Volunteer Duty To Act

[LTNRFD 266]

And how should you protect yourself from any blood or other disease carrying fluid if you don't have the equipment? If you do not identify yourself as an ems provider and you do not start patient care then you are not guilty of any misconduct. Please post the law that says if I have an EMT sticker on my car I need to stop and render help. This is absolutely ridiculous.

Patient abandonment.

You must have been on a run during your on duty EMT training when medical legal was covered. If you advertise that you are an EMT, stickers, lights on your car and you pass an accident scene and someone grabs your license plate, you could be cited for patient abandonment. It has to be proven that the EMT was driving and he aid would have made a difference. The chances of this happening are slight, however it could.

How would you deal with the blood and fluid issue. Your training tells you not to come in contact with it. If you don't have gloves and eye protection, you are covered by your training. Safety first. You can only function at your level of training and equipment on hand.

[Guest]

If i'm reading your post correctly, its most likely because EMS calls don't require the manpower you'd need for a MVA or fire call. Having 40 or 50 people show up for an EMS call would be a waste of manpower and time. If you have 5-6 people to assist at an EMS scene normally thats all you need.

I'm sorry want I was saying is that I get maybe 2 to 3 people for a rescrue call (ems), but if we have a fire or MVA the whole department will show up. I'm not saying that we don't need more manpower for fires and ect, but its really to hard to backboard someone with just 2 respounders. believe me I have had to do this. My chief did ask people after that to come help with rescrue calls more and they have. I'm the only EMT at the station right now and go on all the call I can, but I do have to work.

[Guest MVFD334]

Patient abandonment.

You must have been on a run during your on duty EMT training when medical legal was covered. If you advertise that you are an EMT, stickers, lights on your car and you pass an accident scene and someone grabs your license plate, you could be cited for patient abandonment. It has to be proven that the EMT was driving and he aid would have made a difference. The chances of this happening are slight, however it could.

How would you deal with the blood and fluid issue. Your training tells you not to come in contact with it. If you don't have gloves and eye protection, you are covered by your training. Safety first. You can only function at your level of training and equipment on hand.

If you havent initiated patient care how can you be charged with patient abandonment? You never stepped out of you vehicle. That is among the first things you learn in EMTB class (scope of practice,standard of care,negligence,abandonment,duty to act, consent) Once you have started care it your duty to act on what you have been taught until someone with the same training or a higher level takes over.

[gamewell45 258]

5 or 6 people? 3 or 4 is more than enough.

I was factoring in the EMT, Driver, 2 fire police for traffic/scene safety and 2 additional hands incase help lifting is needed.

[NWFDMedic 58]

Patient abandonment.

You must have been on a run during your on duty EMT training when medical legal was covered. If you advertise that you are an EMT, stickers, lights on your car and you pass an accident scene and someone grabs your license plate, you could be cited for patient abandonment. It has to be proven that the EMT was driving and he aid would have made a difference. The chances of this happening are slight, however it could.

How would you deal with the blood and fluid issue. Your training tells you not to come in contact with it. If you don't have gloves and eye protection, you are covered by your training. Safety first. You can only function at your level of training and equipment on hand.

This is actually a misnomer. There are states that require EMT's to act in the event of coming upon an emergency. New York state is not one of them. I have paramedic plates and nobody could do anything to me if I didn't stop to help an ill or injured person. However, is there really an EMT, firefighter, or LEO here that wouldn't offer assistance to a person in need? It may not be safe for me to stop or if I do, I may not have any equipment to do anything safely, but I would at least call 911 and I think most public safety providers would do the same.

There ARE some towns out there that require EMT's in their jurisdiction to stop and offer whatever aid they can. I would suppose that would be something you would have to agree to as a member of that agency.

Finally, the issue of the EMT at the station. If I were the officer, I'd probably want to insert some foot in rear end if qualified and able personnel sat in front of the television while a call went out. We have some guys at our house that may not prefer to go, but in the absence of other personnel, they will respond. While it may be a departmental issue, I don't believe there is any liability on the provider unless the patient presents to the fire station (or locally established policy requires you to respond). If someone comes to your station sick and you don't offer aid, I would suspect you'd better get a good lawyer.

