FROM THE EMERGI-PRESS SUMMER 2000
Rendering Care Off-Duty
Underwood, RN, BSN MICN
Portions of this article are reprinted, with permission, from the Alameda
County EMS newsletter.
The Los Angeles County EMS Agency, as well as other
local EMS agencies throughout the State, often receive questions regarding what
type of aid prehospital care personnel may render when they are off-duty. This
includes rendering care off-duty during special events or other gatherings when
pre-hospital care personnel are not working for an approved provider. Recently,
we came across an article in Alameda County’s newsletter which did an excellent
job of covering this topic. The following are excerpts from that article which
include the most frequently asked questions and their answers.
Q: If I pass the scene of an accident, am I
obligated to stop and render aid?
No one is obligated to stop and render aid. Likewise, no one is obligated to
render aid even if they do stop. Those are decisions that are up to each
individual. However, if you are the kind of person who does choose to stop and
render aid, it is good to be prepared to safeguard your well being, as well as
to understand your responsibilities and protection under the law.
Q: What level of care can paramedics and EMT-Is
legally provide on the scene?
Paramedics and EMT-l's may only offer basic life support (BLS) level care when
they are off-duty. Paramedics may only perform advanced life support (ALS)
skills as part of an organized EMS system while working for an approved
paramedic service provider. Therefore, paramedics may NOT provide ALS level
care off-duty pursuant to the California Code of Regulations, Title 22, Division
Q: What does
California law say about pre hospital care personnel providing care off-duty?
A: Section 1799.102 of the California Health and
Safety Code states:
“No person who in good faith, and not for
compensation, renders emergency care at the scene of an emergency shall be
liable for any civil damages resulting from any act or omission. The scene of
an emergency shall not include emergency departments and other places where
medical care is usually offered.”
.... In order to encourage the provision of
emergency medical services by firefighters, police officers or other law
enforcement officers, EMT-l's, EMT-ll's or EMTP's, . . [these individuals]
who render emergency medical services at the scene of an emergency shall only be
liable in civil damages for acts or omissions performed in a grossly negligent
manner or acts or omissions not performed in good faith. A public agency
employing such a firefighter, police officer or other law enforcement officer,
EMT-l, EMTII, or EMT-P shall not be liable for civil damages if the . .
.[individual] is not liable.”
Q: Does a paramedic, when working for an
approved paramedic service provider, have to take orders from a nurse or
physician at the scene of an emergency?
either on-duty or off-duty, may only offer assistance and suggestions, they may
not assume medical management of the patient. Physicians licensed in the State
of California, either on-duty or off-duty may lend assistance to a pre-hospital
care team that is in charge of the patient; however, they may not direct
paramedics in advanced life support procedures. Medical direction must come from
the base hospital. When encountering a physician at scene, paramedics must
obtain proper identification, consisting of a California Physicians and Surgeons
License and note the physician’s name, license number and license expiration
date on the EMS Report form. In the event radio communication cannot be made or
maintained with a base hospital, paramedics may assist the physician at scene
and may provide ALS level care under the direction of the physician provided
that his/her instructions are consistent with Los Angeles County EMS Agency
policies and procedures.
California law does not preclude a licensed
physician from rending patient care at the scene. When a physician at scene
chooses to assume or retain responsibility for medical care of a patient,
pursuant to Reference No. 816, Physician At Scene, such physician must take
total responsibility for the care given. Reference No. 816 further states,
“He/she must also accompany the patient until the patient arrives at a hospital
and responsibility is assumed by the receiving physician, unless relieved of
the responsibility by the base hospital.” (For additional information
regarding “Physician At Scene” please refer to Reference No. 816 in the Los
Angeles County Pre-hospital Care Policy Manual.)
If you have a question or issue that requires immediate response, please contact Luanne Underwood, Chief, Pre-hospital Care Operations at (323) 890-7576. It is preferred that non-urgent questions be put in writing and faxed to (323) 890-7629 or e-mailed to firstname.lastname@example.org. We will print as many of the questions, as possible, in this column. If you want to ensure a response, please be sure to include your name and telephone number.