Emergency physician with 35 yrs experience here. Contrary to “what everyone knows” it is very rare to be offered any freebies or compensation when you step in during an in-flight emergency. I got vomited on during one such episode and Delta wouldn’t even let me into the Club Lounge to clean myself up after deplaning. It was gross. No upgrades No free drinks and certainly no free miles.

My mom is an anesthesiologist or was for more than 40 years and had saved a woman on the plane from choking on some food. Was given nothing in return by the airline and the woman she saved never once thanked her or contacted her after the incident. The daughter of the woman did find and call my mom but only to try and have my mom verify untruths about the airline's food in an attempt to sue the airline. Some people are just ridiculous....

I was on a flight from Atlanta to Seattle and a flight attendant asked for anyone with medical training. A young man next to me pushed his call button and was asked to go to the back of the plane. He returned moments later complaining that he had never before been required to show his medical license, but retrieved it and rendered aid. It was just someone having a panic attack, but when we were all on the escalator in Seattle going to baggage claim, a couple of guys said "If he's a doctor, what's he doing riding in coach?", so I informed them that he was one of those poorly-paid residents just returning from a medical conference. Sheesh - the expectations of the uninformed public! Not every physician is a multimillionaire with his own plane!! Great video, thanks.

Very good answers. Not only did he answer what's legal, he answered what's ethical and what's practical. I am majorly impressed.

Former flight attendant here. I've been in several situations where a physician (or anyone with healthcare knowledge, really) was needed during a flight. Usually, it's not a problem to find someone. The only times we had trouble getting ANYONE to come help was on flights to or from the US, likely because people are so unsure of the legal situation. And we even carried legal papers explaining that there would be no consequences to anyone offering help, even in the case of injury or a fatality of the patient. Coming from Germany, where it is illegal to NOT help, this is just absolutely ridiculous. It makes me sad to think that a qualified person might not offer to help someone experiencing an acute health issue because there's the possible threat of legal action should they fail to save the person. Edited to add the following: "Helping" in this case means at the very least calling emergency services, similar to how another person in the comments described it being in Switzerland. Technically though, one might be required to help more than this. And everyone should be able to do so anyway, as any person with a driver's license acquired in Germany has to have taken a day-long first aid and CPR course and is required by law to carry a fully-stocked, non-expired first aid kit in their car at all times. I really wish the US, or rather its states, would loosen the legal barriers to providing aid in the case of an emergency, and require people with drivers licenses to obtain a minimum qualification in first aid.

As a paramedic of 25 years, I can tell you that, when on an aircraft, if you decide to provide medical care, the airline has physicians on call and available to consult. As a paramedic that works under the license of an MD at home, this allows me to provide much more care than I could legally without that resource. it also takes the liability off an MD, Nurse, or Paramedic on the flight that decides to assist.

Dear Max, you should be proud of what you did! I am not a doctor, I encountered a drowning of a 16-year old this summer - when he was pulled out of the pond by the heroic people who rescued him, he was unconscious, blue in the face and his red eyes were not responsive. I was not a certified lifeguard back then (which I am now), so I called my doctor, put him on loudspeakers and did what he said until the ambulance arrived. Thankfully, the boy is alive and well

Out of the "3 dos" mentioned, telling someone directly to call for emergency services is easily the most important. So often people will just assume that someone else has done it already, potentially causing a life threatening delay in getting that patient getting to the care they need

As a retired EMT I believe it is important to note that while we appreciate MDs being on scene, it's also important to note that we are under a medical control from a nearby hospital so any on scene doctor should be aware that if they want to assert full control over the case they must continue with us to the hospital. We will gladly mention their presence to our medical control and what has been done but unless they (the on scene doctor) are willing to assume full control and express as much to medical control, have their consent and come with us to the hospital we will only accept orders from our medical control.

