# First Responder



## musicislife (Feb 9, 2012)

I am 15 years old and I am wondering about being a first responder. If i witness a crash or some other emergency, would it be ok to place some flares in the road and go into the car and hold c spine? Assuming i have called 911, and the car isn't on fire or anything. Would it be ok to render aid to a witnessed event (following protocols of course) Also, what would happen after as far as documentation? And is it acceptable to stop at a crash (with injuries) where just police officers are on scene?


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## DesertMedic66 (Feb 9, 2012)

If your off duty then it's all covered by the good Sam law (assuming you don't do something extremely stupid.)

If police are on scene you can stop and ask. If they say no, then keep on going.


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## musicislife (Feb 9, 2012)

good sam laws are no longer in my state (NJ) i think..


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## Aidey (Feb 9, 2012)

As a general guideline, ASK if people want assistance before you even call 911. Everyone has cell phones these days, and chances are the people involved have already called 911. And frankly, don't bother with c-spine unless they are A) Still sitting in the car B) Unconscious or C) Specifically state they are having neck pain. 

I admit, there is something uniquely annoying about arriving on scene and finding my previously ambulatory patient with no complaints sitting in their car with someone holding c-spine for no reason what so ever. It usually takes longer to get the person to stop holding c-spine than it does to get the refusal.


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## musicislife (Feb 9, 2012)

yes, i was talking in the sense that he required help/asked for it.


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## Anonymous (Feb 9, 2012)

You are only 15? 

Oh and Good Samaritan laws vary from state to state...


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## DesertMedic66 (Feb 9, 2012)

And and far as documentation if your off duty then you don't need to write down anything. You don't even have to tell the fire/ambulance crew your name. 

If I stop at an accident scene when I'm off duty I'm not going to give anyone my name or say that I'm an EMT. How can someone sue you if they don't even know who you are? (I've never seen police ask for the name of someone who was helping at a traffic collision.)


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## Jon (Feb 9, 2012)

musicislife said:


> good sam laws are no longer in my state (NJ) i think..


Oh?

http://lmgtfy.com/?q=good+samaritan+law+new+jersey
First two seem to indicate the law is still active.

What training do you have? Are you a member of any form of service / junior squad, etc?
What are THEIR policies relating to you doing stuff like this?


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## bigbaldguy (Feb 10, 2012)

Aidey said:


> As a general guideline, ASK if people want assistance before you even call 911. Everyone has cell phones these days, and chances are the people involved have already called 911.



I would recommend calling 911 as soon as you become aware of the accident. Asking someone who's just had their head scrambled if they need help and then basing your decision to call 911 on their answer might meet with mixed results. Ambo can always be disregarded if need be. Beyond that 

1. Do only what you are trained to do 
2. Do only what you are comfortable doing
3. Do only what you can do safely

Generally if you apply 1 through 3 it pretty much rules everything beyond calling 911 out.


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## Monkadelic (Feb 10, 2012)

musicislife said:


> I am 15 years old and I am wondering about being a first responder. If i witness a crash or some other emergency, would it be ok to place some flares in the road and go into the car and hold c spine? Assuming i have called 911, and the car isn't on fire or anything. Would it be ok to render aid to a witnessed event (following protocols of course) Also, what would happen after as far as documentation? And is it acceptable to stop at a crash (with injuries) where just police officers are on scene?



As a general rule of thumb IMO, ( I'm studying scene size up and the assessments module right now)  if you come into an area of an MVC, you should look and smell for fuel leakage- as throwing flares down would not be the greatest of ideas in that scenario, plus you also have the possibility of downed power lines that could ignite fuel as well. I'd say if you were off duty or whatever the best bet would be find something reflective if you have it or just use a flashlight to direct traffic around the incident.  even if you are uphill from it. You would be covered under Good Samaritan Laws; just make sure you stay there until someone shows up, otherwise you can still be liable for abandonment. Watch out for maintaining the c-spine too; you might do more damage to the patient than you are helping them without a KED extrication .  If there are LEOs on the scene already; that is just an ethical judgement by you to stop or not; 9-10 times they are gonna tell you to move along anyways.
and also- just because the vehicle is not on fire when you arrive does not mean it wont catch fire later- constant scene size up. There wouldn't really be any documentation involved on your behalf other than stating your observations and procedures you did to the ones in charge of the scene.

veterans- am i right on this?