[INIT915 1,119]

Patient abandonment.

You must have been on a run during your on duty EMT training when medical legal was covered. If you advertise that you are an EMT, stickers, lights on your car and you pass an accident scene and someone grabs your license plate, you could be cited for patient abandonment. It has to be proven that the EMT was driving and he aid would have made a difference. The chances of this happening are slight, however it could.

How would you deal with the blood and fluid issue. Your training tells you not to come in contact with it. If you don't have gloves and eye protection, you are covered by your training. Safety first. You can only function at your level of training and equipment on hand.

Please cite under what section "you could be cited for patient abandonment." I suspect you will not be able to, as this is nonsense.

[ny10570 745]

Worst case you're looking at failure to act.

[CAM502 6]

As previously said, in NY YOU DO NOT HAVE TO STOP AND ACT AS AN EMT , MEDIC OR OTHERWISE. If you do stop and intiate patient care you must be relieved by a higher medical authority (IE: EMT hands off to the medic, Medic to a flight nurse or doc, etc...). Locals laws may differ. A town law may say a member of the local VAC must stop if they see something in town. If you are in a marked Emergency vehicle it is a different story.

Now as for this crap about sitting in quarters and still picking and choosing calls....your chief needs to get some....and kick them in the rear.

[helicopper 1,050]

As previously said, in NY YOU DO NOT HAVE TO STOP AND ACT AS AN EMT , MEDIC OR OTHERWISE. If you do stop and intiate patient care you must be relieved by a higher medical authority (IE: EMT hands off to the medic, Medic to a flight nurse or doc, etc...). Locals laws may differ. A town law may say a member of the local VAC must stop if they see something in town. If you are in a marked Emergency vehicle it is a different story.

Now as for this crap about sitting in quarters and still picking and choosing calls....your chief needs to get some....and kick them in the rear.

If you stop your personal vehicle and render assistance while off-duty you could also transfer care to another BLS provider who is the primary provider for that area. You do not have to transfer care to only a higher level of certification. If you're a paramedic, you're only operating as an EMT in such a scenario and also wouldn't have to wait for ALS to turn over care. Whoever is "on-duty" and arrives gets 'em.

If you're in a marked vehicle you'd better abide by the rules and regulations of the agency who owns and operates the vehicle. If you're in the station, you better find out what the rules are. Personally, if there's no rule and I can sit and watch the big screen TV whle others respond to calls then its time to update the SOP!

As for abandonment, unless you have had established a patient care relationship with the victim abandonment would not apply. You stop, drop an airway in an unconscious victim and leave 'cause you have tickets to the game = abandonment.

I'm also under the impression that Good Samaritan Laws only apply to the lay public but its been a really long time since I've researched that and could be wrong.

If anyone has any citations to the laws that apply to cases like this please post them so we can back up the discussion with facts. "I heard" doesn't cut it and as good as many instructors may be, erroneous information does get out there.

Future posts citing a law or referencing an official regulation will be deleted if they are not backed up by a citation or reference to the source. The last thing we want is someone to use as their defense "But on EMTBravo it said..."

[LTNRFD 266]

Please cite under what section "you could be cited for patient abandonment." I suspect you will not be able to, as this is nonsense.

As I stated earlier you may be charged. It would be a stretch to think that by you just driving by this could happen. With that said, the med/legal lawyers that I have heard talk on this topic all make this point that you may be charged. If you just drive by and can't stop, most likely nothing will come of it. No one is even going to know you were there. What they refer to is the people with the placards, stickers, lights, sirens etc. on there POV or jackets that are a walking billboard, slowing up or stopping at the scene, looking then going on there way. The lawyers explained it as, it may have prevented some other trained person from stopping because they saw another responder already on the scene.

You may not have contacted the patient directly, but you may have prevented the patient from receiving 1st aid.

I don't make these things up, this is how the Med/Legal lawyers view the statutes.

[helicopper 1,050]

As I stated earlier you may be charged. It would be a stretch to think that by you just driving by this could happen. With that said, the med/legal lawyers that I have heard talk on this topic all make this point that you may be charged. If you just drive by and can't stop, most likely nothing will come of it. No one is even going to know you were there. What they refer to is the people with the placards, stickers, lights, sirens etc. on there POV or jackets that are a walking billboard, slowing up or stopping at the scene, looking then going on there way. The lawyers explained it as, it may have prevented some other trained person from stopping because they saw another responder already on the scene.

