I recently went on vacation & was on an airplane. A person on the plane had a seizure & then went into full arrest. There was another RN on the plane with me. We are both ER nurses & ALCS certified. We used a BVM & an AED. We started an IV and gave epi. All supplies were from the plane. My license is in California. We Diverted to Nevada.
Looking back I wonder if I was covered under the good Samaritans law or did I practice outside my state & scope of practice. Technically, although we left California we landed in Nevada so I wasn't in my state. Also, there was no doctor on the flight who gave the epi order.
Ditto! I'm so anxious when I fly that on an international flight, I usually have a couple of drinks on board. Probably not the best person to assist in a code, now that I think about it.
When I fly overseas, specially to Europe, I always go with Lufthansa because they offer free booze!
The whole point of ACLS is so that you know what to give if a provider isn't available (which happens). It is not inappropriate or outside the scope of anyone to give ACLS medication during an arrest. What was she supposed to do? Ring 30,000 feet down for an epi order?
As a former flight attendant with 17 years experience, the main concern is to save the passengers life. If you could prudently perform any procedure than we hoped you would. You also have every right to decline. Even if the outcome is not favorable, I have never heard of a volunteer being brought up on any sort of discipline. I'm sure if they could prove gross negligence that would be a different story, but I never heard of any such thing.
Good Samaritans are at risk any time they do Good Sam acts. Check out Malpractice and Negligence insurance companies.
First off- if someone is needing epi in a code situation, they're ALREADY dead. Nothing is going to make them more dead. Everything being discussed is what's being done to try and resuscitate them.
Secondly, I can't imagine if a plane is stocking anaphylaxis/IM epi it wouldn't be in pre-dosed auto injector form.
As our BON no longer issues physical licenses, I would have no identification on me attesting to my nursing credentials, though I do have my ACLS card in my wallet.
Texas BON license verification is online only. I guess as long as there was wifi, I'd be good.
The ACLS card should be good enough. ACLS requires the BLS for Healthcare Providers as a prerequisite, so, in a way, your ACLS card proves you are an RN, EMT, medic, or doctor.
Someone could have a medical license or a nursing license and have 30 years of pschiatric or neonatology experience, but have no idea how to run a code on an adult.
Some docs don't either. We had a GI doc who just became a partner in a free-standing GI clinic get his ACLS cert for the first time as I was getting my renewal. He was, however, pretty good during the mock codes.
You are correct about medication being secondary, but you are 1000% incorrect about needing an order for ACLS medications - that is the entire point of ACLS certification and why people get it. If you are ACLS certified with those medications available (and no MD) you would be negligent for *not* giving them. I bring this up because lives could be lost because of this incorrect and flawed line of thinking.
You would not be negligent. There is, to my limited knowledge, no requirement to render aid when you are not on the job. There is no requirement to volunteer, qualified though you may be.
I'm confused on what part of the following you don't understand...
In 1998, these protections were expanded to medical professionals in the sky providing in-flight emergency care, with the enactment of the Aviation Medical Assistance Act by Congress. The act specifically protects state-qualified EMTs and paramedics, along with physicians, nurses and physician assistants.
EMS...Emergency Medical Services...that means everyone that is licensed, nurse, physician, NP, EMT, paramedic, etc. It is NOT the same as an EMT.
So yes, the article addressed and it addressed it thoroughly.
I gave my students a challenge..I told them that I would give someone $50 that could find any nurse in our state that was sanctioned by the BON for attempting to render aid to a patient in an emergency situation that ended up getting in trouble for it.
Not a single student could find one.
In fact, they couldn't even find where one had ever been disciplined for a medical error...everything was drugs, false charting, abuse, etc.
It's time we stopped spreading these nursing myths as if they are common occurrences when they are not. Yes, you'll always be able to dig up a couple of stories on the internet. People have had meteorites hit their houses too but it sure doesn't happen every day.
There is a reason why I can carry $2 million in malpractice insurance for around $200 a year. It's because nurses are rarely sued.
Students couldn't find any cases? You shouldn't let it stop there. Why not check at your local law school or county law library? OR check with the BON in your state?
I think the article specifically did not mention NP's. I remember being a little agitated about it naming everyone but NP's. Yes, I know NP's are first nurses, so I let it go. LOL
Specializes in Critical Care, Emergency Medicine, Flight.
im late to the party but:
A- do we know if this person was DNR or not? maybe they took something and wanted to die flying over the atlantic who knows
B- besides that fact. I would provide high quality CPR ,attach AED.. advise pilot flight needs to be diverted first, and call for online med control if there is medications that need to be given until we land and hand off to EMS waiting on the other end. god forbid someone wants to sit and calculate a way to give 1:1000 epi in place of 1:10,000 epi. eww.
You would not be negligent. There is, to my limited knowledge, no requirement to render aid when you are not on the job. There is no requirement to volunteer, qualified though you may be.
This is an interesting question. The last I looked - which was a long time ago - four or five states have "duty to rescue" laws. So, if you were an RN in Wisconsin and saw someone collapse on a Wisconsin sidewalk you'd be legally required to render aid. But if you're a Wisconsin nurse in federal airspace I assume it doesn't apply... though IANAL (thank god).
This is an interesting question. The last I looked - which was a long time ago - four or five states have "duty to rescue" laws. So, if you were an RN in Wisconsin and saw someone collapse on a Wisconsin sidewalk you'd be legally required to render aid. But if you're a Wisconsin nurse in federal airspace I assume it doesn't apply... though IANAL (thank god).
Whether or not there is a duty to rescue law or not, ignoring someone in need would be unprofessional and immoral.
All states BONs govern the latter whether on duty or not.
In AZ for example a husband and wife had their licenses revoked for producing Media at home.
armyicurn
331 Posts
When I fly overseas, specially to Europe, I always go with Lufthansa because they offer free booze!