The sad thing is the following. One thinks "Good Samaritan Law", well, I recall reading Florida's version. It says : "medical professionals are held to the standard of their profession". I HAVE driven past accidents that JUST HAPPENED and simply say "Someone will call 911, they will be in a hospital within the golden hour" and carry on. It is awful, but I am not willing to risk myself. The problem is that "negligence" is the loosest term on Earth.

'I am both an attorney and a physician' 😬 Yep MD/JD is very, very impressive! Informative video, thanks Max! In France, we can be prosecuted for non assistance to a person who is in danger. Ugh. It's complicated.

Number one rule I learned (the hard way) is to never stick around after you hand them off to a professional. A neighbor from two streets down, that I didn't know one bit, fell asleep with a cig and caught his house on fire. I smelled it and called for fire to come out while I was running to the house. I ended up getting there before the fire dept and ambulances. So I pulled him, his wife, and their dog out of the house. Luckily, I'm fairly fire resistant... but they weren't as their skin looked like it was staring to melt (dog was fine though). Responders come along, do their thing, I talk with them and give them the story, then they send those two out to the hospital (another neighbor took the dog for them). About a week later I get a call from the police with claims from the guy that I was the one who must have set the fire since I was there so quickly and it was two in the morning. So we do a little back and forth for a couple weeks while the fire investigator does his things (they were backed up at the time). Once he was done, and found out it was a lit cig in his recliner, I didn't have to worry about anything. But there was talk from his camp that he was going to sue the hell out of me and get me thrown in jail for my (cough) "heinous" actions. So yeah, never going through that kind of stress again and I've never stuck around to give anyone any info since. Upon hand off its simply: this is what happened, this is what I did, and, in medically related cases, what i think is going on... then I'm out. Bye!

Different in every state and every country. In Switzerland, the laws says anyone should help someone in need, and try to save the person with all the capabilities and knowledge they have. If you don't stop, even if the only thing you know what to do is call emergency services, you go to jail. At the same time, the good samaritan rule protect the helper.

Those are questions we would never wonder about in Europe... Seems terrible that you would refrain from helping to avoid a lawsuit!

One of the police officers I work with saved the life of somebody in Waterloo station (London, UK). I did not know anything about it until a week later when another officer told me that they knew the person who had the heart attack and was saved by my colleague's CPR. That is what I call modesty/humility. That is the kind of stuff that London's Metropolitan Police should be proud-of.

I'm from Norway, and in Europe you generally have a legal obligation to help, whether you're a lay person or professional. Just the notion that helping will have legal implications for you is frightening for me. If I see a person slumped over in the street, no matter how much I think he's a drug addict and don't want to go near him, if I don't do anything, I can serve actual jailtime.

Being a medical doctor and a lawyer is a parent's dream come true!

I am a MD and psychiatrist, so not exactly my speciality - I was once asked to make a psychiatric evaluation in Arlanda aerodrome in Stockholm - but that is another story. In Finland everybody is obliged by the law to help anybody in emergency situations. Whatever your competence is, you are to do all you can. Especially a medical person could face a severe reprimand and even a prison sentence, if you would just walk away. But of course we have no culture of sueing physicians...

Awesome video, thanks! Having a dual MD/JD is amazing. You quite literally picked the most qualified person to help answer this question. Thanks for all the great content too! 25 years ago I narrowed my career choices down to either wanting to be an anesthesiologist or my current career. So now I get my "dose" of anesthesia from watching yours and other anesthesiologist's KZfaq videos!

As a critical care nurse, I would not hesitate to help on in flight emergency. However, stopping at an car accident scene is a tough call. You can get hit by other vehicles while helping. Calling 911 is often the best thing to do. I carry reflective triangles to redirect traffic.

