Medical Information on Waivers

[tombuch 0]

There is an interesting side thread under the main thread:
An introduction to Skydive Secure - data unity for skydivers about the storage and retrieval of emergency health information and emergency contacts.

BIGUN wrote:

Quote

On a separate note (which may require a separate thread - feel free to delete)... At virtually every incident I've been on the scene at; not once have I seen anyone run into manifest and give the paramedics a copy of the waiver that includes current meds or drug allergies (i.e., I'm seriously allergic to Codeine (which I only found out after the wisdom teeth extraction and subsequent hospital experience)) The flip side of that coin is how many skydivers do not list their meds out of concern for privacy issues - but it is important to do.

As I recall, there was a case a few years ago where a tandem student was in a nasty wreck, but should have survived. Unfortunately, she was asthmatic and died in the operating room. The medical team had no idea of her pre-existing condition and wasn’t prepared for the attack. Following that fatality my DZ made it a manifest policy to check the waiver of any injured and non-responsive jumper and relay critical health information to the responding medics. For more information about our general response policy, see article 10 “In an Emergency” at http://theblueskyranch.com/STA.php.

Most drop zones have a place for medical information on their waivers, even if it is just under “medical conditions.” My question is how many DZ’s actually retrieve this information for the rescue squad, and how many skydivers with critical conditions make it a point to include them on the waiver?

Perhaps this is something to discuss at your Safety Day…

Tom Buchanan
Instructor Emeritus
Comm Pilot MSEL,G
Author: JUMP! Skydiving Made Fun and Easy

[steveorino 7]

Most likely most people do not divulge. I know of an IAD student who passed out under canopy and survived with no major injuries (lucky dude) His wife stated he had high blood pressure, but even though that medical concern was on the check list on the waiver it was not marked.

I remember a lady asking me if she thought it was okay for her to do a tandem with me as she had a kidney problem. I asked her what her Dr. said about it. She said he said don't do it. She was surprised when I refused to take her on a tandem without a written note from her doctor clearing her of that condition enough to jump.

steveOrino

[Thanatos340 1]

And how long would it take them to find it if they did have it on paper somewhere? Some DZ`s I have been do not exactly have the best filing system in place. How long would they have to dig through Filing cabinets to find that waiver you filed out a couple years ago?

[Glitch 0]

Aren't/Shouldn't waivers be re-signed yearly at all dropzones? ...or just the ones I've been fortunate enough to frequent?

Randomly f'n thingies up since before I was born...

[sunshine 2]

I'm sure a lot people don't divulge personal information on waivers. They know if they admit to having a problem the dz will require a doctors note.

That being said, i don't have any serious medical concerns myself, but i do make sure my jump buddies are aware of any medications i may have taken that day...such as sudafed etc.

___________________________________________
meow

I get a Mike hug! I get a Mike hug!

[pilotdave 0]

My fear with doing that is liability. If the DZ knows about an existing condition (ie it's written on the waiver) and lets the person jump, couldn't that cause trouble? Or if we have the information and for whatever reason don't relay it to medical personnel. Could the DZ be held liable? I'm guessing of course that depends on how well the waiver is written... but we're not doctors and we don't keep medical records. I think doing so could open more cans of worms.

But I guess if it can save lives, worrying about liability is pretty silly...

Edit: We do ask on our waiver if the person has any medical conditions that could affect their ability to skydive... if they do, we'd make them get a doctor's note to be able to jump. But I'm more thinking about experienced jumpers that are more likely to put "none" no matter what, because they know some minor condition isn't a big deal and they want to jump.

Dave

[Andy9o8 0]

I think your concerns are quite valid. And so are Tom's. I'm not entirely sure how to reconcile them.

[Mr17Hz 1]

Quote

My fear with doing that is liability. If the DZ knows about an existing condition (ie it's written on the waiver) and lets the person jump, couldn't that cause trouble? Or if we have the information and for whatever reason don't relay it to medical personnel. Could the DZ be held liable? I'm guessing of course that depends on how well the waiver is written... but we're not doctors and we don't keep medical records. I think doing so could open more cans of worms.

But I guess if it can save lives, worrying about liability is pretty silly...

Edit: We do ask on our waiver if the person has any medical conditions that could affect their ability to skydive... if they do, we'd make them get a doctor's note to be able to jump. But I'm more thinking about experienced jumpers that are more likely to put "none" no matter what, because they know some minor condition isn't a big deal and they want to jump.

