First aid facilities

[DuckJordan]

Re: First Aid Kits

Before this gets too far I'd like to point out it is extremely Illegal to issue medication to anyone (including Tylenol or ibuprofen) without a medical certification. Even if its asked for by the person. The most you can do as far as first aid to anyone would be a bandage and cold pack, and of course ambulance call. Defibs are a weird scenario. They put them all over the place but almost no one knows how to use them. Even though there are directions on the case, by the time someone read them to do the job its likely too late.

That said we just stock Band aids and a few Ice packs. Anything else they need to have or we call the ambulance.

I know its all meant in good faith but a lawyer will sue even if the person you help doesn't want to press charges. So keep in mind, medicate at your own risk.

 

[metti]

Re: First Aid Kits

Before this gets too far I'd like to point out it is extremely Illegal to issue medication to anyone (including Tylenol or ibuprofen) without a medical certification.

Define medical certification. You are absolutely correct that pre-hospital care is not totally straight forward from a legal perspective. A couple points though:
-Issuing medication and making medication available are substantively different things. Anyone can legally purchase a bottle of ibuprofen and legally allow someone to use a couple (unless that person is a minor, in which case things get sticky again) if the recipient want to. As long as you are not issuing the medicine under the pretense of it being official medical care it is completely legal and you (the provider) are not incurring any liability.
-It is completely illegal to use an AED (defib) under any circumstances if you (the operator) has not been certified to use it. This is a few our long class that is frequently offered in conjunction with first aid/CPR classes. Publicly accessible AEDs tend to offer voice prompts to the care provider and the certification is actually pretty useless but you still can't use one if you don't have it. I think you would be surprised how many people have ended up with them at this point, though.
-In general, the most straight forward way to understand the law is to think of it like this: Practice up to but not beyond your level of certification/ability (whichever is lesser). As an EMT I am legally required to render care up to the level of skills that I have been certified for and it is illegal for me to practice first-response medical care beyond this level. The exact same thing is true of anyone who has taken the 8 hour first-aid/CPR class through work or school although the level of skills for which we are certified are obviously pretty different. As long as you follow this rule and get patient consent before doing anything (unless they are non responsive, an unaccompanied minor, or functioning at a level below A&Ox3 in which case consent is assumed) you are protected under the good Samaritan laws and you legal precedent can demonstrate for us that this is exceptionally good legal protection for you, the first responder.

 

[MarshallPope]

Re: First Aid Kits

As a side note - Does anyone know how long CPR/AED certification lasts? I have no idea where my paperwork went...

As far as first aid kits go, IIRC, my school has 4 - one backstage in each of the two theatres, the shop, and the box office. They are the basic Johnson & Johnson plastic all-in-one boxes. In addition to that, whenever I SM/ASM, I always make sure to carry a handful of band-aids and Extra Strength Tylenol just to keep from having to break out the first aid kit and to be able to respond more quickly if someone has a minor emergency.

 

[MNicolai]

Re: First Aid Kits

That's a little broad of a judgement on first aid. With Good Samaritan laws, typically if you act in a rational manner within your level of training, you cannot be held legally liable for your response to the situation.

In our case, it's a moot point because we're a school district so there isn't any kind of medication in any first aid kit in the building, but should someone ill need assistance getting their inhaler or a medication that's been prescribed to them, no one's going to get into any trouble for helping them.

We're lucky though in that the hospital is just next door. Nearest ambulance would be dispatched from a couple of minutes away, but most night's we have a custodian staffing our facility who doubles as a firefighter. In the past we've had to call 911 and he's sprinted from the other end of the building to the scene and was able to to administer first aid until the EMT's arrived.

As a general rule, everyone on front of house, management, and even some technical staff are required to have first aid, CPR, and AED training. If someone cuts their finger off in the shop or falls off of the front of the stage into the orchestra pit, I'm not going to sit around on my hands for fear of being sued; I'm going to have someone call 911 while I work within the scope of my training, and then once a dispatcher is on the phone they'll be able to give instruction to the person administering first aid while the EMT's arrive, at which point someone will be sent to the front door to meet them so that they can as quickly as possible be pointed in the direction of the victim.

I'm not saying go ahead and perform battlefield surgery while you wait for the EMT's, but there are situations where someone on site will have to be capable of handling a situation for anywhere between 5 and 15 minutes (on average) given the supplies laid out in front of them.

