Online Heart Rescue Simulator

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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Copyright 2012 Recreation Law (720) Edit Law

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#RecreationLaw, #@RecreationLaw, #Cycling.Law #Fitness.Law, #Ski.Law, #Outside.Law, #Recreation.Law, #Recreation-Law.com, #Outdoor Law, #Recreation Law, #Outdoor Recreation Law, #Adventure Travel Law, #law, #Travel Law, #Jim Moss, #James H. Moss, #Attorney at Law, #Tourism, #Adventure Tourism, #Rec-Law, #Rec-Law Blog, #Recreation Law, #Recreation Law Blog, #Risk Management, #Human Powered, #Human Powered Recreation,# Cycling Law, #Bicycling Law, #Fitness Law, #Recreation-Law.com, #Backpacking, #Hiking, #Mountaineering, #Ice Climbing, #Rock Climbing, #Ropes Course, #Challenge Course, #Summer Camp, #Camps, #Youth Camps, #Skiing, #Ski Areas, #Negligence, #Snowboarding, #RecreationLaw, #@RecreationLaw, #Cycling.Law #Fitness.Law, #SkiLaw, #Outside.Law, #Recreation.Law, #RecreationLaw.com, #OutdoorLaw, #RecreationLaw, #OutdoorRecreationLaw, #AdventureTravelLaw, #Law, #TravelLaw, #JimMoss, #JamesHMoss, #AttorneyatLaw, #Tourism, #AdventureTourism, #RecLaw, #RecLawBlog, #RecreationLawBlog, #RiskManagement, #HumanPowered, #HumanPoweredRecreation,# CyclingLaw, #BicyclingLaw, #FitnessLaw, #RecreationLaw.com, #Backpacking, #Hiking, #Mountaineering, #IceClimbing, #RockClimbing, #RopesCourse, #ChallengeCourse, #SummerCamp, #Camps, #YouthCamps, #Skiing, #Ski Areas, #Negligence, #Snowboarding, sport and recreation laws, ski law, cycling law, Colorado law, law for recreation and sport managers, bicycling and the law, cycling and the law, ski helmet law, skiers code, skiing accidents, Recreation Lawyer, Ski Lawyer, Paddlesports Lawyer, Cycling Lawyer, Recreational Lawyer, Fitness Lawyer, Rec Lawyer, Challenge Course Lawyer, Ropes Course Lawyer, Zip Line Lawyer, Rock Climbing Lawyer, Adventure Travel Lawyer, Outside Lawyer, Recreation Lawyer, Ski Lawyer, Paddlesports Lawyer, Cycling Lawyer, #RecreationalLawyer, #FitnessLawyer, #RecLawyer, #ChallengeCourseLawyer, #RopesCourseLawyer, #ZipLineLawyer, #RockClimbingLawyer, #AdventureTravelLawyer, #OutsideLawyer, #HeartRescueProject, #HeartRescueNow, Cardiac Arrest, Heart Attack, #AED

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Articles from the Summer 2012 Wilderness & Environmental Medicine

If you are in the Outdoor Recreation industry you should be a member of the Wilderness Medical Society

This issue has it all, altitude issues, canoeing issues, mountain biking injuries, insect and snake bikes, CPR and the National Ski Patrol round out the articles.

Oximetry Fails to Predict Acute Mountain Sickness or Summit Success During a Rapid Ascent to 5640 Meters

Change in Oxygen Saturation Does Not predict Acute Mountain Sickness on Jade Mountain

Rare Mitochondrial DNA Polymorphisms are Associated with High Altitude Pulmonary Edema (HAPE) Susceptibility in Han Chinese

The Hawkesbury Canoe Classic: Musculoskeletal Injury Surveillance and Risk Factors Associated with Marathon Paddling

The Epidemiology of Mountain Bike Park Injuries at the Whistler Bike Park, British Columbia (BC), Canada

Fatalities from Venomous and Nonvenomous Animals in the United States (1999 – 2007)

Hyponatremia in an 85 Year old Hiker: When Depletion Plus Dilution Produces Delirium

Black Widow Spider Envenomation, a Rare Cause of Horner’s Syndrome

Effects of Cardiopulmonary Resuscitation at High Altitudes on the Physical Condition of Untrained and Unacclimatized Rescuers

Prehospital Medical Care and the National Ski Patrol

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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Copyright 2012 Recreation Law (720) Edit Law

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Summer Camp not liable for injuries of camper inflicted by another camper.

