you think? Leave a comment.

First Aid has its Limits. By law!

Posted: July 13, 2010 | Author: Recreation Law | Filed under: Criminal Liability, First Aid | Tags: criminal liability, first aid, protocols | 2 Comments

However, you need to understand the law as well as first aid. Especially if what you are being taught is an illegal act.

A question posted on Facebook by a first aid training organization asked the question of its face book fans. The responses were all along the lines of a not been trained to perform the illegal act. Most of the answers were correct. However, what has me concerned is the issue that is an issue floating around in the wilderness first aid world.

The question asked about doing an illegal act. The question was, would you stitch a wound if you were in the wilderness? The vast majority of the answers was no. There were a few yes’s, most of them qualified.

There the correct answer is no it is an invasive act. Therefore, it is illegal for anyone other than a physician, or dependent upon the state, someone under a physician’s direct supervision and control. There seems to be a real issue on what someone can do in a first aid situation. Most people who received wilderness first aid training believe they can do anything if they have a doctor or physician advisor or who has taught them how to do it. There are many physicians who have the same belief.

(Remember this is a legal blog: no morals, no ethics just law.)

This blog is not the place to do a complete legal analysis of this issue. However, a short synopsis is appropriate. All first aid training divides the first aid provider into two groups: those who are licensed to provide first aid care and those who are not. A licensed first aid provider is an EMT, paramedic, nurse, nurse practitioner, physician assistant, or physician, etc. A person who has taken a test administered by the state and required by the state to take the test before practicing is a licensed health care provider. Non-licensed first aid providers are everyone else. The non licensed category includes Boy Scouts, wilderness first aiders, Wilderness First Responders, any person happening by the accident. Dependent upon the state where you are operating, a licensed first aid provider may be allowed to do invasive acts. No state allows a non-licensed first aid provider no matter what the training, to do any invasive act.

An invasive act is one where the first aid provider does anything more to an open wound other than clean and bandage the wound. It does not matter what they had been trained to do, or what they think they can do.

If it is a criminal act the person receiving the treatment, the injured person, cannot waive their right and allow the person to do it. It is still a criminal act the matter. The next legal issue is, no criminal act is protected any state Good Samaritan act.

I guess what I find disturbing is the idea that if the person has been trained to do this it would be okay for them to do it. That is not the case. You can be trained to perform heart surgery, but if you do not have a license to practice medicine it does not matter if you are the best heart surgeon in the world it is still a criminal act. If a physician will be standing in the room next to you and has agreed to abide by the state laws you may or may not be able to do something under that physician’s supervision and control. Supervision and control is defined differently in each state. In most states, it means the physician is in the same room where you are performing the procedure you have been trained in.

Does this mean that you get arrested if you do something like this? It totally depends on the outcome. If it’s a good outcome possibly not, if it’s a bad outcome possibly.

The issue is not my paranoia, the issue is the first aid training being received based on the egos of the instructors. And I’m not saying this to condemn any first aid instructor. I’ve met dozens and they are wonderful people. What I’m saying is we all love to impress people; we all love to stand in front of a group of people and tell them how to do things, to educate them. We want them to like us. This is one of the reasons why we teach. If that goes so far as to teach people that if they knew a little more they could do a little more that is where we cross the boundary. Sometimes it’s more than what you have been trained, sometimes it’s whether not you are teaching someone to violate the law.

So am I overly paranoid about that issue? Probably. Is my concern legally correct? Yes.

For more information about these issues see Legal Issues in Wilderness First Aid: Value of various first aid certificates and training, Legal Issues in Wilderness First Aid, and Legal Issues in First Aid #3: The prescription drug conundrum

See http://www.facebook.com/wildernessmedicine?ref=nf

What do you think? Leave a comment.

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CPR is not fool proof

Posted: April 20, 2010 | Author: Recreation Law | Filed under: First Aid | 2 Comments

$7.6 million jury award for seizure that occurs on a school playground. Suit based on a allegation that CPR was not performed fast enough.

It has been said the worst thing to do is outlive your children. Losing a child must be horrendous. Having a child survive but in a barely vegetative state must be close, but with no closure. However, when a child has a seizure, the chances of CPR (Cardio Pulmonary Resuscitation) working is slim at best.

The seizure was an epileptic seizure that occurred when the child was playing on the basketball court. Either the seizure or the fall stopped his heart. The parents argued that the CPR was not soon enough and not adequate.

Now this is where it gets real exciting. The family had received $361,237 from a seizure the child had in 2003. The child fell on a playground and suffered burns from the metal grate he fell on. A nurse and marine administered CPR bringing the child around.

WHAT IS THE KID DOING ON THE PLAYGROUND A SECOND TIME?

The school district offered to transport the child for free to another school where there was a full time nurse. The mother declined because it was too far away. Boy is it tempting to say something about losing opportunity at this point!

This is a sad case. This is also a disgusting case. This is a case where the phrase Fool me once shame on you, fool me twice shame on me fits. This is just stupid.

See Jury awards $7.6M for playground seizure.

What do you think? Leave a comment.

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It's not what I write, It's what you Learn

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You can use this to learn to save a life or to test others in how they would respond.

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If you like this let your friends know or post it on FB, Twitter or LinkedIn

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If you work in the Outdoor Industry, you should be a member of the WMS.

The Articles in the Volume 23, Number 1, Spring 2012 edition of the Wilderness Medical Society (WMS) journal are great!

You can become a member of the WMS by going here. Sign up today and learn for the rest of the year.

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Why does everyone in the outdoor industry continuously want to reinvent the wheel?

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If you are in the outdoor industry you should be a member of the WMS.

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Supervisor prevented an employee from performing CPR on co-employee having a heart attack.

So?

So Now What?

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To Read an Analysis of this decision see: Stopping a rescue when someone is willing to perform may create liability

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This form will tell the plaintiff you screwed up!

Stupid Human Tricks in Writing

It was easier to run around and scream in a panic.

Now for the best “line” I’ve seen in decades on paper.

So?

How should you do it?

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This Presentation was given at the 2010 Association of Outdoor Recreation and Education Conference at Keystone Colorado.

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However, you need to understand the law as well as first aid. Especially if what you are being taught is an illegal act.

So am I overly paranoid about that issue? Probably. Is my concern legally correct? Yes.

What do you think? Leave a comment.

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