Former EMT, now long time ED/trauma PA putting in my two cents: if you want to carry any supplies in your vehicle, I recommend keeping it fairly simple. Especially if you're traveling in most of the country where EMS response times are decent. Mine has mostly first aid level- dressings, wraps, Sam splints, ice packs, tourniquets, OPAs, trauma shears, etc. I do have a spring-loaded center punch to break car windows, lots of gloves, Purell wipes, and camping type headlight. A yellow reflective vest is right on top. The only advanced item is decompression needle and chest seal. You might want z-fold gauze and multiple tourniquets if you want to be ready for a shooting situation. For me, I consider that the car gets hot, so lots of things don't last long. Other things expire in a way that matters. I can't afford to replace expensive clotting products, for example, but would probably keep those if I could.

Nice video, great to hear advice from a MD/JD. I've had 2 situations where I assisted on a plane flight. I am internal medicine trained and specialized in oncology, with prior experience as a hospitalist. I will say, helping on a plane is an extremely stressful job. You are limited in equipment/meds, have the stress of someone's life in your hands, and may be alone to triage until the plane lands. Both flights were very exhausting as I was by the patient's side the entire flight. Did not expect any compensation. Anytime there's a call for a doctor on a plane, I pray an ED doctor is onboard. They can handle most situations much better than other specialties.

I always love the videos where you have a guest on. They always bring an interesting perspective on things just a little outside the topic of anesthesia, but that still apply to it indirectly. This is the perfect example of that. Thank you!

I encourage anyone to read the story about the Paramedic that assisted in a cardiac arrest either at the airport or during a flight, that paramedic had ACLS training and knew the change in defibrillation guidelines per AHA, that included no longer giving stacked defibrillator shocks, with single defibrillation delivered followed by two minutes of CPR and then a rhythm check, followed by another defibrillation if needed...etc. The AED provided by the airline or airport had not yet been reprogrammed, so it instructed the paramedic and bystanders to continue shocking in a stacked fashion up to three shocks, per old ACLS guidelines. The paramedic followed the new guidelines as trained, and not the prompts from the AED. He was sued by the window of the man who died, and she won. She sent him a gift of flowers or something else so that the Good Samaritan law would no longer be in effect, so be aware. After reading this story I am very hesitant to assist anyone, especially if others are already assisting. This happened at least a decade ago, and a year or two after the AHA changes involving defibrillation. I would strongly caution against carrying any advanced equipment, such as intubation equipment and AEDs etc, as you then become responsible if they malfunction and are not usable on the call, and honestly as a paramedic I can tell you the chances of you being able to intubate someone not in cardiac arrest, on a scene, without medications is almost zero, and as a medic if someone claiming to be a physician just shows up to my scene telling me they are going to intubate my patient, I am gonna respond with a no, because I don't know you, and intubation is within my scope of practice and RSI (depending on the area) are also within my scope of practice . If it's a cardiac arrest, the last priority is intubation, unless they arrested because of choking or airway obstruction, the focus should be on quality CPR and early defibrillation, as long as effective ventilations can be given using an oral airway and BVM! If you are a physician wanting to continue care alongside EMS, you would have to discuss that via radio or cellphone with our medical control physician, who would then decide, in conjunction with EMS personal as to whether that was warranted or needed. As usual, thanks for the video Max Anesthesia.

Loved it Max. As a paramedic, the only thing I would add to what this highly informative video was saying is remember folks, Good Samaritan law covers you only if you are working within your scope of practice. Don’t go beyond what you are trained to do, if you are trained at all. Great video Max. I learned a lot like usual

in Germany, before getting the drivers license you need to take a first aid course. When witnessing an accident or something similar it's your duty to help, at least as good as you can. In the car there also must be a little first aid kit, with bandages and stuff. You might get up to 1 year of jail time if you didn't help.

"consult an attorney or marry one" lol and remember- "no good deed goes unpunished"

Video like this, remind me how much I love being from Europe. Germany has a duty to help and it is mandatory to carry a first aid kit, gloves and masks in your car. It is also mandatory to do a first aid course as part of your driving licence.

