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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