off-duty ethics

[AnthonyM83]

Honestly, if you want to help, then help. Just do it right (might have to only hold c-spine for 20 min). Liability's probably not too much different than when on-duty.

Just know you have to go all out and help as of on-duty (THAT'S the danger in helping off-duty...not working within a system, so somehow getting sloppy, missing something, and being targeted if something goes wrong).


But the reason for most people helping is Personal Gratification. You get a positive thought or feeling about what you did or a negative one for not doing.

If running to your car to grab a band-aid provides personal gratification, then do it (preservation of comfort). If helping stabilize someone's broken arm provides gratification, do it (preservation of pain prevention). If working on ABC's (CPR) gratifies you, do it (preservation of life).

The more times you do each one, the less gratification you get (especially w/ negative consequences...write-ups, injuries, etc). Then, it just becomes a judgment on Personal Gratification versus Risk. Risks/Cons include (disease, screwing up because not working within a system, litigation, roadside hazards, lack of pay, etc).


I think all who have replied to this thread work under those premises. We just have different experiences that change our perceived gratification level and risk level, or the personal importance of each pro/con. THOUGH, there's something to be said for those who have been around longer and seen more pros and cons play out...

 

[LIFEGUARDAVIDAS]

just my opinion...

I can only tell you what I would do, what I have always done...

In my case, being a lifeguard (ocean, lake, river, ...), I have an even wider range of situations where while off duty I could be asked to respond, or urged to respond. Medical emergencies and water rescue situations.

40% of my ocean rescues were when I was off duty. -I'm very strict about prevention when I'm on duty.

I had 2 river rescues while off duty -one of them a multiple victim one.

I had 1 lake rescue and 1 river rescue while on duty but outside of the area I was assigned to guard.

15% of medical emergencies I responded to, happened while I was off duty and/or outside of my guarded area.

I understand your legal concern, I've seen questions like this more and more often in the last years. It's sad because it shows that there are too many lawyers in the world, AND that emergency personnel training is not as complete as it should in the sub-field of legal considerations / civil & penal responsibility.

Of course, as you know, each state and each agency has its own laws, regulations, protocols... for emergency personnel while off duty.

I respond to any water rescue situation while off duty as long as I know official dispatched help is on its way, or if I'm in a remote area where no one will come to help the victim(s). (I work seasonally and counter seasonally in Argentina and the US, many areas of Patagonia are very remote and isolated).

I respond to any medical emergency situation while off duty as long as IT'S AN ACTUAL EMERGENCY, and I know official dispatched help is on its way, or, if in a remote area, no one will come to help the patient(s).

In either case, being a professional lifeguard, I FIRST think about my own safety, then I think again about my own safety, I then carry whatever proper equipment available to me and needed for proper response, and I respond.

Being a professional lifeguard, and knowing that I will always encounter situations like this I ALWAYS CARRY: 2 pairs of Nitrile gloves and a Microshield CPR mask ON ME. And a complete basic first aid kit and a Pocket Mask in my back pack or duffel bag. Regardless if I'm on foot, on a bike, in my vehicle (which may be equipped with more equipment).

When I go to a beach or waterfront before or after the local lifeguard service hours, or to an unguarded beach where no lifeguard service is available, I carry a rescue flotation device with me.

In that way, if there is no other immediate way of helping the person in question and I decide to respond, I have minimum equipment to provide the first steps of the response, safely. -Even if I'm off duty.

When official dispatched help arrives, I give the emergency personnel every piece of information I consider important for them to know about the victim(s) and/or patient(s), I report my actions, I ask if they need any assistance from me, and I stay on the side until they decide to leave the scene and or have any paperwork for me to sign.

When it's a medical situation, and I'm not sure if it's an emergency, I check for my own safety, if it safe to I approach the scene and check what happened. If it's not an emergency, I still ask the patient(s) if they need help, and/or if help has already been called. If I see that the situation could get worse due to dangerous conditions or dangerous behavior I then inform the people in question and give advise as needed. If everything is OK, I just stay on the side, monitoring the situation until dispatched official help arrives. If I think they might need additional help I ask them if they need my assistance or my information, and then I leave.

In the past I had part time jobs where co-workers (and lived in places where my neighbors) knew about my other job (before being a full time LG), I did have very few occasions where emergency medical care was needed. I provided care as needed within my scope and according to my equipment limitations until help arrived. In the cases where only very basic first* aid was needed, I provided care as needed and advised to see their doctor later -when applicable. * = rinse and put a band aid or gauze on a tiny cut or abrassion.

Simple, professional and adjustes to the "Good Samaritan Laws" and "Duty to Act" of the different states and provinces where I work and live.

Emergency personnel properly trained usually can tell if you're there just to help or to show off / to take over / to get an adrenaline rush.

If your certification / training / profession gets known afterwards, and you haven't responded even if it was clear that your help would have decreased the damage or avoided a death, the chances of having legal problems are quite high!

Again, just my opinion. There is a balanced middle ground between being an "off duty EMS rambo" and hiding your knowledge / not responding while off duty.


Guri

 

[emt_irl]

i use my duty of care simply.. when im working its on..
when im off duty, unless its right infront of me i wont stop and help. e.g like a mvc infront of me, or i cannot pass and there is no ems there yet.

or if im out shopping and someone drops in the line ahead of me, but other then that id never go out and look for things to do off duty

 

[firetender]

If you can show me five lawsuits in the last ten years I'll be very surprised

Actually, I really am curious. Can anyone point me to somewhere there are such statistics? Where are all those off-duty medics who get sued for doing what they can do to help someone?