Shortly after, write down what you did - this is good advice for lots of situations. I make notes after witnessing an accident, or anything else of consequence that might become a legal issue in the future. This has come in handy when I've been a witness in court - I think the term is "present recollection recorded" - and I can describe the details that led me to an opinion. The rest of this is a long description of two cases where this came in handy. TLDR: Notes are a good idea. In one case, I noted a car behind me using a following distance that was consistently less than 1 second _and_ a tendency to pull hard right when braking. I had seen that for about 7 miles before that car braked hard and veered into a pedestrian - who was thrown about 20 feet. (The pedestrian lived, but had an unstable pelvic fracture.) The court case was months later, and the prosecutor said that she had the better evidence than she could ever imagine for that case. (It wasn't just me - at the time of the crash, a power company worker was on a nearby pole, and a sheriff's deputy was on-site for traffic.) In another case, after witnessing a crash, the officer that interviewed me at the scene failed to write some details in his report. When an Asst. DA interviewed me by phone, I went to my notes, and she ended up being able to add charges of assault & battery and vehicular assault. The officer who had interviewed me ignored that I saw the passenger swing nunchucks (sp?) at pedestrians on the sidewalk, and hit a couple of kids who ran off, and that I saw the vehicle repeatedly aimed at peds - and the pedestrian that was hit was probably not just because the driver lost control. That ADA started some investigation that found the kids who had been hit and ran away, and some pedestrians that had seen the driver aiming at them. (Those guys took guilty pleas - no trial.) There have also been times that my notes have defended me from accusations, but those examples are uninteresting.

This is so SAD, most places in the world you would never risk a lawsuit for attempting to help, and you would never expect composation.

Dr. Appel is so knowledgeable, his answers just flow right out. Great interview.

I have attented to few inflight medical emergency. One time the flight attendent refused to open the medical kit siting she has to do long paper work afterwards and the other time an air hostess asked me if im a real doctor, i had to show her my licence.

As austrian its kinda surprising to hear the state of laws for us/NY. In Austria also Germany (not sure if it applies to all EU countries), you have to attend a first aid curse before getting a driver license. Things like checking cardiac arrest, performing CPR are trained here and it is expected you could perform this in case of emergency. You could even face high fees/jail if you do not perform first aid. Of course you could not face trial if you did mistakes..

I'm an EMT in Los Angeles. My teachers told me that while the good Samaritan exists and applies to us off duty. We are held to the same standards as an on duty EMT. A (minor) mistake that a normal good Samaritan could make, would not be acceptable as an EMT, even off duty. As I understand it, If it ever went to court, the judge would look at my protocols as an EMT in LA county, and if I did not act within them, it would qualify as gross negligence. We talked about a very interesting area of this as well when it comes to Narcan. Narcan is over the counter so anyone can carry it, however our protocols state you must be on duty to administer and that it cannot be on your person. Now that I'm trained to administer Narcan, it is illegal for me to do so off duty, when a non-EMT can do it with no problem. My teachers told me they had to have someone else press the shock button on an AED in the past, and that this type of legal quirk is not new.

I cant be begin to express how much i appreciate how concisely Jacob speaks

Thank you Dr. Max and Dr. Jacob! Really appreciate the information that you both have provided!

"If you need legal advice, either consult an attorney or marry one" now THAT is a smart man

In Australia anyone who assist someone unconscious or in need of help you are completely protected from the law lay person or dr. But I’m pretty sure it’s illegal to drive past if your a healthcare professional and required to stop and help. I carry pretty well stocked first aid kid that includes a bag valve mask both child and adult but gloves and cause are most important. Getting others to protect you from getting hurt (hit by a car etc) is really important. I pulled up to a car accident and the pt was seizing and there were two truckers there and one other guy pulled up and I asked them to protect me leaning non the car and the other guy to help hold the head up to keep the airway save and neck safe. They also were helpful in shutting down the car as it was jammed and the keys couldn’t turn off.

Attorney and physician is truly an impressive accomplishment. Thank you for the video!