Two months ago there was a guy in Minnesota who had a heart attack just outside of the grocery store of a town without a hospital or ambulance. It took a line of volunteers/rescuers 96 minutes of CPR to keep the man alive before EMT's were able to arrive via helicopter. The man lived, but only because there were 20 people standing around capable of performing CPR who took turns while waiting for help.

Because you can't predict what sort of life or death situations might be presented before you and when they might happen, I'd like to be prepared with more than just band aids and ice packs instead of living in fear that ever having to administer anything else would get me or one of our staff members in legal hot water.

 

[zmb]

Re: First Aid Kits

As a side note - Does anyone know how long CPR/AED certification lasts? I have no idea where my paperwork went...

I think it is good for two years, speaking of which, my is expired. The CPR training always seems to be changing too.

And something else to remember for the purchased, fully-stocked first aid kits, remember to restock band aids for small cuts and scrapes. There's usually not enough in the kit to begin with

 

[metti]

Re: First Aid Kits

That's a little broad of a judgement on first aid. With Good Samaritan laws, typically if you act in a rational manner within your level of training, you cannot be held legally liable for your response to the situation.

Just to clarify, the law is that you have to act in a rational and COMPETENT manner within your level of training. If you provide care that you were trained to provide but since getting certified you forgot half of it (as many people do) and provide the care wrong you can most certainly be held liable. We covered the legal aspects of first-response during my EMT training at length and, while my comments only reflect the legal situation in MA, it is my understanding that most states have similar arrangements.

Giving someone something for a headache could get you into trouble, but if someone's going to anaphylactic shock and their EpiPen isn't accessible but someone else has one, no one's going to get in any trouble for giving them that dose.

To repeat my earlier comment, providing access to over-the-counter medications to an adult is NOT illegal and CANNOT get you into trouble. Regarding the EpiPen, epinephrine is a prescription medication and using someones EpiPen on a different individual constitutes felony narcotics distribution. I am not kidding on this, this is the same as using giving someone any of your prescription meds and it is incredibly illegal. Beyond that, if the person who's EpiPen you used goes into anaphylactic shock before getting a new EpiPen issued, you could and probably would be held liable for their no longer having one. Beyond that, it is completely illegal to even help someone use their own EpiPen unless you are their parent (in the case of minors) or you have received training and certification in anaphylactic emergency management (part of EMT training or available separately for people who are often around those with severe allergies).

 

[MNicolai]

Re: First Aid Kits

To repeat my earlier comment, providing access to over-the-counter medications to an adult is NOT illegal and CANNOT get you into trouble. Regarding the EpiPen, epinephrine is a prescription medication and using someones EpiPen on a different individual constitutes felony narcotics distribution.

Whoa. That seems like a pretty big detail that was not included in my first aid training.

 

[metti]

Re: First Aid Kits

remember to restock band aids for small cuts and scrapes. There's usually not enough in the kit to begin with

+10000000
You will find that ordering generic supplies from a decent online first-aid supplier gets you much cheaper and often higher quality stuff than CVS, etc can offer. For my rather substantial personal first aid kit, I have a certain number of each item that I keep in the kit itself and then I keep additional boxes of the supplies in my closet at home. As soon as I use anything from the kit I restock it to it's full inventory. If I was responsible for a venue I would probably keep larger quantities of items in one place and restock individual kits from that cache.

 

[metti]

Re: First Aid Kits

Whoa. That seems like a pretty big detail that was not included in my first aid training.

There is so much to cram into first aid training that, unfortunately, there is never nearly enough time to cover everything that participants should know. Often medico-legal issues end up taking back seat to learning how to actually do stuff. I think this is probably a good thing since I would rather competent first-responders then people who understand the law but can't actually help anyone in an emergency. EMT and other more advanced training paths include a significant amount of additional coverage of legal issues as well as topics like emergency management and handling the psychological/emotional implications of emergency situations on patients, bystanders, and the responder. If anyone has an extra 200 or so unscheduled hours in their schedule I can't recommend the training highly enough.

 

[chausman]

Re: First Aid Kits

While people are talking about where AEDs are located, my school which was built three years ago, had one for a while in the commons, the closest to the center of the school as they could get, and another case for one. They have these white cases they sit in that have an alarm, i don't know what the alarm is hooked up to, but it's there, one is used, one isnt. Earlier this year, they go another AED to fill the case just inside the doors by the football fields for events that happen at our school.

Sent from my iPad.

 

[metti]

Re: First Aid Kits

They have these white cases they sit in that have an alarm, i don't know what the alarm is hooked up to, .

