Volunteering as "Medical" at a community event

[CPhT]

Two-three times a year, a local group puts on a cool event called "Thunderdrome" in Northwest Detroit. The basic gist of the event is a bunch of people gathering at an abandoned velodrome (1000' concrete banked oval race track) and racing pit bikes, minibikes, mopeds, scooters, mountain bikes, "fixies", and commuter bikes. It's a legal event, with insurance and permits and such. However, over the last couple of events, I've noticed a disturbing lack of medical coverage. They have a small plastic case with neosporin and band-aids, but that is the extent of first aid available on scene.

My questions to the city dwellers are:

1. Would you, as a licensed but off-duty EMT, volunteer to provide any on-scene medical care, limited obviously to your provider level, but also with the stipulation that 911 will still be called, as needed?

2. What type of equipment would you bring with you? I'm really interested in doing this, but I have nothing aside from a small first-aid kit in my trunk, and my school gear (shears, stetho, BP cuff, CPR mask, and pen light). I don't want to feel like I'm carrying a portable trauma unit to this event, and I don't know if I can justify buying a wacker-kit just for 2-3 events per year.

3. The obvious one; liability. All racers have to sign a release form before being allowed to compete. However, if someone were to get hurt, and I was to provide care, what sort of liability does that open me up to? Does it open the organizers up to any liability if they allow me to provide care?

My main reason for asking, is that I have friends that attend this event. I also know quite a few of the racers. They all wear proper safety gear, but things happen. I'd hate to see someone go down and actually get hurt to the point where they need EMS care, then have to wait the 20-30 minute response times of Detroit EMS.

Your reward for putting up with my incessant nagging; a video from last year's event.

I forgot to add. The video above was taken at the April event, which had around 50 racers and probably 200 spectators. The September event had almost 200 racers and well over 1000 spectators.

Then again, I don't count the hipsters as people, so there are probably even more.

[DFIB]

It looks like a really cool event. There are a few questions I would try to answer before getting involved.

Am I just going to be a guy that buys a ticket and brings my skills with me or am I going to offer my skills as an EMS provider?

If I offer as a provider does the law require me to have medical direction?

What level of trauma am I going to attend? If it is more than simple scrapes I think i would need the right gear?

[CPhT]

It looks like a really cool event. There are a few questions I would try to answer before getting involved.

Am I just going to be a guy that buys a ticket and brings my skills with me or am I going to offer my skills as an EMS provider?

If I offer as a provider does the law require me to have medical direction?

What level of trauma am I going to attend? If it is more than simple scrapes I think i would need the right gear?

That's kind of the things I would be talking about with the organizers. They don't charge for spectators, and they welcome volunteers, so it would probably be more of column B (offering my EMT services).

As for medical direction, that's the type of thing that I don't know the legality of. Am I just a guy putting band-aids on scrapes, or am I bound by the protocols of Detroit at that point? In my own mind, I don't see myself having any medications (no glucose, no ammonia, no O2, no aspirin), no airway kits, no BVM, no c-collar. I think I would primarily want to be there to have one person who's at least had SOME training, rather than 100 people who have watched House, MD and/or stayed at a Holiday Inn last night. Kind of a "central point of contact" for any medical issues.

[Richard B the EMT]

I must have mentioned this on other strings, but here I go again...

In New York State, for each specified number of participants and/or spectators, an ambulance and crew must be staged at the event. Over a certain number, a "MASH" or equivalent tent(s), with full medical staff(s) must be assigned, and access/egress routes to and from must be established and secured open from several hours prior to opening, to a determined number of hours afterwards.. If big enough, a temporary heli-pad area should be secured.

And all of this, following a musical exhibition at a Mr. Yasgur's Farm in New York, in 1969, called Woodstock!

[paramedicmike]

Those sound like questions for your State EMS Office. That would probably be the best place to check.

Personally, unless they had an official medically oriented "first aid tent" or similar staffed with licensed medical professionals I wouldn't volunteer my time or services for such an event. The organizers either need to get something together to officially staff it or arrange to have an ambulance on location should they be needed. The potential for liability just seems too great to be undertaking such activities solo. Especially with as much alcohol as is probably floating around such an event.

All this being said it looks like a cool event. It looks like a fun time for both participants and spectators alike. I hope they can keep it going.

[Richard B the EMT]

Oh, just as a mention on this, Last summer, I attended a free Aretha Franklin Concert at the Coney Island Amusement Area, next door to the Municipal Credit Union Ball Park (Home of the Brooklyn Cyclones), and the Midwood Ambulance Service supplied 4 BLS ambulances. The concert series normally has 3 assigned to the event.

It would take me and lady J, normally, about 10 minutes to get out of the area following the concerts, this time took over an hour, due to the number of concert attendees. Coney Island is a limited access area, there's only 4 ways by road in or out, or come in illegally by boat (no docks).

[DwayneEMTP]

Great question, but man, so many variables....

Probably you wouldn't be covered by Good Sam even if you were volunteering your time, if you claim to be an EMT then legally you will likely be liable (if sued) for having for whether or not you had equipment and provided local Standard of Care treatments, even if not doing so professionally....

I think you need to take your little medical kit, get drunk, have fun, put bandaids on your buddies that need it if you want to, but the liability for the reast seems really, really scary....