Dave

I think this is the purpose of putting the emergency contact information on the waiver itself; the waiver can indicate that it is the customers responsibility to check with their doctor if they have any questions or concerns, and that the dropzone may not be held liable. It can also specify that emergency information is collected for the sole purpose of being available to emergency response teams upon request - meaning that the dropzone is not obligated to provide it, but that it's there if necessary.

Of course, the DZ can then implement a policy to make the information available right away all the time, not just when requested - they just won't be legally responsible if they don't offer it up without a request.

Matt Christenson

[email protected]
http://www.RealDropzone.com - A new breed of dropzone manifest software.

[councilman24 36]

We pulled them for rescue crews.

But, how does HIPPA regulations apply? Are DZ's violating federal law by asking for it and not having all of the paper work that every doctor or other place gives me?

I don't have a clue.

And not enough time tonight to research it.

I'm old for my age.
Terry Urban
D-8631
FAA DPRE

[smiles 0]

some stuff is so easy like diabetes, i figure dz's should carry glucose tabs in their first aid kit just incase a diabetic is in need. I supply them at my d.z. as i am a diabetic skydiver who always carries them in my jumpsuit pocket.

there is a thread somewhere on here about a tandem instructor with diabetic (type 1) coming back to jump again. Her first jump she carried a can of pop with her for ride to altitude incase her blood sugars got low (as if one can down a pop on jump run...) in comparison to carrying glucose tabs makes way more sense as they dissolve quickly in the mouth.

When medical info is known re: passenger a diabetic, tandem instructors could check if they have eaten a meal recent or have glucose tabs in their possession.........

SMiles

eustress. : a positive form of stress having a beneficial effect on health, motivation, performance, and emotional well-being.

[justinb138 0]

I've often wondered why people don't keep the important medical information on them in case of an emergency, like in the pocket with their reserve data card.

If someone's seriously hurt skydiving, there's a good chance they're gonna be wearing their rig, and the info would be right there and easily accessible.

[cjsgrlsx3 0]

My medical is written in the Emergency contact area on the computer. It would be pretty important as I have a blood disorder where my blood does not clot properly. If my husband is there he can tell anyone who needs to know. If he is not there then they will have to look at the contact list to call him and see it there also.

[peregrinerose 0]

For something like that it might not be a bad idea to get a medic-alert bracelet to wear at least while jumping.

Do or do not, there is no try -Yoda

[tombuch 0]

Quote

some stuff is so easy like diabetes, i figure dz's should carry glucose tabs in their first aid kit just incase a diabetic is in need. I supply them at my d.z. as i am a diabetic skydiver who always carries them in my jumpsuit pocket.

In many states giving those tabs without a prescription is illegal. I'm an EMT, and in New York, Connecticut, and Vermont (the states I've in which I've been licensed) I can assist a diabetic with his own medication, but cannot provide that medication to anybody else. The same is true with an inhaler for asthma, and an epie pen for allergic reactions. Heck, under the law our drop zone is not even allowed to provide oxygen until a responding rescue worker arrives.

In most states a lay person may be somewhat better protected by "Good Samaritan" laws, but you still need to be very careful about what you do as an individual who just happens to have the needed medication, and as a business owner who stocks medication. Check with your local rescue squad for the laws in your state and then make an informed decision about what you will stock on the DZ.

Tom Buchanan
Instructor Emeritus
Comm Pilot MSEL,G
Author: JUMP! Skydiving Made Fun and Easy

[cjsgrlsx3 0]

I had thought about it just in case it was overlooked. I just may do that today!

[BIGUN 1,053]

Quote

But, how does HIPPA regulations apply?

HIPAA has a provision for express and implied consent. There is also a provision of exclusion for emergency medical situations.

As an employer, we must maintain the provisions of HIPAA compliance, but if one of our employees falls over and we call an ambulance, we can release their medical info to an emergency response team.

I mean it's such a big ugly regulation, you're fucked either way you go if the person wants to get pissy about it. If you release it, they can sue you, if you don't release it and they suffer as a result of it - the litigators will get you either way.

Personally (if I were still a DZO), I'd rather be sitting in court saying we released the information not with the intent of violating their confidentiality, but in the interest of saving their life. Let the jury decide.

Nobody has time to listen; because they're desperately chasing the need of being heard.