The alarms on AED wall boxes aren't hooked up to anything beyond the box itself. The boxes have a built in speaker that is triggered when the door is opened without turning a key to deactivate the alarm first. It is just there to discourage theft since AEDs are pretty expensive. It also alerts bystanders that there is something emergency-ish going on and they should maybe run and get help or call 911.

 

[chausman]

Re: First Aid Kits

The alarms on AED wall boxes aren't hooked up to anything beyond the box itself. The boxes have a built in speaker that is triggered when the door is opened without turning a key to deactivate the alarm first. It is just there to discourage theft since AEDs are pretty expensive. It also alerts bystanders that there is something emergency-ish going on and they should maybe run and get help or call 911.

I didn't think there would be much for them to do, a student openin a box on the wall is not a good reason for an ambulance to show up at a school!

 

[jglodeklights]

Re: First Aid Kits

As a note on providing OTC medications, all medicine should be in INDIVIDUALLY wrapped doses with FDA approved packaging (from the supplier) so that A. you can be sure of the expiration date of a dose, B. be sure of the particular medicine in the package, and C. reduce the risk of contamination of the dose with another medicine.

On CPR, I believe it was two years between certifications (or was that life guarding, and CPR was 3 or 4?). The following is not meant to be taken as legal or medical advice, but only put out here my personal feelings. As someone who has a conscience and has received CPR training in the past, I would perform CPR regardless of the fact that I no longer have my certification (I do tend to read up on the current standards), provided there was no one else there able or willing to perform it. By definition, CPR is a form of resuscitation, meaning the person it is to be performed on is medically considered dead. If I see no Do Not Resuscitate bracelet/tattoo/other identification of such, I would feel morally obligated to perform it if I knew the person's heart had stopped. That said, one of the main factors in performing it, were I to perform it, would be the proximity of more qualified care.

 

[DuckJordan]

The way we were taught if we we're not on duty when something as far as epi pen goes. is you place it in their hand have use their hand to issue the dose of epi, I had to go through the training for a local camp and this is what the full time emergency response team told us to do.

The reason for my blanket statement of do not issue medication is most of the people who frequent these boards are minors and if they were to issue even Tylenol at least at the district I went to, you were given a minimum of a month suspension from school. There was no kind of tolerance what-so-ever for it.

So my policy is always if they don't have it, then you shouldn't give them it. But +1 on Metti's Epi pen deal. Its way too huge of risk and even epi pens need specific ways of injection.

 

[metti]

Re: First Aid Kits

As a note on providing OTC medications, all medicine should be in INDIVIDUALLY wrapped doses with FDA approved packaging (from the supplier)

You are absolutely correct. Boxes of individual dose packs of generics (ibuprofen, etc) are actually cheaper than big bottles from CVS anyway and are the only acceptable thing to use for a first aid kit.

On CPR, I believe it was two years between certifications (or was that life guarding, and CPR was 3 or 4?).

CPR certifications last for 2 years.

The following is not meant to be taken as legal or medical advice, but only put out here my personal feelings. As someone who has a conscience and has received CPR training in the past, I would perform CPR regardless of the fact that I no longer have my certification (I do tend to read up on the current standards), provided there was no one else there able or willing to perform it. By definition, CPR is a form of resuscitation, meaning the person it is to be performed on is medically considered dead. If I see no Do Not Resuscitate bracelet/tattoo/other identification of such, I would feel morally obligated to perform it if I knew the person's heart had stopped. That said, one of the main factors in performing it, were I to perform it, would be the proximity of more qualified care.

I think most people tend to subscribe to this way-of-operating, myself included. While I keep my certs current, if they eventually lapsed I would definitely be willing to do what it takes to save someones life even if legally I'm not supposed to within reason. I go back and forth on the EpiPen thing since it is a pretty significant moral dilemma but CPR is different than that. As long as the person does not have a visible DNR, I don't think there has ever been an attempt to prosecute someone for correctly performing CPR in a medical emergency for which it is indicated. Most people don't even carry their cert card and when the paramedics come they aren't going to card the bystanders who were providing CPR anyway.

 

[avkid]

Since I started contracting my own crews I have been carrying a prepackaged Johnson & Johnson first aid kit.

 

[Footer]

Before this gets too far I'd like to point out it is extremely Illegal to issue medication to anyone (including Tylenol or ibuprofen) without a medical certification. Even if its asked for by the person. The most you can do as far as first aid to anyone would be a bandage and cold pack, and of course ambulance call. Defibs are a weird scenario. They put them all over the place but almost no one knows how to use them. Even though there are directions on the case, by the time someone read them to do the job its likely too late.

