# Witnessing an accident off duty



## Ed3SJ (Oct 8, 2006)

Hello all, first off let me introduce myself, i am a EMT student and will be in the field shortly. I am going to be a EMT-B for now and then work up to paramedic. Absolutly love the career! and i got mad props for all you guys.

Now my question... have any of you ever been driving down a road, seen a crash, or scene someone fall off a lader or seen anything that would benefit from your expertise when you were off duty? Now i think the most obvious question is yes... so my question is... do you guys carry a basic med bag with you in your vehicle consisting of a BMV, NR mask, ORAs, Oxogen ext? I was told by my instructer that he doesnt and i know i have a few basic CPR things in my car, but wondered if any of you guys ever needed the basic stuff when being first on scene when not even a ambulance is there yet. He told me that your obviously not covered under your medical supervisor when responding, but hey, if you see someone fall off a lader and could really use some Oxogen and some help, can you help them? I figured it would be a yes, but with people now a days sueing everybody that you may not want to deliever oxogen and such... thanks guys


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## MedicPrincess (Oct 8, 2006)

Ed3SJ said:


> He told me that your obviously not covered under your medical supervisor when responding,


 
First off, welcome.  

Now, in my for my service we are county employees.  When we stop to render aid and EMS is required, we are 1. immediatley put on the clock and paid for at least 1 hour, 2. covered by our counties policies, services protocols, 3. and any other procedures as if we were on shift.

In my car I have a pair of gloves, some basic first aid supplies, and a pocket face mask.  No O2, nothing spectacular.

Generally, though our EMS response times are less than 8-10 minutes depending on time of day and where the closest unit is.  There are always those exceptions, but the rule is we are on scene in under 8 minutes.  So there really isn't a need for all the extras.  

If you see someone fall off a ladder while your driving down the road, or more likely than than, a MVA with injuries, basic BLS will hold you until EMS gets there.  Grab your gloves.  Hold C-Spine, or get a bystander to do it if you have more than one patient.  Basic airway manuevers if required.  If your on the phone with dispatch let them know your an off duty EMT w/ such and such service (we are required to tell them our unit number as well) and tell'em what you have.


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## Ridryder911 (Oct 8, 2006)

I have more medical education and licenses than some others... my policy is I don't usually stop. I will call 911.

I have found out unless you are in a rural remote area, there is really nothing much you are going to do. One, can only work at the first responder level off duty no matter what level you are unless you are a licensed physician. 

One needs to remember again, unless you are in a remote or rural area, some form of EMS is going to be arriving soon. 

I suggest if you are only going to be there for a short period of time, and you still desire to have a pack,  a few bandages, ice packs and gloves.... that's it. As a sole provider you will not be able to perform much by yourself.. as well many providers will immediately remove the bandages and splints as soon as they arrive... ( I do, I have to note the wounds, etc...) 

Oxygen is a drug... one has to have a prescription to obtain it and carry it. A Physician order to needed to administer it.. Believe it or not, unless you have protocol through an EMS service or a medical director order, one is violating a Federal Law. 

Don't be surprised that most professional providers do not carry equipment and supplies, and very few stop off duty... 

Good luck in class...
R/r 911


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## Celtictigeress (Oct 8, 2006)

I stopped once...even made the news the post is on here somewhere basically MVA involving car and semi semi jackknifed flipped and slid I was in Heels a Miniskirt bent over a patient all of SC got to se my panties or rather the thin peice of fabric between buttcheeks that was my thong..top down on the convertible heh...

I will stop to assure everyone is okay if I witness an accident and will call 911....as soon as the Unit arrives I rad off information and leave


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## ffmedic (Oct 9, 2006)

I usually don't have any thing with me when I see something happen. 

I was recently in Vegas and had a guy have a diabetic siezure in front of me. While extremely nice the casino EMT's were worthless, mostly because the casino refused to let them do anything. They sadly easily took my direction and pretty much let me run the call. County medics arrived and took over. Of course I could have had he guy up and back in his room  for an hour by that time. AMR guys showed but lost out on a transort. From my background a very complex top heavy system. 