Murawski v. Camp Nageela, 4 Misc. 3d 1025A; 798 N.Y.S.2d 346; 2004 N.Y. Misc. LEXIS 1542; 2004 NY Slip Op 51045U

No advance knowledge of the possible assault does not make camp liable.

The plaintiff was a ten-year-old boy attending a multi-week summer camp. The plaintiff was attached by a smaller camper causing minor injuries and a broken finger. The plaintiff sued for “improper supervision and a failure to provide proper medical care after the assault.”

The defendants were the camp, camp employees and church officials who ran the camp. The defendants raised the defense of a spontaneous altercation that could not have been anticipated, and any delay in medical treatment caused no adverse effect upon the plaintiff.

The plaintiff shared a cabin with the camper who assaulted him. There had been a yelling altercation between the two boys prior to this incident. Generally, the two boys did not get along. The plaintiff was in the cabin looking for something. The smaller camper thought that the plaintiff was holding something of his when the two started yelling. The smaller camper eventually hit the plaintiff with a hockey stick.

The plaintiff did not complain to anyone about the other camper. The camp had no record of any problems and no one who saw the prior exchanges between thought those exchanges amounted to a major problem.

After the assault, the camp nurse splinted the finger of the plaintiff and followed up with the plaintiff twice. Each time the plaintiff informed the nurse his finger was feeling better. Two days later the plaintiff’s mother came to camp and took the plaintiff away for several hours. When she came back she asked the plaintiff’s finger be x-rayed. (For some reason, some reason this seems like a red flag to me.)

So?

For camps, the first hurdle that is always misunderstood by parents, rarely understood by camps and sometimes missed by courts is the standard of care that a camp owes to a camper. That standard is that of a reasonably prudent parent. That standard does not require constant supervision. The court found that constant supervision would not be a desirable situation because it would not foster self-reliance in the campers.

Camps, like schools are not insurers of safety for they cannot reasonably be expected to continuously supervise and control all movements and activities of the campers. . . .. In order to establish a breach of the duty to provide adequate supervision a plaintiff must show that the camp authorities had sufficient specific knowledge or notice of the dangerous conduct which caused the injury; that is, that the third-party acts could have reasonably been anticipated

Because constant supervision is not required, to be liable under New York law, the plaintiff must prove the camp was on notice that there was a problem or that a camper had exhibited dangerous conduct.

….there is no factual basis to conclude either that the camp’s agents had knowledge constituting notice of a particular danger to the infant plaintiff prior to the incident or that the incident that caused the infant plaintiff’s injuries was anything other than a sudden, unanticipated independent act by a fellow camper.

Thus without knowledge of prior bad acts or an intent on the part of the attacking camper, the camp is not liable for the acts of the smaller camper.

The next issue the court reviewed was the medical care. Several issues supported the camps’ defense.

The camper was inspected by a nurse initially and twice with follow ups. Each time the plaintiff told the nurse he was getting better. There was also no long-term damage to the plaintiff’s finger which would give rise to a claim or greater damages. Also, the plaintiff could not prove that the failure to provide immediate care did not cause injury upon the plaintiff.

So Now What?

You cannot rely on courts to inform parents of the standard of care that you must use with their children. That will eventually lead to insurance premiums you cannot afford.

Nor can you tell parents that you will treat their child with the same care they would. Again, parents never do anything that injures their child and any injury will create a problem for you.

What you can do is inform the parents of two things.

·        How hard you work to keep kids safe.

·        Kids get hurt.

As I have said repeatedly, absent foam rubber on every tree and trial, kids are going to find a way to get hurt. You need to make sure that parents know that the adventures and excitement that draw kids to your camp are the same things that may issue them. Like riding a bike, it takes a few crashes to learn how to ride a bike, and as you get better you push your limits more and crash some more.

If you do not get this idea across to parents, every time a kid is hurt, you may have to have a judge prove to the parent you are not liable. That is costs too much time and money.

The scary aspect of this case is the issue of medical care. Twenty years ago when I first started looking at cases in the outdoor recreation community, I never saw any allegations concerning medical care or first aid. Recently, I’ve written about two cases where it was an issue, and it seems to be a growing issue.

What do you think? Leave a comment.

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Copyright 2012 Recreation Law (720) Edit Law

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WMS Trailblazer – January 2012

[Wilderness Medical Society (WMS) Updates]

5.jpg?a=1102933063419Leading 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 ConferenceAmphu_laptse.jpgFebruary 4-8, 2012

Park City, Utah

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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

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.