You may not have contacted the patient directly, but you may have prevented the patient from receiving 1st aid.

I don't make these things up, this is how the Med/Legal lawyers view the statutes.

Is there a legal interpretation regarding this situation that you can post? Is there a website from such an attorney that you can link us to?

Sounds very very fishy to me. Were this the case, there would probably be much more discussion about it somewhere.

[vtach39680 23]

the good Samaritan laws pertain to the lay public. all certified EMS providers in NYS are covered under part 800 of the public health law. below is a segment of part 800 that holds some of the answers to the questions posed

"800.15 REQUIRED CONDUCT

Every person certified at any level pursuant to these regulations shall:

(a) at all times maintain the confidentiality of information about the names, treatment, and conditions of patients treated except:

(1) a prehospital care report shall be completed for each patient treated when acting as part of an organized prehospital emergency medical service, and a copy shall be provided to the hospital receiving the patient and to the authorized agent of the department for use in the State's quality assurance program;

(2) to the extent necessary and authorized by the patient or his or her representative in order to collect insurance payments due;

(3) to the extent otherwise authorized by law;

( when acting as a certified first responder, an emergency medical technician, or advanced emergency medical technician, treat patients in accordance with applicable State-approved protocols, unless authorized to do otherwise for an individual patient by a medical control physician; and

© comply with the terms of non-hospital order not to resuscitate when provided with such order issued on the standard form prescribed by the Department of Health, or when a DNR bracelet, developed by the Department of Health to identify individuals for whom a non-hospital order not to resuscitate has been issued, is identified on the patient's body.

(1) Emergency medical services personnel may disregard the order not to resuscitate if:

(i) they believe in good faith that consent to the order has been revoked, or that the order has been cancelled, or

(ii) family members or others on the scene, excluding such personnel, object to the order and physical confrontation appears likely.

(2) Hospital emergency service physicians may direct that the order be disregarded if other significant and exceptional medical circumstances warrant disregarding the order.

(3) No person shall be subjected to criminal prosecution or civil liability, or be deemed to have engaged in unprofessional conduct, for honoring reasonably and in good faith pursuant to this subdivision a non-hospital order not to resuscitate, for disregarding such order pursuant to paragraph (1) or (2) of this subdivision or for other actions taken reasonably and in good faith pursuant to this subdivision.

(d) note use an automated external defibrillator unless:

(1) he or she is acting as a certified first responder, emergency medical technician or advanced emergency medical technician; and

(2) under medical control; and

(3) when authorized by and serving with an agency providing emergency medical services which has been approved by the regional emergency medical advisory committee to provide AED level care within the EMS system; and

(4) after completing AED training which meets or exceeds the state minimum AED curriculum."

The key to the statements above is "when acting as part of an organized prehospital emergency medical service" so it could be argued with good success that when you are in a non marked IE (full lettered agency vehicle) you are not working as part of an organized prehospital emergency medical service. and have no duty to act.

Edited July 30, 2008 by vtach39680

[vtach39680 23]

also as a follow up. http://www.health.state.ny.us/nysdoh/ems/pdf/98-05.pdf

"NYS statutes do not obligate an individual citizen, regardless of training, to

respond to a situation or provide care unless there is a formal duty by job description

or role expectation. Such a duty to act arises from participation with an agency having

jurisdiction."

"Pursuant to the provisions of Public Health Law, the individual having the

highest level of prehospital certification and who is responding with

authority, “has a duty to act” and therefore is responsible for providing1 2

and/or directing emergency medical care and the transportation of a

patient. Such care and direction shall be in accordance with all NYS

standards of training, applicable State and Regional protocols and may be

provided under direct medical control."

[Guest alsfirefighter]

Good post Vtach...isn't that somewhere along the lines as well as why the DOH requires agencies to mark vehicles with "out of service" if you are on the road and cannot utilize the vehicle to answer calls? The having your car marked up with this and that sticker and not pulling over to me is a week and stretch of an arugment. Not to mention the fact I really don't get why people put all those stickers on their cars in the first place...but needless to say as a certified provider I believe its much different then having a known licensed provider pass by.