[smiles 0]

Quote

In many states giving those tabs without a prescription is illegal. I'm an EMT, and in New York, Connecticut, and Vermont (the states I've in which I've been licensed)

You need a prescription to give glucose tabs and it would be illegal if you did????????????????????

Why do you think one would need a prescription for glucose tabs??? As a EMT you would be fully aware what a prescription drug is and what is'nt?

Glucose tabs can be bought at any corner store, on the shelf or off every drug store shelf in my country- and I am certain they are in your country too.

Quote

I can assist a diabetic with his own medication, but cannot provide that medication to anybody else.

hey buddy, as long as you are aware of what is medication and what is glucose tabs!

glucose tabs=
4 grams of carbohydrates per tablet
ingredients= glucose

SMiles

eustress. : a positive form of stress having a beneficial effect on health, motivation, performance, and emotional well-being.

[tombuch 0]

Quote

You need a prescription to give glucose tabs and it would be illegal if you did????????????????????

Why do you think one would need a prescription for glucose tabs??? As a EMT you would be fully aware what a prescription drug is and what is'nt?

Glucose tabs can be bought at any corner store, on the shelf or off every drug store shelf in my country- and I am certain they are in your country too.


hey buddy, as long as you are aware of what is medication and what is glucose tabs!

glucose tabs=
4 grams of carbohydrates per tablet
ingredients= glucose

Wow, relax. Your profile says you are in Canada, and your country tends to do things differently, and sometimes even better. Here in the United States our national emergency medical protocols reflect an urban environment with close by definitive care, and a relatively untrained group of responders. Sadly, those protocols have not kept pace with the training an EMT now receives, nor do they appropriately serve the more rural areas of our country, where definitive care may be an hour or more away and prompt field care is critical.

In the three states that I have been licensed glucose tabs are considered a drug, and the administration of glucose by an EMT must be specifically approved by medical control (EMS doctor) either in a standing order, or for a specific case through radio type approval. An asthma inhaler is a drug that must also be approved by a doctor. The use of an epinephrine pen must be approved by a doctor. Heck, an EMT cannot even administer aspirin at all. It’s pretty nuts.

I’ll give you an even crazier example. Medical oxygen is considered a drug and cannot be administered by a responding EMT without the specific authorization of a doctor, either through standing orders or online (telephone/radio). As an EMT with significant training in the administration of oxygen, I still cannot deliver oxygen to a patient unless I have been specifically dispatched and am covered by a medical control agreement. At my drop zone we are not legally permitted to maintain oxygen, or to deliver it to an injured jumper. Yet, as a pilot, the FAA encourages me to use oxygen anytime I’m flying above about 8,000 feel at night, and I can supply oxygen to my passengers at any altitude based on my status as pilot in command. Gosh golly, I’m even REQUIRED to use oxygen, and to provide oxygen to my passengers at higher altitudes, and the FAA offers a pilot absolutely no training in the administration of oxygen. I suppose if I had a trauma patient I could drag him into an airplane and then provide oxygen as a pilot in command, but of course that’s silly.

In many cases, a lay person acting as a Good Samaritan can actually do way more than an EMT. It’s important for a business owner to understand that if the business is providing medical services it must comply with state regulation regarding delivery, while an individual can follow his own conscious as long as the treatment offered is “reasonable.” If I come upon a conscious person with chest pain, shortness of breath, shooting pain in the left arm, and a history of heart attacks, I can offer aspirin as a Good Samaritan (and so can anybody else), but I cannot identify myself as an EMT and then provide that aspirin, even if a doctor tells me it’s alright. As an individual I can certainly provide another persons glucose tabs to a person who I think is in insulin shock, but I must do that as a Good Samaritan. I can’t do that as a licensed EMT, nor can I carry around glucose tabs in my pocket “in case” I come upon a person in need unless it done as part of a recognized program with medical control.

My DZ has had a serious conflict with our local rescue squad and has hashed these issues out in great detail with the New York State Department of Health. We cannot provide things like glucose, oxygen, epie pens, or any other drug without first obtaining medical control coverage. To do otherwise would subject us to the potential of litigation, and licensed medical providers (such as EMT’s), could face action against our state licenses. It’s nuts. It’s really nuts.

Any DZ in this country that is going to provide any medical services should consult their local EMS provider and clarify what they will allow, and what they will prohibit. In many cases it will be a matter of the local rescue squad agreeing to “look the other way” in the interest of patient service. Hopefully most drop zones have a better relationship with their local rescue squads and will be able to do a bit more in terms of providing life saving medical support.