Funny thing was, even though there were three medics on that engine, I easily had more certified years than all three of them together. Still I got some of the same medicine I have to give out sometimes. I was just another civilian and thank you very much but we are here now. I will say the Capt. did thank me and one other guy at least talked to me nicely. The casino serving staff treated me special the rest of the time but the casino "suits' with radios forgot me pretty fast. 

After a recent MC vs Car accident in the mountains near here a medic of ours ran a scene with a critical patient for over two hours by himself. Did a great job too. He came back and put together a kit from a bag he got on Ebay. I had often thought of it but never followed through. So, I came back from Vegas and ordered an Isreali combat Medic vest and filled it with equipment to carry in the car. With a patch on the back that says MEDIC, I at least will look like I belong and might not feel so naked out there. Its got some great pockets for ringers, upsidedown so you open it and the bag falls into your hand. I hopefully won't need the m-16 or grenade pockets though.


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## ffmedic (Oct 9, 2006)

_Ridryder911

I have more medical education and licenses than some others... my policy is I don't usually stop. I will call 911.
_
Not sure if its your state or I'm just crazy but I can't not stop. Our medical director has already stated we would be covered through him and has not had a problem with it. Somehow I think the good samaritan law comes into effect here also. I'm no lawyer of course but if i listened to everything lawyers were worried about I'd just quit and lay in front of the tv. 

I'm not a physicion of course but we all practice a form of medicine and thats usually under the liscense of a physician. If I did not use my skills to do the best I could for a patient until a higher authority arrived I personally couldn't live with myself. I also think if I held back skills because I thought I had to work only as a first responder, well, I'd probably get sued anyway because I might have been able to prevent something. The only way to win is to live with yourself and do the right thing. 

I do back off when the locals arrive though, I have seen way too many crap systems out there to drive on by and blindly expect that the cavalry was on the way.  No offense but if you can just drive on by and not help, well sorry but thats just not in the spirit of the profession. And from my experience I think you will find just the opposite, most PROfessional providers will stop.


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## Tincanfireman (Oct 9, 2006)

I've been doing the EMT thing for over 20 years and travel a good many miles back and forth to work. In my truck I carry a medium sized fanny pack (because I'm cheap and it fits everything I need without buying another new bag) with a few 4x4's, some gauze rolls, a couple of cold packs, 2-3 5x9 pads, gloves x 2 sets, a few OPA's, a pair of scissors, and a handful of bandaids.  In all honesty, I replace the bandaids more than anything else.  It's all I've ever needed except for one time, and both fatalities at that one would still have died even if it had happened in front of a hospital.  As a side note, you would be hard pressed to tell I'm a FF/EMT unless you saw the stethescope in my console tray. No Stars of Life, Maltese Crosses, no "Bad Boy" stickers, no nothing.  If I want to stop, I stop. If I don't want to stop, I keep going.  My EMT instructor had an alphabet soup of letters behind his name and doesn't carry more than an auto first aid kit and has only an old Pink Floyd sticker on the back window.  I agree with Rid; when we are away from our tools and protocols we are essentially highly skilled first responders.  Don't get me wrong, if I was out in the boonies and someone was hurt I'd do what I could, but with the current EMS availability in most urban/suburban areas you are likely to be considered more of a hindrance and a pest than an asset. Just my .02, your mileage may vary...


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## c-spine (Oct 9, 2006)

I remember you posting that, Celtic... hehe

I bought a first aid kit a while ago from shopko (I hate shopko); and it's got some basic meds (though I wouldn't be able to give them) including diphenhydramine (benadryl). 

I carry gloves and bandages, mainly. Some triple antibiotic and "sting swabs" etc.