Additionally after some research I found the following under Public Health Law Article 30, which may have added to my confusion or someone who discussed this in a classroom format I was in stretced it as well:

Section 3013. Immunity From Liability.

1. Notwithstanding any inconsistent provision of any general, special or local law, a voluntary ambulance service or voluntary advanced life support first response service described in section three thousand one of this article and any member thereof who is a certified first responder, an emergency medical technician, an advanced emergency medical technician or a person acting under the direction of an emergency medical technician or advanced emergency medical technician and who voluntarily and without the expectation of monetary compensation renders medical assistance in an emergency to a person who is unconscious, ill or injured shall not be liable for damages for injuries alleged to have been sustained by such person or for damages for the death of such person alleged to have occurred by reason of an act or omission in the rendering of such medical assistance in an emergency unless it is established that such injuries were or such death was caused by gross negligence on the part of such certified first responder, emergency medical technician or advanced emergency medical technician or person acting under the direction of an emergency medical technician or advanced emergency medical technician

2. Nothing in this section shall be deemed to relieve any such voluntary ambulance service or voluntary advanced life support first response service from liability for damages or injuries or death caused by an act or omission on the part of any person other than a certified first responder, an emergency medical technician, advanced emergency medical technician or person acting under the direction of an emergency medical technician or advanced emergency medical technician acting inbehalf of the voluntary ambulance service or voluntary advanced life support first response service.

[vtach39680 23]

Good post Vtach...isn't that somewhere along the lines as well as why the DOH requires agencies to mark vehicles with "out of service" if you are on the road and cannot utilize the vehicle to answer calls? The having your car marked up with this and that sticker and not pulling over to me is a week and stretch of an arugment. Not to mention the fact I really don't get why people put all those stickers on their cars in the first place...but needless to say as a certified provider I believe its much different then having a known licensed provider pass by.

Additionally after some research I found the following under Public Health Law Article 30, which may have added to my confusion or someone who discussed this in a classroom format I was in stretced it as well:

The way it had been explained to me in my EMT class was that. when you are not working as part of an agency response, you are covered under the good samaritan law. When you treat and or transport a patient as part of a agency response and do not seek or expect monetaryy compensation for the action you provide you have to be found "grossly negligent"

if you are working as part of an agency response and expect to receive monetary compensation for the acts or actions you provide then you only have to be found "negligent"

here is a question that perhaps we could move to a different forum but what are the chances that a lawyer could argue that any person who is part of a volunteer agency that does not receive a "paycheck" from that agency ie volunteers, would only have to be found negligent due to the new fuel reimbursement act and the states "pension" programs for volunteers

[Guest]

if you have EMT blatant agency sticker/decals or EMT state tags or any other blatant EMT insignia on your car, you better pull over. you're advertising that you are a EMT, therefore you shall be pulling over. i was told by not doing so is punishable by the courts and the revokation of your card.

MODERATOR NOTE: Please post a reference or citation for this comment.

My response to the Moderators request:

i was told this in my emt class in 2002. i recall taking off my vac/fd stickers bc of this. it's not abandonment, but it's considered lacking the duty to act.

if things have changed since then, i wasn't aware of it.

there are a lot of non-firefighters who wear FD shirts, and i have never seen someone not in ems wearing an ems/emt shirt. again i was told a few years ago this was because ems has the duty to act and FF's do not. having a person wearing you vac shirt who is not in ems is a liability.

again this is what i was told, although it seemed logical, things may have changed.

Edited July 30, 2008 by vacguy

[Guest alsfirefighter]

The way it had been explained to me in my EMT class was that. when you are not working as part of an agency response, you are covered under the good samaritan law. When you treat and or transport a patient as part of a agency response and do not seek or expect monetaryy compensation for the action you provide you have to be found "grossly negligent"

if you are working as part of an agency response and expect to receive monetary compensation for the acts or actions you provide then you only have to be found "negligent"

here is a question that perhaps we could move to a different forum but what are the chances that a lawyer could argue that any person who is part of a volunteer agency that does not receive a "paycheck" from that agency ie volunteers, would only have to be found negligent due to the new fuel reimbursement act and the states "pension" programs for volunteers

As I was reading around I saw something to the effect that under the volunteer protection act there are certain compensations which are allowed that aren't considered "compensation." Such things as agencies who pay for meals, give uniform stipends and such were still covered.