As for Canada…one of my favorite pain relievers for muscle aches is Tylenol with codeine. It’s available as an over the counter drug in Canada (just 8mg of codeine and a bit of caffeine), but codeine is a federally controlled substance in the United States. Possessing that stuff could get me in serious trouble here, but I make sure to pick up a bottle or two when I travel up north.

Tom Buchanan
Instructor Emeritus
Comm Pilot MSEL,G
Author: JUMP! Skydiving Made Fun and Easy

[brianfry713 0]

So you're saying a person with no medical training has more protection under the law to do whatever they want to an injured person than a licensed EMT?

As an EMT could you just help them in any way you see fit as a first responder and not identify yourself as an EMT?

Less training = more rights to administer first aid and drugs?

[tombuch 0]

Quote

So you're saying a person with no medical training has more protection under the law to do whatever they want to an injured person than a licensed EMT?

As an EMT could you just help them in any way you see fit as a first responder and not identify yourself as an EMT?

Less training = more rights to administer first aid and drugs?

Yup. Essentially that's it.

An EMT is licensed to practice under the direction of a physician. When an EMT (or paramedic) is serving in that role the patient has the benefit of physician directed medical care. Sometimes that's as simple as pre-existing direction to, for example, use oxygen in a predefined situation, and sometimes it's a specific as a radio link with verbal direction.

If I say or indicate that I'm an EMT, the patient has a right to expect that full level of care. If, on the other hand, I simply assist as a citizen, the standard of care expected by the patient is much lower, and as a responding Good Samaritan I have more leeway to act responsibly. But in that case, I can't offer anything more than basic level first aid.

The specifics of what protection is offered to a Good Samaritan will vary from state to state, but generally, a responding citizen can do whatever he thinks is reasonable to assist another person who is in trouble. A licensed medical provider, on the other hand, is limited by his specific scope of practice.

The laws vary from state to state, so if you have specific questions about your region I suggest you contact the local ambulance squad and chat with a training officer.

Tom Buchanan
Instructor Emeritus
Comm Pilot MSEL,G
Author: JUMP! Skydiving Made Fun and Easy

[kmfenaughty 0]

As a former EMT ...certification long since expired ... If you have ANY kind of medical condition that you need to convey to a health care professional in the event that you are unable to ALWAYS wear a MEDIC-ALERT, they even offer a new style http://www.medicalert.org/E-Health/

Back on topic .. here in the USA we have HIPAA regulation (as somebody already mentioned) that attempt to control who has access to your private medical information.

If you provide this info to your local DZO ... I am not sure that they are any requirment to keep that info private ... if I recall the wavers are usually stored in a file cabnet that allows anybody who works there will have access to it.

If you are concerned about an medical condition you have ... ALL emergency medical care personnel are trained to check for the braclet or perhaps now the more advanced versions.

This method works 100% of the time and it also relieves the DZO of the burden of sharing that info with the EMS, let alone the legal implications if PRIVATE medical information is inadvertenly disclosed.

Just my opinion ....

99% of the people on this earth are sheep ... dare to be different

[Eule 0]

Quote

My question is how many DZ’s actually retrieve this information for the rescue squad, and how many skydivers with critical conditions make it a point to include them on the waiver?

Having recently filled out a waiver ( time jumping at a DZ far from home), I got to think about this again. I'm happy to put down that I've got Ti in my left leg and I wear glasses. For meds, I usually put down the three antibiotics that I'm allergic to, because I figure that's where the problems would come from if I was given emergency medical care and wasn't able to tell someone about it.

In my wallet, behind my driver's license, I do carry a piece of paper with medical and contact information. That one has _everything_ on it. I don't usually have my wallet on me when I jump, though. (I started keeping that info in my wallet several years ago when I went on a trip out of the country, well before I started jumping.)

When I broke my leg jumping, I was conscious throughout, and was able to tell the nurse about all the allergies, conditions, etc. Also, somebody at the DZ got my wallet and made sure that it got to the hospital shortly after I did.

When I first moved to Oklahoma from Texas, I went to get a new driver's license, and the OK application asked about several types of medications. I was pretty sure I wasn't taking anything they cared about, but I asked my doctor to be sure. He told me that I wasn't taking anything on the list and that even if I was, he would advise me to simply not mention it on the application, as he felt that they had no need to know.

Eule

PLF does not stand for Please Land on Face.