10 First Aid Myths

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
What do you think? Leave a comment.

Copyright 2010 Recreation Law (720) Edit Law, blog@rec-law.us


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First Aid has its Limits. By law!

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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This is how a standard in the industry changes

It moves up because the best get better.

Many people believe that the standards of an industry change three basic ways.

#985 Airport not in Japan

#985 Airport not in Japan (Photo credit: Nemo's great uncle)

1.)    The entire industry gets better.

2.)    The bottom, or worst part of the industry gets better; or

3.)    Written standards are created that makes the industry get better.

All three are incorrect. (The third belief serves the opposite effect and usually promotes lawsuits.)

Standards change when the best get better and move the standard in the industry upward. It was recently reported that the Boy Scouts of America purchased AED’s for all of its offices and camps. That is an example of the standard changing for camps. It may not affect the youth the camps are designed and run for, however it will affect the adults at the camp.

Has this changed the standard of care for adults and visitors at camps?

In this case we have the largest promoter of camping in the US with 4 million members and more than 300 offices and close to 400 camps putting AED’s in their camps. This is a major move on the part of the industry. A significant, as measured by numbers or percentages of the industry now has AED’s at their camps.

If other youth camps, either based on this, or on their own start installing AED’s as their camps the standard in the industry is shifting towards or requiring having AED’s in camps.

The standard changed.

What do you think? Leave a comment.

Copyright 2011 Recreation Law (720) Edit Law, Recreation.Law@Gmail.com

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History of the Boy Scouts of America

Image via Wikipedia

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Letter to the editor: Camp Business

May 1, 2008

Rodney J. Auth, Publisher

Camp Business

PO Box 1166

Medina, OH 44258-1166

Re: Medical Matters: Properly stocking a first-aid station
Camp Business May/June 2008
Dear Mr. Auth:

I read with interest and concern the article Medical Matters in the May/June Camp Business. I believe it should be pointed out that no liability protection is provided by receiving doctor’s standing orders or physician protocols. I’m going to use the term protocol to refer to standing orders. This is the term used in the medical industry and by state statutes to define a physician directing a non-physician to do a procedure that is more than first aid. A physician issuing a protocol which the camp follows does not provide any liability protection to a camp.

There are two main issues that define how a protocol can be issued by a physician. The first is to whom the physician’s protocol is transmitted. That can be either a licensed health care provider within the scope of their duties as defined by state law or an employee of the physician under the supervision and control of the physician.

A licensed health care provider is a nurse, physician assistant, paramedic or emergency medical technician; someone is has been issued license by the state. Whether and how someone is licensed is controlled by state law and varies by state. The scope of the duties a licensed health care provider can provide outside of the supervision and control of a physician also varies by state. A good example is the states are split about evenly on whether an EMT can use epinephrine without a physician’s approval. This difference is also important if you are hiring a health care provider. Make sure you hire the person who is licensed by the state to perform the level of health care you expect under the law where the health care is to be performed.

The second, if a person is not a licensed health care provider they may still be able to act, however they must be under the direct supervision and control of a physician. That generally means the physician has trained the person in the procedure, the physician has employed the person to administer the procedure and the physician is within the distance required by law. Distance varies by state. In Colorado the physician must be within 30 minutes of where the procedure is being done and be able to get there. In Arizona the physician must be in the same room as the person administering the procedure.

As such, for most camps in most states physician protocols for non-licensed camp personnel provide no liability protection. Any liability protection that a proper protocol does provide does not stop any litigation; it just changes the claim from failure to provide proper first aid to a medical malpractice suit and ads the physician as a defendant.

Also of concern is asking a physician to issue a protocol that puts the physician at risk for review or worse by their state physician licensing agency.

Things have changed dramatically from my camp staff days. One of the main duties in preparing for the campers was scraping the m off M&M’s in anticipation of homesickness problems.



Sincerely,



James H. Moss
Editor Outdoor Recreation Law Review
www.snewsnet.com/lawreview
http://rec-law.blogspot.com/

For more information on this subject see: Legal Issues in First Aid #3: The prescription drug conundrum, Legal Issues in Wilderness First Aid: Value of various first aid certificates and training, Arizona adopts epinephrine Good Samaritan law, Legal Issues in Wilderness First Aid

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