Old RN here. Did home health in islands area with makeshift vessels coming ashore containing all sorts of health emergencies. (This was before cell phones.) Many times along the single road performed various Good Samaritan acts hoping another driver would arrive for me to ask help to call 911…which occurred. Another time at school waiting on my son, a terminal patient collapsed next to me where the spouse begged for help. Assist arrived to help get person from vehicle to ground and I did CPR. A deputy who did school duty arrived, called for ambulance, then assisted CPR. EMTs arrived and took charge. The patient‘a child came with me and my child to the ER, where we waited for the spouse. The patient lived and was admitted to the unit. The spouse took the child. And my child and I went home. Your videos are watched with anticipation of excellence. This one was most beneficial and the remembrance of my events over 30 years ago came to fore in mind. (A note, I have required 15 surgeries and am grateful for my past anesthesiologists.)

Nice job Max. I have been in these situation innumerable times. Good, practical presentation. Kudos.

Thank you for providing us with such detailed and enjoyable content Dr. Feinstein! Special thanks to Dr. Appel for his insight in this video & on this topic too!

This was a really fun episode! Great work!

one of the most interesting interviews!! Great work!!

It is sad that in US, doctors may hesitate to help someone in an emergency because they worry about getting sued. I hope this changes in America one day.

In the UK at least, you will never be prosecuted for trying to perform first aid. The courts will never, ever convict anyone because it would discourage further people from helping in other situations.

Fantastic video, Max. Topics like this keep me coming back. Well, that and the perfect mix of information and humor!

There were some interesting episodes of Bondi Rescue (an Australian show following life guards on Bondi Beach), wherein it wasn’t unusual for off duty doctors/medical professionals doctors to attempt to help with serious incidents. More often than not, the life guards would ask them to take a step back; these life guards were trained to deal with these very specific types of incidents, and trained to work well together in high stress environments. Often the doctor , whilst well intended , was ultimately a hindrance.

Great vid, I’ve had several situations here in nyc where I took control of a scene until EMS arrived and have been meaning to look up all this legal stuff 😅. Thank you!

We were told on school help and leave fast!!! Give no info!!

This guy gives such great and balanced advice. Thanks.

You’re both so sweet! Best of everything to both of you!

I’m not a physician, but ever since the opening scene of “The Good Doctor” (which many have reasonably questioned), I’ve found the question of benevolent emergency care law to be very interesting and complex. Fantastic discussion guys! I found it incredibly engaging.

The concept of a country or state where you can legally just ignore a person in need of assistance is bleak to someone from developed countries with duty to assist and good samaritan laws. These are usually super forgiving and sane, too. Like, just calling 911 equivalents is enough to be in the clear, and your obligation is waived if you'd put yourself in danger, are pregnant etc. I'm not trying to virtue signal or boast, but even as a regular guy who took a few first responder courses and only had to assist someone like, twice, the thought of ignoring a hurt person in need of help is really distressing.

Enjoyed the discussion. It clarified a few contentious situations and medical responses. The book looks like interesting reading. Look forward to reading it.

Crazy how i was thinking about the same topic last week and it just appears in my recommendations! Thats exactly what i wanted to know! Thank you very much for this information!

In Belgium, everyone has a legal obligation to help the person who is sick, if all you know is calling the emergency this is good too. I'm a trained first aid helper (not EMT). If I don't help someone in need, I risk more legally than someone who isn't trained. The fear of being sued after helping someone is not really a thing here.

Super interesting video Max!! I found myself in a similar situation with a random pedestrian trauma in Manhattan not too long ago. This is all great to know if that ever happens again!

Just started the audio version of his book. It’s super interesting! I’m not a healthcare professional, but someone who finds medicine super interesting, and it’s still intriguing.

This was one of your best videos. Great idea

Good Samaritan laws don’t keep people from suing you. Even if it’s ultimately thrown out of court, you still hired an attorney, were deposed, ran up legal fees with your attorney and missed work. And I’d say that your malpractice rates would increase. When people see “rich” doctors they don’t think they have anything to lose and good luck recovering the money you spent.

