To Treat or Not to Treat When May

To Treat or Not to Treat? ! When May ANG Medics Treat? Moderator: Col. Frank Yang

Choices • YES!! Go for it! All the way! • NO!! Don’t‘ touch that! • “Fitness for duty” determination only. • “Depends” ……

Scene 1 • You, the Va. ANG Medic, is asked to see Mbr who has fever or vomiting or shortness of breath while on UTA.

Scene 1 “answer”? • You may examine that Mbr to determine if he/she is medically fit to continue UTA or to billeting and rest or to ER / local hospital for treatment.

Scene 2 • If Mbr develops acute respiratory distress while in medical clinic, and there is oxygen and bronchodilator nearby, you administer emergency oxygen and give rescue inhalant, while someone calls ER/911 to evacuate the Mbr to base ER or local civilian hospital.

Scene 2 “answer”? • Your treatment was for an emergency, and your acts are covered as long as you acted within your license and scope of practice. • You, however, are not authorized to prescribe Cipro, Z Pak, or Albuterol (to be filled and electively picked up from a pharmacy) if the Mbr’s condition does not constitute an emergency. This would be non-emergency treatment, for which you are not covered while on UTA status.

Scene 3 • You are helping the base 5 K run, or monitoring the Group fitness test on Sat UTA, Mbr develops sudden chest pain and becomes ashen. • You attach AED, and a shockable rhythm appears.

Scene 3 “answer”? • You continue emergency treatment until EMS arrives and transports the Mbr to an ER. You are covered.

Scene 4 • At the base 5 K run or fitness test, Mbr sprains an ankle.

Scene 4 “answer”? • You are authorized to wrap or splint the ankle. This is “treatment” (self aid and buddy care), but it is considered emergency treatment, and you are covered. • You ask the Mbr to follow up with his PCP. You are not authorized to treat that Mbr’s ankle next UTA day or next UTA, because by then it is no longer an emergency.

Scene 5 • You are called to a flight emergency on the runway. You render emergency treatment on the tarmac.

Scene 5 “answer”? • Your emergency treatment is covered. • You visit the Mbr at the hospital and provide “wingmanship”, while hospital staff provides treatment.

Scene 6 • You are activated for CERFP, and there are many civilian victims/patients, and fellow CERFP Mbrs hurt/ill …. .

Scene 6 “answers”? • You are covered for all medical treatments, as long as you acted within your license and scope of practice. • You are covered to treat, regardless of your activation status, as long as you are “activated”: Title 10 Federal, Title 32 State, or State Active Duty (SAD). • You are covered even if you are sent to another state as part of CERFP; state to state mutual assistance agreements cover you.

Side show -- does pay status matter? ! • Title 32 & 10 are Federal pay status, therefore covered by Federal tort. • UTA & AT are 32, therefore covered by LOD (line of duty) determination. • CERFP almost always 32. • SAD (State Active Duty) eg. hurricane relief, is state pay, so Workers’ Comp covers.

…. . and as the curtains come down …. . • OK or clear as mud?