# Ambulance Vs private vehicle



## DrParasite (Jun 2, 2013)

Hypothetical question:

you are driving your ambulance (either to another emergency call or just around, no patient on board), when another car blows a traffic control device (red light, stop sign, you name it), and you end up t-boning them.  at least 1 foot of intrusion into the driver side of the car, which blood visible. You and your partner are shaken up, but not seriously injured.

PD is notified, your nearest EMS resource is at least 10 minutes out.  Whats your next step?


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## exodus (Jun 2, 2013)

Proceed and treat as if it's an EMS call as usual? You obviously can't transport?


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## DesertMedic66 (Jun 2, 2013)

exodus said:


> Proceed and treat as if it's an EMS call as usual? You obviously can't transport?



That. Make sure you are safe from other vehicles, turn on your lights, get on protective gear, and start treating patients if you are able to. If you are injured at all then don't treat.


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## Ecgg (Jun 2, 2013)

1-Check self and partner for any life threats if  present that is #1 treat asap.
2-Call dispatch inform of location and incident
3-If you or partner injured that  takes priority over anyone else
4-If you did not sustain injuries I'd be very careful getting out if you are in the middle of intersection. 
5-Given scene is safe, do your best to render pt care.


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## Summit (Jun 2, 2013)

What everyone said already


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## Fire51 (Jun 2, 2013)

Couldn't say anything better then what Ecgg said. He nailed it right on.


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## DrParasite (Jun 3, 2013)

See, that's pretty much what I was thinking too.....

But my supervisor had a different point of view.  He said (and the policy at my part time job states) we are not to render aid at all.  The reasoning was any care we do provide could open the crew up to signifigant liability, as the crew has a conflict of interest in the MVA, and if the injured party would die, the accusation could be made that the death was caused by the actions of the EMS crew.  He said there was case law and legal precedant to back it up, but I wasn't able to find any

Again, I haven't heard anything about his point of view, and was just curious if anyone else thought the way he had.


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## chaz90 (Jun 3, 2013)

I don't understand how a conflict of interest comes into play here. Yes, the ambulance was involved in the initial accident, but I don't believe anyone could make the case that the EMS personnel thereby wanted the people in the car to die. It would be morally reprehensible to fail to do anything in this situation, and it honestly blows my mind that your supervisor fails to acknowledge that. This sounds like a prime example of legal scare tactics that stem from someone's confusion over what you can actually get sued for.


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## jefftherealmccoy (Jun 3, 2013)

DrParasite said:


> See, that's pretty much what I was thinking too.....
> 
> But my supervisor had a different point of view.  He said (and the policy at my part time job states) we are not to render aid at all.  The reasoning was any care we do provide could open the crew up to signifigant liability, as the crew has a conflict of interest in the MVA, and if the injured party would die, the accusation could be made that the death was caused by the actions of the EMS crew.  He said there was case law and legal precedant to back it up, but I wasn't able to find any
> 
> Again, I haven't heard anything about his point of view, and was just curious if anyone else thought the way he had.



I don't know if it's true or not, but here's an instance to think about along side it-

One county in Utah has sheriff deputies/paramedics.  If a deputy has to fire a weapon/taze/take down a suspect, he/she is no longer allowed to act as a paramedic and has to wait for another deputy to give medical care.  Due to the same idea of conflict of interest.


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## Akulahawk (Jun 3, 2013)

DrParasite said:


> See, that's pretty much what I was thinking too.....
> 
> But my supervisor had a different point of view.  He said (and the policy at my part time job states) we are not to render aid at all.  The reasoning was any care we do provide could open the crew up to signifigant liability, as the crew has a conflict of interest in the MVA, and if the injured party would die, the accusation could be made that the death was caused by the actions of the EMS crew.  He said there was case law and legal precedant to back it up, but I wasn't able to find any
> 
> Again, I haven't heard anything about his point of view, and was just curious if anyone else thought the way he had.


The flip side of that is that should the other party die and the ambulance crew was on scene and the death could have been prevented by them acting instead of not acting... that failure to act could very well be as significant as deciding to act in that situation. 

The problem with the scenario is that the next nearest aid is 10 minutes away and some of the actors involved aren't covered by Good Sam by virtue of their being professional rescuers.


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## Akulahawk (Jun 3, 2013)

jefftherealmccoy said:


> I don't know if it's true or not, but here's an instance to think about along side it-
> 
> One county in Utah has sheriff deputies/paramedics.  If a deputy has to fire a weapon/taze/take down a suspect, he/she is no longer allowed to act as a paramedic and has to wait for another deputy to give medical care.  Due to the same idea of conflict of interest.


Not a conflict of interest per se but rather they recognize that the Deputy that has used some level of force against another person and they want to eliminate any possibility that the Deputy continued in their use of force. You see, the initial use of force may be legal... but after the subject has been subdued, if that same Deputy has to provide care, then it could be argued that it allows that same Deputy to apply force that's unnecessary and therefore illegal. 

