Coast Guard Triage Question (U-869)

[rawls]

Just because someone's CPR (BLS) card has expired does not mean they forgot how to perform it. Even in our hospital, many staff members' cards are expired for a few months until their schedule allows recertification.

Hmmm...Say a patient starts going bad...then goes into v-fib arrest and CPR is begun. The pt doesn't make it. For whatever reason the family hires a lawyer and sues. Lawyers are trained to look into every nook and cranny to try to find fault. You can bet they would not miss the fact that the person who was performing CPR had an expired card. Of course he or she would know how to perform it. Do you think it would hold water in a law suit. I doubt it. And it is hard for me to believe that a staffer could go a few months without recert...Don't let the regulatory agencies know it. Talk about a lawsuit...

As instructors we are well aware of potential litigation against us. And we know when something goes wrong that any "i" not dotted or "t" not crossed can get us in big trouble. Chatterton knew this. He had been a scuba instructor. He no doubt recognized the potential risk of having a lawsuit. Again...I see nothing abnormal about him asking Kohler if his CPR cert was current.

I know, I know...fftopic:

 

[northen diver]

Thanks for the replies from northern Diver down to...well...northern diver The info you all provided answered alot of questions and at the same time brought more...So...USCG rescue swimmers can "determine" death...as opposed to officially pronouncing it and make the call whether or not to take the deceased diver on the ride back. And it also seems that from what you guys said, that it's basically an educated judgement call as to the triage parameters...in general. In other words there is gray area to work with. IMHO these people should be given the ability to make those calls. Now the question remains as to why the decision was made to take both Chris and Chrissy instead of leaving Chris? And as Charlie said it is sometimes a judgement call...In other words the CG gives some degree of credence to someone who says...hey...the person is deceased. Hell...It has now piqued my interest even more as to why the triage was carried out in the manner it was. I go diving with John on occasion during certain events and I have not asked him questions regarding the book...and he doesn't talk about the book unless someone asks him a question. I may have to break down and ask him about this...It is one not only myself, but alot of people have had for quite awhile.

This is NOT what I said. Please re-read my post. ALS and some BLS can with the medical control/medical command (a licensed doctor) can call a ceased effort under certain conditions. Each state is different. Many of protocols will come from what the indiviual state dictates.

With no disrepect here but it sounds like you are "fishing" here and it seems that there is some litigations going on here and YOU know some of the people invovled...Have you ever performed a life threating rescue? You ever performed CPR on a non responsive person? EVERY rescue is different. These guys and gals (there are five female AST's now) put there lifes in danger on most of these resuces to include the entire helo crew. They work in some pretty extreme conditions.

Here is a small sample of what these guys go through.

Coast Guardsman Receives Heroism Award

 

[JayJudge]

Actually, in regards to the accident that was asked about, in 1993 or so, the CG did not carry O2 on all flights, at least according to the former swimmer I know. Also, administering CPR with an out of date card still is protected by the good samaritan laws, if acting in a PRUDENT mannner, as with anything. Read Law and the Diving Profession, for more in-depth info on this. Furthermore, who would ask someone about their card in the middle of an emergency? As for incidents (not just dive) that I have been around, my last question to someone helping is what date their card expires on. But maybe thats me, and let them cover their own assets as it were.
-J

 

[northen diver]

Actually, in regards to the accident that was asked about, in 1993 or so, the CG did not carry O2 for divers, as this was fairly new theory. Also, administering CPR with an out of date card still is protected by the good samaritan laws, if acting in a PRUDENT mannner, as with anything. Read Law and the Diving Profession, for more in-depth info on this. Furthermore, as for the books' allegations, CPR was conducted for 1 hr or so until the chopper arrived- by only JC in SD. If you have ever done CPR, even on an res. Annie, an hour? with the amount of compressions? BS.
-J

Actually, the good smaritan law does not apply here if the person is a first responder.

Any first aid provided must not be in exchange for any reward or financial compensation. As a result; medical professionals are typically not protected by Good Samaritan laws when performing first aid in connection with their employment.


I dont think a single person or even two can perform CPR for one hour without a thumper and BVM.......

 

[dashark]

This is NOT what I said. Please re-read my post. ALS and some BLS can with the medical control/medical command (a licensed doctor) can call a ceased effort under certain conditions. Each state is different. Many of protocols will come from what the indiviual state dictates.

With no disrepect here but it sounds like you are "fishing" here and it seems that there is some litigations going on here and YOU know some of the people invovled...Have you ever performed a life threating rescue? You ever performed CPR on a non responsive person? EVERY rescue is different. These guys and gals (there are five female AST's now) put there lifes in danger on most of these resuces to include the entire helo crew. They work in some pretty extreme conditions.

Here is a small sample of what these guys go through.

Coast Guardsman Receives Heroism Award

All too true. None of us can know what the right call was that day unless we were there, working on those divers. I don't care how much experience you have...

There is no definative answer to this question. Only conjecture.

 

[rjack321]

Which is why the general protocol is not to rescue dead people (with helos or otherwise). The CG has the capacity to cease rescue efforts at their discretion. They are not making a legal pronoucement of death or causality through that decision, just a risk/benefit decision for themselves.

Maybe they didn't triage much at all they just picked up both "because". Or maybe they chose to evac Chris because 5 mins either way on Chrissy was irrelevant. I don't understand the motivations of the OP to 2nd guess the discretion of the CG servicepeople at the time.