That said we just stock Band aids and a few Ice packs. Anything else they need to have or we call the ambulance.

I know its all meant in good faith but a lawyer will sue even if the person you help doesn't want to press charges. So keep in mind, medicate at your own risk.

You can give anyone over the counter meds, you just can't shove them down their throats.

...... Something involving tapatalk.......

 

[rphilip]

Re: First Aid Kits

Defibs are a weird scenario. They put them all over the place but almost no one knows how to use them. Even though there are directions on the case, by the time someone read them to do the job its likely too late.

In my experience laws relating to AED's vary state to state. I know that in Washington any one may use an AED be be protected by Good Samaritan Laws. (At least this was true in '08). In Michigan on the other hand you are only protected by the Good Samaritan Law if you have had AED certification training. In other words check too see what your local rules are.

I'll also agree with jglodeklights and metti, while my CPR/First aid cert has lapsed (I need to get that fixed) I would still provide care to the best of my ability if it were needed.

Philip

 

[ScottT]

Re: First Aid Kits

metti I take issue with a few things you have said...

It is completely illegal to use an AED (defib) under any circumstances if you (the operator) has not been certified to use it.

This is completely false. It depends on the state that you are located in.
For example:
In Virginia, in 2005/2006 the AED filing and training requirements were repealed. In that same time period, Maryland created requirements so that every high school and school-sponsored athletic events must have an AED available. In 2010 Maryland created new laws that guarantee protections to people (who are not trained) who, in “good faith” use an AED when working to save someone from sudden cardiac arrest.

Source: State Laws on Cardiac Arrest & Defibrillators

In general, the most straight forward way to understand the law is to think of it like this: Practice up to but not beyond your level of certification/ability (whichever is lesser). As an EMT I am legally required to render care up to the level of skills that I have been certified for and it is illegal for me to practice first-response medical care beyond this level. The exact same thing is true of anyone who has taken the 8 hour first-aid/CPR class through work or school although the level of skills for which we are certified are obviously pretty different. As long as you follow this rule and get patient consent before doing anything (unless they are non responsive, an unaccompanied minor, or functioning at a level below A&Ox3 in which case consent is assumed) you are protected under the good Samaritan laws and you legal precedent can demonstrate for us that this is exceptionally good legal protection for you, the first responder.

metti I'm sure that you know this, but for everyone else if your certification was issued by state X, you cannot use your training in state Y. The exception to this is nationally recognized certifications (American Red Cross). The trick to that though is if you have an ARC certification and go to Canada, you cannot use your training, because they have different regulations.

As a side note - Does anyone know how long CPR/AED certification lasts? I have no idea where my paperwork went...

The Professional American Red Cross First Aid/AED certification is valid for 3 years. The CPR is valid for 1 year. I'm not sure about the others BUT you should check with your state, as it can vary.

 

[metti]

Re: First Aid Kits

This is completely false. It depends on the state that you are located in.
For example:
In Virginia, in 2005/2006 the AED filing and training requirements were repealed. In that same time period, Maryland created requirements so that every high school and school-sponsored athletic events must have an AED available. In 2010 Maryland created new laws that guarantee protections to people (who are not trained) who, in “good faith” use an AED when working to save someone from sudden cardiac arrest.

Fair enough. My legal info is mostly applicable to MA, NH, and NY which are the three states in which I have received training. Scott is completely right that you should check your state's laws; while many states have similar setups there is some pretty significant variation.

I'm sure that you know this, but for everyone else if your certification was issued by state X, you cannot use your training in state Y. The exception to this is nationally recognized certifications (American Red Cross). The trick to that though is if you have an ARC certification and go to Canada, you cannot use your training, because they have different regulations.

Also an excellent point. Since I have a NREMT certification in addition to my MA DOT EMT-B cert I can practice in any state as long as I practice within that states EMT treatment protocols. Obviously I have not memorized treatment protocols for every state so I have to be a little bit careful. The one caveat to my agreement with your statement that I would offer is that in general good Samaritan laws are such that one could still render care in a state in which they are not certified and, as long as they do so within that states legal guidelines, it is highly unlikely that there would be any legal repercussions unless they administered the care incorrectly.

The Professional American Red Cross First Aid/AED certification is valid for 3 years. The CPR is valid for 1 year.

This is incorrect. From the American Red Cross website, "All First Aid, CPR and AED training carry 2-year certification."