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.
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
Just like in the hospital, if you don't know the code status then they're a full code.
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.
Much like putting Baby in a corner, nobody tells the pilot when to divert. Your authority extends only to the patient, the pilot controls the plane. The JEMS article posted earlier recommends against even suggesting diversion, but instead telling the pilot the prognosis of the patient (CYA, I guess). I imagine it's a moot point, though, since I doubt a pilot is going to carry on while someone dies on the cabin floor.
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.
Yeah, I'm firmly in the camp of people who would do everything within their training regardless of the legal question, but because I'm not a lawyer (thank god), the legal question is uncertain and therefore just a little interesting... :)
Specializes in Critical Care, Emergency Medicine, Flight.
lol one hospital i worked at they coded a guy--- not until the charge went and got his chart, theyre like oh-- hes a DNR..stop cpr. (how the RN who had him didnt know this..idk ) but this is why i ask.
it sucked having to tag and bag that guy with crushed ribs who didnt really need that intervention.
i work fixed wing now, so i have a pretty good relationship w/ my pilots that i can say..um hey guys we need to divert, pt status declining or whatever.
i didnt get a chance to look over the article. but its good to know. I will tell the FA that pt is critical and let them do the talking because god forbid we talk to the godly commercial pilot.lol. i mean they are in charge of the plane. if they want to fly a meat bird around all day more power to them lol
I dated an airline pilot at one point, and he and I discussed this. The pilot has control over who uses the emergency kit in the plane. It's not meant for use by flight attendants, only trained medical personnel. If the pilot calls for medical volunteers in the plane, he will allow that person (or people) to use the kit, provided they have medical training and haven't been getting toasted in first class. Some airlines also have direct communication with a physician on the ground via the radio.
I recently spoke to a NP who is a pilot and he told me that staff on the plane are trained to do ACLS typed treatment. hmm....sort of conflicting.
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.
Every CNA or PCT I've ever worked with has had a card for BLS for Healthcare Providers. I *think* the only difference that the "healthcare providers" have in their course (as opposed to the babysitter's variety) is that use of an ambu-bag is taught. Same course, otherwise.
I don't know if one really IS required to be an RN, EMT, medic, doctor in order to take an ACLS class. If one MUST have a license in nursing or medicine in order to take the course, well then it would be clear that possessing an ACLS card would indicate the person also has a license to practice. But if it's a course that anyone can take (say, a nursing student?) then no....it's no proof of anything.
ANYONE can take BLS for the healthcare provider. Does anyone know if anyone can also take an ACLS course?
Specializes in Complex pedi to LTC/SA & now a manager.
Every CNA or PCT I've ever worked with has had a card for BLS for Healthcare Providers. I *think* the only difference that the "healthcare providers" have in their course (as opposed to the babysitter's variety) is that use of an ambu-bag is taught. Same course, otherwise.
I don't know if one really IS required to be an RN, EMT, medic, doctor in order to take an ACLS class. If one MUST have a license in nursing or medicine in order to take the course, well then it would be clear that possessing an ACLS card would indicate the person also has a license to practice. But if it's a course that anyone can take (say, a nursing student?) then no....it's no proof of anything.
ANYONE can take BLS for the healthcare provider. Does anyone know if anyone can also take an ACLS course?
Anyone can take an ACLS course and get the course completion card. It's your license status & scope of practice that determines whether you can implement the protocols in a clinical setting. Some people just like collecting cards. EMT-basic can take the class but cannot do cardio version, only defib using an AED. EMT-B cannot intubate, start an IV, administer any medication IV or otherwise other than the patient's own MDI, nitro, asprin or epipen.
Healthcare BCLS includes AED, 2 rescuer CPR, oxygenation and use of a BVN as well as protocols for infant, child & adult. Anyone can take the class.
Healthcare BCLS includes AED, 2 rescuer CPR, oxygenation and use of a BVN as well as protocols for infant, child & adult. Anyone can take the class.
You just described everything in a "regular" BLS class, with the exception of ambu-bag. AED, 2-person CPR, etc is all in the "normal" BLS course. Which, of course, is what makes me think that there's no proof of anything concerning higher licensing just because someone has taken ACLS after BLS.
Methinks when it comes to helping out in the Friendly Skies....no good deed goes unpunished!
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.
Sorry but asking if the pt is DNR is like might as well carry a sign saying "dead man or woman walking" 😳
If they are outside a hospital environment, they are full code unless they pull a gun on my and tell me to back the truck off!
Several times people have mentioned showing credentials and/or certification. I am a fairly new nurse - wondering if anyone carries a business card with their license number on it?
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.
A patient is considered a full code until proven otherwise. A suicide attempt negates a DNR in most circumstances.
Dogen
897 Posts
Just like in the hospital, if you don't know the code status then they're a full code.
Much like putting Baby in a corner, nobody tells the pilot when to divert. Your authority extends only to the patient, the pilot controls the plane. The JEMS article posted earlier recommends against even suggesting diversion, but instead telling the pilot the prognosis of the patient (CYA, I guess). I imagine it's a moot point, though, since I doubt a pilot is going to carry on while someone dies on the cabin floor.