 

[Lead_carrier]

Hmmm...Say a patient starts going bad...then goes into v-fib arrest and CPR is begun. The pt doesn't make it. For whatever reason the family hires a lawyer and sues. Lawyers are trained to look into every nook and cranny to try to find fault. You can bet they would not miss the fact that the person who was performing CPR had an expired card. Of course he or she would know how to perform it. Do you think it would hold water in a law suit. I doubt it. And it is hard for me to believe that a staffer could go a few months without recert...Don't let the regulatory agencies know it. Talk about a lawsuit...

As instructors we are well aware of potential litigation against us. And we know when something goes wrong that any "i" not dotted or "t" not crossed can get us in big trouble. Chatterton knew this. He had been a scuba instructor. He no doubt recognized the potential risk of having a lawsuit. Again...I see nothing abnormal about him asking Kohler if his CPR cert was current.

I know, I know...fftopic:

Under North Carolina good samaritan laws, from what I have been taught, if you do nothing beyond the normal scope of care for which you've been trained. You are covered, period. Which means, my cpr card has expired but I administer cpr. No problem. I try to perform surgery. Nope, can't go there. If I acknowledge someone has a problem and DO NOT perform basic first aid, I can be gotten for negligence. Both civil and criminal. I'm sure if I was taught wrong I'll be corrected, or at least I hope so.

 

[northen diver]

Which is why the general protocol is not to rescue dead people (with helos or otherwise). The CG has the capacity to cease rescue efforts at their discretion. They are not making a legal pronoucement of death or causality through that decision, just a risk/benefit decision for themselves.

Maybe they didn't triage much at all they just picked up both "because". Or maybe they chose to evac Chris because 5 mins either way on Chrissy was irrelevant. I don't understand the motivations of the OP to 2nd guess the discretion of the CG servicepeople at the time.

This would be called a recovery mission. Not a rescue mission. And they also do recovery missions. My next door neighbor and his son lost thier lives on Sept 3 when his plane crashed into Lake Erie. The USCG helped performed the recovery.

 

[rjack321]

This would be called a recovery mission. Not a rescue mission. And they also do recovery missions. My next door neighbor and his son lost thier lives on Sept 3 when his plane crashed into Lake Erie. The USCG helped performed the recovery.

Good point, and these are typically multiagency actions. E.g flight 800. For the OPs purposes though they don't convert a risky rescue into a risky recovery willy nilly.

 

[rawls]

This is NOT what I said. Please re-read my post

Apologies...I did reread your post and I can see where it was misinterpreted, but was it "totally" misinterpreted when you wrote

Some of the stations will also act within the local protocals if they are within the US territory. For example, in Ohio, under the Ohio Revised Codes, only a licensed medical physican call call death. But a EMT P, EMT A, RN can assist in determining death (cease efforts)..

And I am not AT ALL making implications as to what you wrote. It is simply a question that will help me better understand. Do rescue swimmers have that authority to "assist in determining death (cease efforts)" where "local protocols" permit.
The bottom line however is I did overall misinterpret you by making a blanket statement as to "determining death" and again I apologize for that.

With no disrepect here but it sounds like you are "fishing" here and it seems that there is some litigations going on here and YOU know some of the people invovled

No disrespect back but who is "fishing." I know of absolutely no "litigation going on" nor am I trying to fish for information. I will retract my saying you are the one who is fishing if you can tell me where I gave any indication of that in anything that I have written. I am like anyone else on this thread, simply interested in the question posed by the poster.

Have you ever performed a life threating rescue? You ever performed CPR on a non responsive person? EVERY rescue is different. These guys and gals (there are five female AST's now) put there lifes in danger on most of these resuces to include the entire helo crew. They work in some pretty extreme conditions.

Where in the world did you read something I wrote that would lead you to ask this question...but ok...to answer it...I had to do a rescue on one of my divemaster candidates and it was a life threatening event. It still haunts me to think what the outcome could have been. Thank goodness it was a success.

I have worked everywhere from pediatric intensive care to cardiac surgery intensive care. So yes...I cannot count the times I have performed CPR. The most heart breaking ones were the children and teenagers I have had to code who had their whole lives in front of them but didn't make it...

When you wrote "these guys and gals put their lives in danger..." it seems to me that you have somehow interpreted that I am bashing the USCG. That can't be further from the truth. I grew up on the coast. I have always had the utmost respect for the USCG and I always will, and I am well aware of the risks they take to save lives. I can't see where you thought I was finding fault with them. In no way was I trying to find fault. I don't think they were at fault in this incident at all. I was simply trying to understand triage protocols.

Under North Carolina good samaritan laws, from what I have been taught, if you do nothing beyond the normal scope of care for which you've been trained. You are covered, period. Which means, my cpr card has expired but I administer cpr. No problem. I try to perform surgery. Nope, can't go there. If I acknowledge someone has a problem and DO NOT perform basic first aid, I can be gotten for negligence. Both civil and criminal. I'm sure if I was taught wrong I'll be corrected, or at least I hope so.

And thank goodness for the Good Samaritan law. It doesn't however prevent suit being brought. Because of them they offer us a great deal of protection from being found liable, but they don't prevent having suit being brought against us. As far fetched as it may sound, you could fart next to a person and they can bring suit for punitive damages from pain and suffering the smell of the fart Hopefully that has never happened but give it time...Recall the judge who sued a dry cleaner for millions of dollars for losing a pair of his pants...