honestly, that's probably the best thing a knowledgeable provider can do: make sure the appropriate resources are on the way. This can be the helicopter, ALS, rescue company, or maybe even hazmat. The sooner they are requested, the sooner they can arrive.
What happens when BLS rig shows up and you’ve started ALS, and you are off duty?
You have some splainin’ to do…
Sacramento County, not that big of an issue. 911 is basically exclusively ALS. If a BLS IFT rig shows up...
As long as you're authorized to have an ALS take-home kit, you ride in if you can't downgrade the patient to BLS, you sign their report as the tech, and you notify EMSA that you witnessed something off-duty, you're authorized to have a take-home kit (EMSA already knows who is), and that you rode in with the patient while off-duty. The splainin' isn't an issue. If you're not authorized to have whatever stuff you have with you... and there was no magical source for the stuff to be there... Yep. Lots of splainin' to do!
What if you can’t just “ride in”? Does “riding in” put you on the clock? What if you’re injured “riding in”?
The marked take home vehicle might trigger a duty to act, depending on local laws. Might want to check into that.
In CA, it does for LE.
PA does not have a specific duty to act for “off duty” providers anywhere I can find when perusing the EMS act or any others related to first responders… but not stopping in a marked vehicle would make for some pretty poor optics.
I would argue that being off duty while driving in a marked vehicle with proper equipment would be extremely poor optics, esp when the news says "@NomadicMedic keeps on driving while baby dies" or some other sensational headline
Clarification: always on duty when you are in the car. That's why many places say you can only drive the take home to and from work, or when you are on company business. If the car is parked outside of your house, or you are in your POV with the family, it's hard to say you are still on duty, even if you are issued a take home vehicle and it's home.
This is true. This is why when I’m in that vehicle I have a set of gear.
I think you have to look really carefully at your local legislation. Remember that those physicians that you are referring to are practising under their own licenses and insurance. In some places paramedics also practice under their own license and insurance and are part of self-regulating colleges but this isn't the case everywhere. However, I also think that if anyone wants to provide whatever help a typical lay-person could reasonably provide (stop bleeding, do CPR, one an airway etc) there probably isn't a jurisdiction in the world that would prosecute for something like that as long as there is neither negligence nor malfeasance.
In the US, without physician oversight? Where?
I’m not trying to be rude, but what you said is literally the meat of the Good Samaritan law..
Yeah, I don't know much about the US situation but there are jurisdictions in Canada, UK, Aus, NZ etc where the profession os self-regulated, degree based, self-insured and or some combination thereof. In my primary jurisdiction, I work under my own license and insurance - the service has a medical director but there is nothing in the law that says that the medical director can't be a paramedic rather than the standard physician. I think its still not common to see anything other than the physician in these roles but really, who knows our job better than us and as long as we can back it up with a science-based higher education... I think its a goal to shoot for as a profession.
I 100% agree!