I would also leave contact information with the police or call them afterwards. As too many times working as a firefighter, we get on scene, we focus on the incident first, but the witnesses are gone before we realize. A simple business card with "Blue car hit Red Car" or what you did, and the police can follow up.

Thank you for answering!

Great video! That was very great info

I'm a paramedic and my understanding is that the rule of handing off patients to providers of equal or higher level only applies when the providers are on the clock getting paid. so when I am on the clock I can transfer care of my patients to another paramedic or a nurse, NP, PA, or doctor as long as any of those people are also on the clock. I can never hand over patients to an EMT or bystander, even if the bystander is also a healthcare provider but they are off duty. but if I arrive on scene and the patient is being cared for by an off duty doctor, it is perfectly legal to take over care of the patient even though I am a less advanced provider. I guess what it boils down to is the fact that the off duty doctor has extremely limited resources at their disposal in that moment, whereas I have an entire ambulance full of ALS equipment so in that situation, I am better equipped to help the patient. if we were in the hospital however and the doctor was on duty they could not hand the patient over to me.

In Poland we have lawe that says you have to rescue if its is safe for you. If I remember correctly if you don't rescue you can go to jail for 2 years. But if you rescue you have protection from any damages you do

Very clear, concrete and well presented video, thanks Max!

Very interesting! Perfect guest to bring on.

If I'm not mistaken, here in Luxembourg if you are part of any medical field and you see an emergency that is not yet taken care of by emergency services, you have to stop by and at least ask if they need help. If someone saw you just drive by or run away then they can sue you if they know that you are working in the medical field. That is at least what my mom told me when I was a child of 8 maybe 12 years so it might be different but it's an overall generally good way to approach it.

Great idea. I would make an emergency kit. THANK YOU for this video. This will make many ppl informed. BTW kudos to going through law school AND med school but having a sense of humor is key (which he has). I hope both of you have many children..we need as many intelligent people as we can get in this world.

I think that if someone assists another in an emergency, it's just in a to receive a good will gesture. It's nice to be appreciated, this does not require a continuous gift but a small token of appreciation is nice treat. Everyone like to feel appreciated. Working in a hospital, some patients give a bouquet of flowers to the unit. They're not paying us but it's so appreciated. In an emergency, no one expects anything but a token is just a small way of saying "thank you, and I appreciate what you did".

incredibly good video. thanks max

I am a doctor too and it's sad that in this age of being "civilized" people have a choice of not helping someone in need, or that I have to worry about legal implications before helping someone out...

somehow the advice is the same as for laypeople, if a computer scientist steps forwards and a swiming instructor comes in, the swimming instructor is probably more current on their emergency training. And the general rule is to stay with the person until the emergency vehicle arrives and someone relieves you. I think the difference between a good samaritan doctor and the emergency vehicle is also that however appropriatethe training of the doctor is beforehand (on the emergency care to psychiatry spectrum), the vehicle has gear and a trained team in the appropriate gear, reaharsed procedures and the mindeset to do the job.

Very interesting topic, good pick. Well done.

This reminds me of the Winter Camp I attended while in the Sixth Grade (January 1969), My mother, who was a registered nurse, signed on as assistant cook. While we were there, a kid injured his hand. Naturally my mother volunteered to help, and they took him into town, so that a doctor could attend to him. He begged them not to call his parents, because he was sure they would want him to come home, and he did not want to leave. They explained they had to call them, but when they did, they told the parents that he seemed to be okay, and there was no medical reason for him to leave. The parents consented to him staying.

One slight correction (at least in NY)... you can turn the patient over to another provider consistent with any interventions you have performed are in their scope of practice. So if you have dropped an OPA and are simply ventilating a patient with a BVM, you can pass that off to an EMT, but if you have intubated the patient or performed a surgical airway you must transfer care to a paramedic or ride along.