Is it legal for the same Deputy to function as a Paramedic? Yes. Department policy forbids it out of legal defensiveness. In that instance, the Department Policy likely has the effect of law upon the Deputies that doesn't apply to other members of society there. I would wonder if they'd prohibit a Paramedic from working as a Paramedic instantaneously if the patient needed to be restrained for safety reasons, primarily the patient's... if that Paramedic wasn't a Deputy.

For people working in a dual role like that, it may become difficult to separate Policy from Law and attempt to apply policy to someone not beholden to that policy.


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## ZombieEMT (Jun 23, 2013)

I would have to say, I kind of agree with the policy of not rendering care. 

A conflict of interest is a valid concern. Motor vehicle accidents, especially if injury involved, have high potential to become a lawsuit and legal matter. If the crew were to start treatment, the patient might be inclined to suggest treatment was not fair or provided to the highest level of care.

Also, without complete assessment how can we guarantee that the EMT/Paramedic on the truck is in the right state of mind? Emotions can come out in a situation like this changing the level of care. Whether an increase in stress, anxiety, anger, aggression or empathy. Also, the crew might have underlying injuries that are not found from adrenaline and the excitement. 

I believe the crew needs a full assessment of their condition prior to doing anything and the opportunity to calm down and remove themselves from the situation.


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## Nathan (Jul 1, 2013)

1) Say various explicits regarding the individual who hit you
2) hit up 911
3) Render pt care. Call him an idiot, until you transfer care.
4)?????
5) Profit.


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## Wes (Jul 2, 2013)

I'd love to see the case law on this.  All too many people in EMS hear a war story from their partner's former partner's cousin's ex-roommate who took a con-ed class and think that's the same as case law.

Generally speaking, AND I AM NOT YOUR LAWYER, you'll have an easier time explaining to a jury why you did something than why you stood there with your thumb up your ---.


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## shfd739 (Jul 2, 2013)

Our policy if involved in an MVC no matter who's fault is to take care of ourselves then render aid to the others involved if possible. 

This has been vetted past our corporate lawyers and they agree its the best way to handle these situations.


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## RocketMedic (Jul 2, 2013)

chaz90 said:


> I don't understand how a conflict of interest comes into play here. Yes, the ambulance was involved in the initial accident, but I don't believe anyone could make the case that the EMS personnel thereby wanted the people in the car to die. It would be morally reprehensible to fail to do anything in this situation, and it honestly blows my mind that your supervisor fails to acknowledge that. This sounds like a prime example of legal scare tactics that stem from someone's confusion over what you can actually get sued for.



Were you to follow this plan, you would not only be legally and ethically deficient, but guilty in the court of public opinion. (to watching, not to Chaz's post)


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## Farmer2DO (Jul 4, 2013)

I've actually been in this situation.

I was front seat passenger, and my partner was driving us emergency mode  to a motor vehicle accident, reported as multiple patients and serious injuries. (The reports ended up correct. They transported 8 patients with 2 critical.) We were on a 2 lane rural highway, and the 2 vehicles in front of us pulled to the right, and he went to pass them on the left.  The vehicle in front then turned left in front of us.

We hit her at about 50 mph, driver side, just behind the driver.  Drove her into a telephone pole. All 3 of us were restrained, and there was no airbag deployment.

It took us several minutes to get out, only because our doors were crinkled. The agency I was working for had a large coverage area, and our closest backups from in agency were 20 minutes away. The local volunteer ambulance and fire department were about 10 minutes away.

She was trapped. It was about a 45 minute extrication. The volunteer agency transported her, but we started care. Surprisingly, she had only minor injuries. 

My partner and I both denied complaints, and our medical director cleared us on scene. 

I can tell you that few things have shaken me as much as that incident. It was clearly her fault. Based on our DriveCam footage, the police ticketed her. But after I got my head clear, we rendered care. It was BLS (I was a paramedic on an ALS ambulance), but we provided care. 

I think that you are MUCH safer providing care than ignoring the patient. Were the patient to have a negative outcome, you would be accused of standing there and not providing aid. That looks bad in the public eye, and terrible if you happen to be on the stand. I've testified half a dozen times, and it's no fun. I think it would be far more difficult to defend why you ignored a patient than why you helped one.

The outcome? All the bosses were there for the company. My partner was suspended, and I was reassigned to another crew. No one ever asked either one of us if we were OK, or needed anything, or wanted to go home. (I didn't want to.) I'm still a little bitter over our treatment.


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## Jon (Jul 4, 2013)

I had a similar scenario, except mine was a motorcyclist that crashed in front of me, and required me to go off-roading (with minimal success). No actual contact between us, but the findings was that he was at fault.

My partner and I both initially treated the rider. My partner ended up with significant back issues. We both were seen in ED's, but were transported after the rider.


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## Hwnorth (Jul 10, 2013)

I would agree as above. As a professional, for you to stand there and someone dies because your supervisor said dont do it .. my first question would be... could I live with that ?


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## Fortion (Aug 26, 2013)

i think yoou can not transport so you will have to treat em yourself


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