[vtach39680 23]

As I was reading around I saw something to the effect that under the volunteer protection act there are certain compensations which are allowed that aren't considered "compensation." Such things as agencies who pay for meals, give uniform stipends and such were still covered.

I figured as much just thought it was interesting possibility lawyers are crafty people

[helicopper 1,050]

My response to the Moderators request:

i was told this in my emt class in 2002. i recall taking off my vac/fd stickers bc of this. it's not abandonment, but it's considered lacking the duty to act.

if things have changed since then, i wasn't aware of it.

there are a lot of non-firefighters who wear FD shirts, and i have never seen someone not in ems wearing an ems/emt shirt. again i was told a few years ago this was because ems has the duty to act and FF's do not. having a person wearing you vac shirt who is not in ems is a liability.

again this is what i was told, although it seemed logical, things may have changed.

I'm aware of no state law, regulation, or other provision that would compel or require any off-duty EMS provider to stop and render aid. There are so many variables that could come into play here that it would be impossible to enforce. For example, an EMT driving home with his two toddlers in the car comes upon an accident scene. Does he stop and leave his small children unattended in a vehicle?

If this were the case I imagine we'd see far fewer MD license plates out there since they're licensed healthcare providers.

It is a very interesting question though.

[vtach39680 23]

I'm aware of no state law, regulation, or other provision that would compel or require any off-duty EMS provider to stop and render aid. There are so many variables that could come into play here that it would be impossible to enforce. For example, an EMT driving home with his two toddlers in the car comes upon an accident scene. Does he stop and leave his small children unattended in a vehicle?

If this were the case I imagine we'd see far fewer MD license plates out there since they're licensed healthcare providers.

It is a very interesting question though.

"NYS statutes do not obligate an individual citizen, regardless of training, to

respond to a situation or provide care unless there is a formal duty by job description

or role expectation. Such a duty to act arises from participation with an agency having

jurisdiction."

"Pursuant to the provisions of Public Health Law, the individual having the

highest level of prehospital certification and who is responding with

authority, “has a duty to act” and therefore is responsible for providing1 2

and/or directing emergency medical care and the transportation of a

patient. Such care and direction shall be in accordance with all NYS

standards of training, applicable State and Regional protocols and may be

provided under direct medical control."

[ex-commish 490]

QTIP. I could be wrong but I'm interpreting what he is saying as someone who blatantly refuses to go while able bodied and needed. Not like the SS is going to spy on you and take away your kids for not going to the pump out.

You are correct Danger. I was referring to the post where people were in the firshouse and didn't go because they didn't feel like it. I understand we all have lives, families, and sometimes when you are home you can't go but to be in the firehouse and not go because you didn't feel like it....

[Guest]

You are correct Danger. I was referring to the post where people were in the firshouse and didn't go because they didn't feel like it. I understand we all have lives, families, and sometimes when you are home you can't go but to be in the firehouse and not go because you didn't feel like it....

Wow like I said what a great?????

I do have to say that if I was driving by a MVA and no emt was on the site yet I would ask the oic if they needed help. I would not just jump out and start helping I do think you need to ask first.

[lad12derff 283]

Patient abandonment.

You must have been on a run during your on duty EMT training when medical legal was covered. If you advertise that you are an EMT, stickers, lights on your car and you pass an accident scene and someone grabs your license plate, you could be cited for patient abandonment. It has to be proven that the EMT was driving and he aid would have made a difference. The chances of this happening are slight, however it could.

How would you deal with the blood and fluid issue. Your training tells you not to come in contact with it. If you don't have gloves and eye protection, you are covered by your training. Safety first. You can only function at your level of training and equipment on hand.

But that's my point. If you are driving by whether you have an ems sticker on your car or not and you don't have the proper PPE how can you be held liable? We are taught to protect ourselves first aren't we? Patient abandonment would be starting patient care and stopping I would think.