In the UK I can't imagine anyone could or would sue a doctor or random bystander who performed cpr whilst waiting for paramedics to arrive. Even imperfect CPR and a couple of cracked ribs are preferable to the alternative. Likewise I found someone who'd passed out. Breathing was OK and heart rate was fine, so I put this person in the recovery position whilst calling an ambulance. Turned out they were epileptic and had had a seizure. I know some epileptics in the US don't want ambulances called due to the bills, but in the UK that's not a concern. In the position I was in, I acted in the best way I could. It turned out I had done the recovery position slightly wrong, but of course I didn't face legal consequences. The police aren't wasting their time on a well intentioned civilian doing adequate but imperfect first aid whilst waiting for an ambulance.

A physician and an attorney? Good lord man, doctor, Man-doctor, esquire. On a scale of Single payer system to 100% anarchy - how much do you love school? Love your content, Dr. Feinstein - you've really opened my eyes to some of the complexities faced by the good men & women who've kept me from dying while surgeons were doing whatever it is surgeons do (I'm kidding, the surgeons and nurses are awesome, also) At the very least, they've resisted the urge to take me out. Hell, none have even knicked my recurrent laryngeal nerve in the hope of a minute's peace when I awaken. Good people, all. Doing a job I can't comprehend in a needlessly complex and bafflingly money-centric environment. Have a thumbs-up while knowing I think you deserve much more Cheers!

Wow- this dude is great! The fact this dude has full degrees in both legal and medical is impressive! He is able to sum things up better than really anyone else. There is so much nuance and semantics with these bystander laws and rather than bogging down in well this could and maybe well if then... it sums up the points that are most important. And since it is not advice in ether feild- it is a great crash course.

I loved the "I'm a psychiatrist, but I don't bring a couch with me," comment. Neat video!

Here in Denmark we have defibrillators hanging everywhere. They are never far away. As a respiratory carer I am trained in CPR and other things. I would always step in when needed, but anyone here can be become a Heart Runner (as they are called) and use these defibrillators following CPR. There have very easy to follow step by step guides on them. Do you have them in the US? I think they are a good idea. They've save many lives.

In Tennessee we have the good Samaritan law that protects you against lawsuits. I'm a former CDL holder we are required to stop and assist. Although not many drivers do it

Thank you for your wonderful videos. I am having major surgery in February and you are educating me on what to except. I’m still very scared since this is new to me. Thanks

I feel like even as someone who doesn’t live in the US. It’s food for thought. I’m not a physician but he speaks quite equally on both sides. I always like to say “give with caution”. I think that also applies when someone is having a medical emergency. We have to consider things we do not know. Society needs to heed to contacting 911. A lot of people talk poorly about reality tv but once I heard on one of their shows. That if a person is laying down, you must be carful of their neck. Depending on the situation. As you don’t know if they broke their neck or strained it. A lot of people don’t think of legal ramifications when it comes to medical emergencies as a Samaritan. Which I believe people need to be more careful of paying attention too.

As a retired Paramedic/FF I have assisted on flight emergencies before. First and foremost stay within your standard of care. Relinquish authority to the higher certification (Nurses, doctors and PA’s). Most of which always ask me to assist. And the flight attendants are always very appreciative of your help. And yes I have received miles and plane tickets for helping. I don’t ever expect it but it’s a nice gesture.

00:40 in Germany that's a state law. It's called "unterlassene Hilfeleistung" (Failure to provide assistance) and it's punished with up to 1 year in prison or a hefty fine. The idea is that when someone is about to die you can't make it worse. (of cause it only applies if you do not need to endanger yourself while rescuing)

Being trained in first aid, doesn’t make one a dr. Just like staying overnight in motel six doesn’t either. I did save a life using first aid training using the hemlich maneuver when a guy had a hot dog stuck in his throat. I asked are you choking and do you want me to do the maneuver which he shook his head. It was a lot harder than training. In my mind, I was going to try twice then tell them to call 911. It worked. Amazing how many people were standing around.