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## fm_emt (Oct 9, 2006)

I'll stop even if it's just to call 911 from the scene. A dispatcher friend mentioned that cell phones are a royal pain in the *** because people will call in to report a wreck but not stop, so they're 5 miles down the road and cannot give any useful information about how many people are involved or if there are even any injuries. 
Or, everyone just assumes "oh, someone else will call 911. Surely they've called 911 by now." In most areas in CA, calling 911 will get you routed to California Highway Patrol dispatch in Vallejo, CA, and if they're busy, you could wind up on hold. I have the numbers for our local dispatch centers in my phone. (we use them at work to contact county dispatch since we don't have county radios)

At the very least, I'd stop to call dispatch and say "there are X number of patients with Y injuries" and I'd drop a road flare or two behind the accident scene to hopefully keep rubberneckers from causing more chaos.


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## Celtictigeress (Oct 9, 2006)

I just have too big of a heart I take serious what I do the FF and EMT crew know my car if I drive by Id hear about it over the radio next day...

I do have an EMT bag with everything except Oxygen... It isnt that I have "Used" all of it there... ven with National Registry they support stopping if..IF you are a current employed EMT.....I feel when I chose this field I took a silent oath to help when needed...even if it is to "stop and call" or "stop and assure everyone is okay" It is a different thing then some civi stopping with no medical experiance at all yanno? (We have all had them the bystander running up waving a card going "I know CPR" and you have the pt with his head turned around backwards DOA.... or the pt is breathing but w are treating a fracture)

Ill take the risk of lawsuit Honestly how many badges have you seen pulled due to saving a life..I dont know about you but I couldnt live with myself if I bypassed an accident thinking "Not my respnsibility"to find out they died and had help arrived "sooner"there would have been a chance


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## Ed3SJ (Oct 10, 2006)

This is definitly they response i thought i would get... Definitly stop and do what you can.. but do not administer drugs or oxogen.

So my question to you all... again, i am stull a student so i am not as knowledgeable as you all.. why would there be issues with giving a pt oxogen. not that i even have a ox. cylinder anyways, but why would there be a issue? hell if i was injured id sure hope a off duty EMT would give it to me if possible


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## Chimpie (Oct 10, 2006)

It's not the oxygen that is being given, but the fact of anything being given.  Oxygen is considered a drug, and giving any type of drug off duty may put you in danger legally.


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## Jon (Oct 10, 2006)

I own an O2 Cylinder, but do not carry it regularly.. I only have it with me when I'm doing first aid coverage for the Boy Scouts.

Also - on the ambulance, our O2 botles live in crash-broof brackets. In my trunk, it rattles around and sits next to my road flares. Not a greatplace to keep a hazardous substance like that (O2 isn't hazardous in small quanities but pressurized vessels are dangerous, as well as oxegen supporting combustion).


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## Jon (Oct 10, 2006)

As for stopping - I have a bag similar to Celtictigeress's... I have no problem stopping at an accident scene, at least to asertain if there are injuries.

I will occasionly not stop - I only fail to stop if it isn't safe, or services don't appear to be needed.


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## Celtictigeress (Oct 10, 2006)

Jon...a tank next to road flars...wow never heard that bfore *Feeds Jon a cookie*

If the patient is a heart patient and having chst pains I WILL take BP if its 100/P and they havent taken nitro yet and its in their name Ill administer and then make a note until the unit arrives... little things.. 

At least I know others would stop Now I dont feel so Bad heh...Not to change the subject here but did you hear about the mess with North Korea was watching CNN yesterday apparantly they are p*ssing off the world with Nuclear testing


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## Ed3SJ (Oct 10, 2006)

Only reason i would want to have an oxogen tank wouldnt be for the public. It woudl be fore family and close friends i figured i would use it. Ive had a couple instances where close friends and famly members have had emergencies and could use eveything that i have been learning. I honestly got in the field threw those experiences. It gave me a passion. So is there somthing wrong with delivering "drugs" (such os Ox. or asprin) to your family? children? or close friends?


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## Jon (Oct 10, 2006)

Celtic - Yeah... well, not *Next to* the flares... but in the same trunk... so I don't keep it there...

I have mine in an old orange plastic box case... cira 1980's... it works, and protects the cylinder well, too.


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