Dwayne

[Bernhard]

It's a legal event, with insurance and permits and such. However, over the last couple of events, I've noticed a disturbing lack of medical coverage. They have a small plastic case with neosporin and band-aids, but that is the extent of first aid available on scene.

So the permit and/or the insurance contract don't contain any paragraph about security and emergency management? Usually, they do. However, sometimes not, especially on smaller events like this one - 200 bikers and 1000 spectators are not really much.

If you take over the coverage, let them show you the paragraphs about emergency management or get a written statement that there are none. Another thing: unless you have absolute trust in the organizers (and even then I would do it), make a written contract: what do you cover in what time, what do you take with you (equipment/staff and qualification), who pays the needed stuff and your meals/drinks, where do you take position, how can you reach the organizers and other security/emergency services on the spot or outside plus what this will cost...

My questions to the city dwellers are:

1. Would you, as a licensed but off-duty EMT, volunteer to provide any on-scene medical care, limited obviously to your provider level, but also with the stipulation that 911 will still be called, as needed?

Yes, we do it all the time. It's the base of our funding as a volunteer red cross group, since we usually don't offer the service for free (even if it's a free event), only with rare exceptions. Germans law on providing care as a licensed person seems to be totally other than in U.S., so I can give you just some general tips to cover such an event. We have several rules for such events.

2. What type of equipment would you bring with you? I'm really interested in doing this, but I have nothing aside from a small first-aid kit in my trunk, and my school gear (shears, stetho, BP cuff, CPR mask, and pen light). I don't want to feel like I'm carrying a portable trauma unit to this event, and I don't know if I can justify buying a wacker-kit just for 2-3 events per year.

Such an event I would cover with a medical post providing some coverage when treating patients (tent or ambulance) including equipment of an ambulance and at least one additional mobile team with an emergency kit and a stretcher. This is based on my pretty large experience with such events here. There even are algorithms to estimate needed equipment and staff, one of them, the "Maurer-Algorithm" (named by a fire chief, who came up with the idea) gives around the same numbers.

If the coverage is needed more than 10-12 hrs., you would need replacement stuff and a shift plan. Be sure that your main medical post is visible/marked - but do not use protected logos as the Red Cross or maybe the Star of Life when not specifically allowed to.

Equipment should include communication devices for internal team communication plus reaching organizers, security and other emergency staff as well as dispatch center. It may be helpful to notify dispatch about your existence, maybe they can make sure that you're additional notified about individual emergency calls from the fair ground to provide first responder service: people may call 911 if they don't see a medical post or if they just don't think of going there.

3. The obvious one; liability. All racers have to sign a release form before being allowed to compete. However, if someone were to get hurt, and I was to provide care, what sort of liability does that open me up to? Does it open the organizers up to any liability if they allow me to provide care?

Those question should have answered by someone knowing local law. Maybe ask a lawyer. Over here it's covered by several laws and regulations.

Another question to ask would be, who covers you when you're injured on your chosen duty?

Do the organizers have any numbers or rough estimations of injured/sick people from the last events? When doing new things it is a good idea to ask others who have experience. You did this here on Internet, but maybe you should look for someone covering/having covered similar events and ask them for their experience. This can you bring in some concurrence situation, so take care and take into account that they may not want to give you their information. If there is some official authority for EMS you can try to ask there.

Then again, I don't count the hipsters as people, so there are probably even more.

If there is no possibilities to guess the actual count of people, risk is a bit higher. You may choose to be flexible here with having background staff available you could reach on short-notice.

I'd expect several bruises with the bikers and would be prepared for a single more severe trauma (broken bone, head injuy, maybe even a real polytrauma, ...). The spectators are more likely subject of regular medical problems, depending on age, weather (hot, humid, cold, rain, ...) and ground (meadow? concrete?). The occasional fall of someone should be considered (especially kids), maybe allergic reactions or such depending on local flora and fauna.

Let them give you a map of the location, including access routes and posts of emergency management, organizers office, security posts and such. If toilets are included, it's a plus - people for some reason tend to got to medical posts to ask for the toilets...Every team should be equipped with such a map, it may be a good idea to give one to the next EMS station or even dispatch.

Every thing you treat should be documented. At the end give the organizers a report about number of treatments and some statistical data about cases. Pay attention to confidentiality obligations, data protection and time requirements for report/data storage. See local law/regulations for this, feel free to ask me.

Yes, that's not easy to follow...and a reason why it's usually done by some organisation/company here. Actually I'm trainer for courses about medically covering of events and contributed to a book on this topic. Don't underestimate this - shit happens. A stroke or a heart attack can occur anytime/anywhere.

Have luck & fun! Maybe give us here a report about your experiences.

[Richard B the EMT]

Pursuant to my previous postings, did I mention the establishment of local hospital's participation as primary/secondary/tertiary receiving hospital(s) to the event? One of them best be a Trauma Center, and all on your list should be involved in the pre planning.

No, I hadn't mentioned it before, so it is a good thing I just did!

The generalized suggestion of contacting the state DoH for what, if anything, they require for "Event Medical Coverage" is good, and I wish I'd mentioned it first.

[CPhT]

Wow, lots of good points were raised, and many things I didn't even think of. I think I might just contact the organizers and tell them to start contacting the local EMS companies and asking if they can post a truck on scene, rather than volunteering my time. That way we're both covered medically and legally.