[Guest]

But that's my point. If you are driving by whether you have an ems sticker on your car or not and you don't have the proper PPE how can you be held liable? We are taught to protect ourselves first aren't we? Patient abandonment would be starting patient care and stopping I would think.

I do have ppe on me 99% of the time.

[lad12derff 283]

I do have ppe on me 99% of the time.

And I never have it.

[RWC130 594]

Volunteer Duty to Act?

GOOD POST!

IMO, If you are at the Station and a call comes in Fire or EMS and you are "Fit for Duty"

you should respond.

NYS Law, DOH, Town/City/Village Rules or Laws, Department SOP, Department SOP

it's just THE RIGHT THING TO DO!!!

I say "Fit for Duty" because we all know some Fire Stations do have Bars/Alcohol and with all due

respect we should just leave it at that. No one wants an intoxicated MOS on a call!

If a Chief, Assistant Chief, Captain, or Lieutenant has to question you why you didn't respond to a

call while you were at the Station on call, on duty, or just hanging out you should NOT be in Emergency Services.

"Sorry Chief, I know it was a working fire with people trapped but the Yankees were winning" is NOT a good answer

same would apply to "I was washing my car"

We are all about HELPING our Neighbor No?

TRUE STORY:

I was ON DUTY Volunteering at a VAC.

I was the EMT on the 12 AM to 6 AM shift with another EMT and Driver.

We had a Full Crew.

I was the only one actually on the schedule,

the other two guys were "hanging out" sleeping at the Station.

At 5:50 AM a call came in, both guys suddenly got up, walked out the door and went home.

It really pissed me off because they both denied knowing we had a call. I was like "Dude, where

the hell are you going we have a call" answer "We do?, Oh.. I am going home"

Now cue in the Paging System going BEEP, BEEP, BEEP!!!!!!

I was not very happy, most of you who know me know I am far from perfect but I always try and do

THE RIGHT THING that was clearly NOT the right thing to do. Is it even legal???

Just because YOU may not be getting paid as a Volunteer Firefighter or Volunteer EMT

does not mean you should not be PROFESSIONAL!

Now, the Captain actually DEFENDED both members saying they were NOT on the roster and not actually on duty.

HMMM Let's see here. You are in the Station and Sleeping but 10 MINUTES before the shift ends a call

comes in and you are suddenly NOT on the roster or on duty and go home? Now that is TOTAL BS!

Agree?

BE SAFE!

[Danger 160]

RWC, you hit it on the head. I love pulling in to the station for the EMS call and there are 3 qualified individuals leaning on the bumper of the ambulance smoking cigarettes who have no intention of going. Makes me crazy.

[OnTheWheel 43]

Maybe these people who hang out and don't respond should be reminded that they too (probably)have family living in their district, and how would they feel if one of them, or them personally, called for help and some schlep continued washing his car. I always say, treat every call as if it was your own family member or your house on fire etc.!

[xfirefighter484x 234]

As previously said, in NY YOU DO NOT HAVE TO STOP AND ACT AS AN EMT , MEDIC OR OTHERWISE. If you do stop and intiate patient care you must be relieved by a higher medical authority (IE: EMT hands off to the medic, Medic to a flight nurse or doc, etc...). Locals laws may differ. A town law may say a member of the local VAC must stop if they see something in town. If you are in a marked Emergency vehicle it is a different story.

CAM502, to clarify what you wrote, there does not have to be a hand-off only to a higher medical authority. It has to be an equal, OR higher medical authority.

For example, if you are an EMT-B, from out of the area, and you pull up on an MVA and assist, and another EMT-B from the local department arrives, you CAN transfer care to them.

As far as handing-off to a "higher" medical authority, an EMT-B cannot hand-off to a CFR, but a CFR can hand off to an EMT. Same goes for a medic. A medic cannot hand-off a patient to an EMT-B, unless the medic has declared the patient to not need ALS intervention, in turn making them a BLS patient, therefore, the hand-off to a "lower" medical authority is acceptable.

[DaRock98 76]

Ok lets throw another twist in this situation you are out on driver training in your ambulance with NO EMT on board with you. The people in the bus are drivers only. What happens if you come across a MVA with injuries and your department does not allow you to drive your POV to the scene and the other ambulance you have is already out on a call. What do you do?