 

[Shishkabob]

First, there is a difference between morals and ethics. Morally you might feel an obligation to act, but ethically, in most of the country, you have no obligation to act while off duty.


Now, if you respond or not is your choice. Personally, I've done several BLS things at my local paintball field when they asked for some medical help because I'm friends with the owners and manager.


I don't carry a kit, and have no real intention to. But I do live by one rule: If helping doesn't put me in any physical danger and I have the time, I'll contemplate helping. That means if I'm at my parents business and someone collapses, I'll help. If I'm driving and I see an accident on the side of the road, I will not.

 

[fortsmithman]

With my service we only have a duty to act while off duty only within our operating area. While responding off duty what we can do is minimal only with whatever equipment if any that we have. Basically it would probably be just simple first aid. Although we have a couple of members in our volly/paid on call service who have POV that are nearly as well stocked as our main rig. Whereas all I've got is a well stocked first aid kit.

 

[ExpatMedic0]

If you do not have any equipment you can not really do much to get sued for. You can hold c-spine, perform chest compressions, possibly stop bleeding if there are gloves, if not then instruct the patient how to, and thats about it. Then you wait for a few minutes until fire or EMS show up.

Other than that the biggest thing you can do is to scribe or direct someone else to scribe and get a good SAMPLE HX for the incoming crew along with the patients info, chief complaint, DOB, name, ect.

 

[Ewok Jerky]

i guess i should have called the thread "off duty legal concerns"

thankyou for the few on topic posts.

im not asking if i should help people who need help, there are plenty of threads on that topic.

my original question is, does it create a LEGAL duty to act if i am presented as an EMT by someone. for example: i am off duty at my day job and a customer gets hurt and a coworker says "Ill go get Beano he is an EMT and he can help you"

now a standard of care has been established, but not by me, and do i have a LEGAL duty to act?

i like the recent suggestions of holding c-spine, and getting a history for the few minutes until the on-duty cavalry arrive.

 

[John E]

Here's a thought...

contact the agency that issued you your credential and ask them.

Or continue to rely on opinions from people who don't live or work under the rules and laws that apply to you.

Again, just a thought...

JohnE

 

[firecoins]

my original question is, does it create a LEGAL duty to act if i am presented as an EMT by someone. for example: i am off duty at my day job and a customer gets hurt and a coworker says "Ill go get Beano he is an EMT and he can help you"

now a standard of care has been established, but not by me, and do i have a LEGAL duty to act?

It has been established by you. The person would not know your an EMT unless you told them. Your only doing first aid. If you are volunteered to act and it is an actual emergency, I don't think you would say no. If its a b.s. just say sorry, their is nothing I can until the ambulance gets here.

i like the recent suggestions of holding c-spine, and getting a history for the few minutes until the on-duty cavalry arrive.

you should only hold C-Spine if the incident requires you to do that. If you just hold c-spine on someone who doesn't...God help us.

 

[zmedic]

First, there is a difference between morals and ethics. Morally you might feel an obligation to act, but ethically, in most of the country, you have no obligation to act while off duty.

Ethics is the more formal study of morals. It is determining what they proper course of action is based on basic principles of ethics such as respecting preventing harm, respecting a patient's autonomy etc. Ethics don't really change from one part of the county to another. What changes are the laws.

You could easily have a moral/ethical obligation to help someone without there being a legal duty.

As to the OP, you are a lot more likely to get into trouble/be looked down upon by others if you have been identified as an EMT and refuse to help than if you decided to provide care within your scope.

Look at those two FDNY dispatchers in New York who didn't help that patient (there is another thread on this). They're getting slammed and the truth is it doesn't really matter what the law says. Public opinon doesn't really care if they are on duty or not.

Also for those planning on going on in medicine, you may get to the point where there is no "on duty" or "off duty." As a physician you are licensed in the state you practice, you are always on. I think that this also applies to medics who are not merely certified but licensed, they are considered a paramedic by the state even when not physically clocked in.

 

[MMiz]

I held off on this one, because I've been in this situation many times.

In addition to being an EMT-Basic, I make sure I have my AHA CPR/AED/First Aid certification. 99% of what I'd do as an EMT-Basic with the supplies I have on-scene pre-EMS I'm trained to do as an AHA CPR/First Aid trained person. When I arrive to a situation I make no mention of the EMT-Basic.

I can't think of a single time when I would have changed treatment with any knowledge or training I have as an EMT-Basic, compared to the AHA First Aid cert. You can do the training online via the AHA, and then the in-person testing only takes a few minutes.

I hope that helps.

 

[AnthonyM83]

you should only hold C-Spine if the incident requires you to do that. If you just hold c-spine on someone who doesn't...God help us.

Was that comment really necessary? I see a lot of those. No evidence the poster would do this, yet someone mentions it...

 

[Radioactive]

Keep in mind that i'm just a student and I haven't done any research on the legal aspects of this topic, but I think it's interesting and it's definately something i'm going to ask about in class. Here's my take:

I would think that in the specific instance that you are at a non-EMS place of employment, and there are people there that know that you are an EMT, and there is an emergency, it would create a duty to act for you. I think this because of the same reasoning that it creates a duty to act if you directly offer your assistance. Even though you didn't say so yourself in this case, someone else telling people that you are an EMT may prevent others from acting because they would assume that you will be providing assistance.

Again, I don't know if this is the actual truth, and there is likely not any absolute legal guideline for this specific situation, but that's my spare change on the subject.

As for myself, I would render assistance, regardless of the legal or ethical requirement. If you are at your 9-5, 40hr/wk job, there's a good chance that you know the person well who is in need of assistance. I would say that this would both significantly reduce the likelihood of them suing you, and increase your desire to actually help them.