This is really interesting. Also alarming that you don't have the duty to help over there. I thought that was something that existed everywhere. Although I must admit people rarely get prosecuted under that, at least where I live.

The "Good Samaritan" Laws were largely the results of legislatures acting after a famous "Dr. Kildare" episode on TV. Most of those states which had governors who were lawyers did not enact such laws. The reason was that removing liability creates an additional obligation to act. However, I think that the legal advice offered here was good. To date, I believe that there have been no successful suits against physicians who acted appropriately in good faith during an out of hospital emergency. Personally, I once stopped at the site of a severe auto accident late at night, identified myself to one of the police officers who told me that a pregnant woman was the victim but he was sure she was dead. I grabbed a small surgical kit from my car and rushed down the hill to the vehicle prepared to perform a C-section (not my area of expertise). Unfortunately, she had been dead for a long time and there was no possibility of fetal survival.even if the pregnancy had been more advanced. I realize that a suit would be very unlikely but I would never consign the care of a complex, at risk pt. to paramedics in an ambulance. In one such situation, I once rode with an electrically unstable pt to a major med. center and resuscitated/cardioverted/defibrillated her at least 20 times to get her on the table for cath. and then surgery. She survived and did well.

Very informative and helpful video. First year medical student, not an american citizen but receiving american training. Saving this to reference later

Once got a handful of chocolates. Very hard turbulence on approach to our destination, overhead compartment door above me opening suddenly, unbuckled quickly, slammed the door, sat back down and fastened the seat belt again. If I did not act right there and then, the person on the other side of the aisle could get seriously injured of something fell out and it was really safe for the attendant to walk and close it. She saw what I did, smiled and later on handed me a handful of chocolates with "Sir, I think you forgot this" :)

If you're on a plane assisting, most airlines call Medlink where doctors are on the line and will assist (they know what's in the airline-specific medical kits) and the airline's licensed dispatcher is on the call in most cases too, and that's the person with the authority (shared with the captain) to send the flight to a diversion city, in coordination with Medlink doctors (where they may assess the best options not just for weather, airport services, approach capability, legal authority to operate at the airport, etc, but also conferring with Medlink on proximity to hospitals or special units--like cardiac). If Medlink recommends something, I'd defer to them. By taking the call, they're accepting medical liability and thus the airline isn't on the hook for medical decisions including whether or not to divert. I assume they'd take liability from onboard physicians as well.

Great vid! I’m in school now for a DNP and Bioethics certificate and these ethical situations are always interesting to mull over but we have to remember the legal ramifications in real life situations. And just bought Dr Appel’s book - looking forward to reading it!

Excellent guest and nice episode! Amusing and intelligent👌 I'll get this book on Audible. Thanks!

Pretty crazy over there in the US... Here in Germany, you have to take a day of first aid lessons to get a drivers licence. The first thing we where told there: "don't be afraid to do something wrong. What do you you think could happen? The patient dying twice?". If you do not try to help or at least call the rescue (who will instruct you on what to do) when you see someone needing help, you can get pretty hefty fines or even up to a year in prison for "failure to provide assistance".

Definitely an interesting note on the "hand off to someone with higher training" advice, that probably assumes that it's mostly going to be a lay person handing a patient off to an ambulance crew and then to an emergency room, but not always

I love Max's posts and I particularly liked this one. I'm 79 ½ and have always been interested in medicine so when I learned to drive aged 17 I used to carry 6 x 1ml ¼ gr ampules of morphine sulphate (lets go with 15 mg if you find that easier). I had a glass and metal syringe in an old Alka Seltzer glass tube submerged in methylated spirit. I never got to use them. Remnants of my father's last days of stroke treatment. Oddly enough the local bobby knew I had them in my car but it was Wales and it was the late 1950s.

Very helpful, thanks for sharing.

I always love your posts. Also I don’t mind the eye candy 😁