Legal Issues Surrounding First Aid

First aid is the initial care given to a sick or injured person before more formal medical
assistance is applied. The goal of first aid is to intervene actively to prevent further
damage, to provide life support, and to begin effective treatment of the victim’s
condition, to minimize injury and prevent death. Although first aid is not a substitute for
medical care, those trained in first aid are able to assess the nature and the extent of an
emergency and determine the best course of action to take until professional medical
help arrives.

The need for training in first aid is evident, considering that injury is the fourth leading
cause of death. Falls are the most common cause of injury, but motor vehicle accidents
are the most lethal, accounting for 22 percent of injury deaths.

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An important thing to know when dealing with a first aid situation is to be up to date as
far as procedures are concerned. Procedures like slapping a choking person on the back,
putting iodine on a wound, cutting an X on a snake bite, putting ointment on burns, or
using a tourniquet to stop bleeding are old, out dated procedures and have been replaced
by new ones from the Red Cross association. If you decide to administer first aid, be sure
you are familiar with current procedures.
First aid begins with a scene survey. Before approaching a victim, a survey of the area
is necessary to determine if conditions surrounding the incident may place the victim and
the rescuer in danger. Next, the primary survey will determine if lifesaving procedures
must be immediately performed to save the victim’s life. The primary survey involves
checking the ABC’s: A: Is the airway opened and the victim’s neck stabilized? B: Is the
patient breathing? C: Is the victim’s blood circulating? Is there a pulse? Or is there
active bleeding?
Lifesaving procedures include cardiopulmonary resuscitation , which may be needed to
provide basic life support when a victim has no pulse and is not breathing. The Heimlich
maneuver aids choking victims by forcing ejection of obstructing material from the
windpipe. The severity of spinal cord injuries has decreased 30-45 percent due to
awareness that the neck must be stabilized before moving the accident victim. External
bleeding is controlled by direct pressure and elevation of the bleeding site.

The secondary survey is a total body examination, a pulse check, respiration count, and
observation of skin conditions. The only outward sign of severe medical problems, such
as cardiac diseases, stroke, or internal bleeding, may be shock. Those in shock will have
pale, cool, and clammy skin, a rapid and weak pulse, more than 20 respirations per
minute, weakness, and confused behavior. Treatment involves minimizing body heat
loss, elevating the legs without disturbing the rest of the body, and getting help as quickly
as possible.

No one is required to render first aid under normal circumstances. Even a physician
could ignore a stranger suffering a heart attack if he chose to do so. Exceptions include
situations where a person’s employment designates the rendering of first aid as a part of
described job duties. Examples include lifeguards, law enforcement officers, park
rangers and safety officers in industry. A duty to provide first aid also exists where an
individual has presumed responsibility for another person’s safety, as in the case of a
parent-child or a driver-passenger relationship. While in most cases there is no legal
responsibility to provide first aid care to another person, there is a very clear
responsibility to continue care once you start. You cannot start first aid and then stop
unless the victim no longer needs your attention, other first aiders take over the
responsibility from you or you are physically unable to continue care.

In every instance where first aid is to be provided, the victim’s consent is required. It
should be obtained from every conscious, mentally-competent adult. The consent may be
either oral or written. Permission to render first aid to an unconscious victim is implied
and a first aider should not hesitate to treat an unconscious victim. Consent of a parent
or guardian is required to treat a child, however emergency first aid necessary to maintain
life may be provided without such consent.

Some well-meaning people hesitate to perform first aid because they are concerned
about being sued. Legislators in almost every state in the country have passed Good
Samaritan Laws which are intended to protect good people who offer first aid help to
others. Most of the Good Samaritan Acts are very similar in their content and usually
provide two basic requirements which must be met in order for the first aider to be
protected by their provisions: the first aider must not deliberately cause harm to the
victim and the first aider must provide the level and type of care expected of a reasonable
person with the same amount of training and in similar circumstances.
If there is a situation that is due to the defendant’s own negligence, then it imposes on
him a duty to make a reasonable effort to give assistance. In most states there is a statute
to this effect in reference to automobile accidents. It states that the driver of a vehicle
involved in an accident resulting in injury to or death of any person shall render to any
person injured in such an accident reasonable assistance, including the carrying or
making arrangements for the carrying of such person to a physician, surgeon, or hospital
for medical or surgical treatment, if it is apparent that such treatment is necessary, and if
such carrying is requested by the injured party. In most state Drivers’ manuals directions
are given for behavior required after an accident among them being a part devoted to care
of persons injured in an accident. The directions specify that the injured person is not to
be moved unless necessary, keep the victim lying down, still, and warm, and send for an
ambulance, doctor, and police.

So we see that for an omission to act there is no liability unless there is some definite
relation between the parties which is regarded as imposing a duty to act. The law has not
recognized any general duty to aid a person who is in peril, but if the defendant enters
upon an affirmative course of conduct affecting the interests of another, he is regarded as
assuming a duty to act and will thereafter be liable for negligent acts or omissions. It is
quite clear then, that we are not required by law to give aid to a person in danger or
injured except under conditions of the statute stated above, but if we do take it upon
ourselves to help the injured then we must give reasonable care or we may find ourselves
liable for our actions. However, it would appear to me that it would be very hard for a
court to define what is or isn’t reasonable care, and the outcome of any such case would
quite likely be in favor of the defendant.

The purpose of this paper is to provide some basic guidelines as to what the laws state
in some approaches in first aid situations. With these guidelines it is hoped you can
more readily see and appreciate probable legal implications and also that you will
discover that the law is not engaged in searching for legal wrongdoing. Specific rules of
conduct for your own work should be formulated after proper consultation with your own
legal counsel.

The law recognizes that there are various degrees of skill. There are few problems for
people who stay in their own area. The right and duty to engage in radical procedures,
such as external heart massage and tracheotomies, are necessarily governed by the
circumstances. When communication is good and transportation swift, it is generally
wise to leave such procedures to physicians. The function of para-medical people is to
get the patient to a physician for diagnosis and treatment in as good condition as possible,
not to act as a physician. In times of great disaster or in the absence of transportation and
communication, it may be necessary and appropriate for all medical personnel to be
upgraded. Such promotions must be made with caution and after careful consideration of
the genuine need.

It is not the purpose of the law nor this discussion to alarm you that you do not perform
your duty. Legal complications have been extremely rare in this area and they will
continue to be most unusual so long as common sense and advance planning and thought
are applied. Your participation in first aid is evidence of your desire to achieve the
proper level of skill and training. The careful use of this skill and training will not only
enhance the physical welfare of the persons you care for but will also enhance your own
legal welfare.
On a closing note, here is a copy of Indiana’s Good Samaritan Law as an example of
almost every other states Good Samaritan Law.

“From and after the effective date of this act, no civil action can be brought against a
person licensed to practice the healing arts in the state of Indiana, who has gratuitously
rendered first aid or emergency care at the scene of an accident, casualty or disaster to a
person injured therein, for the recovery of civil damages as a result of any act or omission
by the said person rendering such first aid or emergency care in the rendering of such
first aid or emergency care. This immunity does not apply to acts or omissions
constituting gross negligence or willful or wanton misconduct.”
As you can see, there is essentially nothing to lose if you administer first aid as long as
you try your best to help and know what you are doing. Keep in mind that helping
someone in a life and death matter is a very big commitment, so make sure you are
willing to do so before you act.