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## Ewok Jerky (Feb 10, 2012)

Monkadelic said:


> As a general rule of thumb IMO, ( I'm studying scene size up and the assessments module right now)  if you come into an area of an MVC, you should look and smell for fuel leakage- as throwing flares down would not be the greatest of ideas in that scenario, plus you also have the possibility of downed power lines that could ignite fuel as well. I'd say if you were off duty or whatever the best bet would be find something reflective if you have it or just use a flashlight to direct traffic around the incident.  even if you are uphill from it. You would be covered under Good Samaritan Laws; just make sure you stay there until someone shows up, otherwise you can still be liable for abandonment. Watch out for maintaining the c-spine too; you might do more damage to the patient than you are helping them without a KED extrication .  If there are LEOs on the scene already; that is just an ethical judgement by you to stop or not; 9-10 times they are gonna tell you to move along anyways.
> and also- just because the vehicle is not on fire when you arrive does not mean it wont catch fire later- constant scene size up. There wouldn't really be any documentation involved on your behalf other than stating your observations and procedures you did to the ones in charge of the scene.
> 
> veterans- am i right on this?



omg I just spit beer out my nose. LOL


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## Monkadelic (Feb 10, 2012)

beano said:


> omg I just spit beer out my nose. LOL



okay.  I'm sipping on brews also; any discrepancies you could share?  yes 3 post < 100+; but i already work in EMS/healthcare for 4 years so dont treat me as a nub plz. if you have something to share then share it please- that is if it is in taste and is helpful to the situation presented by the OP.

thanks.


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## DesertMedic66 (Feb 10, 2012)

Monkadelic said:


> okay.  I'm sipping on brews also; any discrepancies you could share?  yes 3 post < 100+; but i already work in EMS/healthcare for 4 years so dont treat me as a nub plz. if you have something to share then share it please- that is if it is in taste and is helpful to the situation presented by the OP.
> 
> thanks.



Without reading the whole post the one major thing that I see is about abandonment. If your off duty then you don't have a duty to act (in most places). So if you don't have a duty to act then you can leave the scene whenever you wanted.


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## Monkadelic (Feb 10, 2012)

firefite said:


> Without reading the whole post the one major thing that I see is about abandonment. If your off duty then you don't have a duty to act (in most places). So if you don't have a duty to act then you can leave the scene whenever you wanted.


Yes you dont have the duty to act except for ethical purposes in that scenario; but.....
 We were told that if you act off duty and leave you can still be liable for abandonment.  But after reading the prior posts; who are they gonna know to sue if you don't tell them your name lol. You can still be charged with abandonment and negligence regardless if you are on or off duty.


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## bigbaldguy (Feb 10, 2012)

Monkadelic said:


> okay.  I'm sipping on brews also; any discrepancies you could share?  yes 3 post < 100+; but i already work in EMS/healthcare for 4 years so dont treat me as a nub plz. if you have something to share then share it please- that is if it is in taste and is helpful to the situation presented by the OP.
> 
> thanks.



Your post was fine just a bit like it was copied out of the text book with the power lines down and possible fuel spill. I think that's probably where the amusement comes from. But if you were going to drop flares then spilled fuel is a real concern and in theory there could be a power line down. Wearing something reflective is an excellent idea. If the OP is going to make a habit of stopping at MVA's then investing in a cheap Hi Viz vest from Walmart might be a good idea.

edit
Oh and while they might not be able to sue you if you start treatment and then realize you're late for your movie and leave the scene do you really want to see your picture or name on TV as someone who did leave. Obligated or not once you start helping someone in nearly any situation you're generally going to be with that person until you're absolutely certain they don't need any help or someone else takes over.


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## EMT11KDL (Feb 10, 2012)

This is what i do when i get on scene to any emergency off duty.. I do not identify myself as an emt until i know i will have to provide some medical treatment. If c spine is indicated ill do that. I rarely call 911 due to there has probably already been 20000 calls already. But i do ask the bystanders that are already on scene and if someone is talking to dispatch ill ask for the phone and give a brief scene size up. Or unless they will need special equipment ie extraction. High low angle gear ext. Now if they are unresponsive ill do my abc. Now with all of this. I only stop if there is no emergency vehicles on scene this includes LE.


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## Tigger (Feb 10, 2012)

EMT11KDL said:


> This is what i do when i get on scene to any emergency off duty.. I do not identify myself as an emt until i know i will have to provide some medical treatment. If c spine is indicated ill do that. I rarely call 911 due to there has probably already been 20000 calls already. But i do ask the bystanders that are already on scene and if someone is talking to dispatch ill ask for the phone and give a brief scene size up. Or unless they will need special equipment ie extraction. High low angle gear ext. Now if they are unresponsive ill do my abc. Now with all of this. I only stop if there is no emergency vehicles on scene this includes LE.



The not identifying oneself as an EMT is a good play in my book. If I stumble upon some sort of accident, I'm not going to be able to anything that a layperson couldn't anyway. The only time I'll mention it is if hysteria is taken over and people are about to/have done silly things to the patient. Then it might be a good idea to "take charge." Or just leave.


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## EMT11KDL (Feb 10, 2012)

If the patient is freaking out or its a pediatric is really the only time ill start by identifying myself. I know some people in here have enough equipment in there car to stalk a bus.. I personally don't unless i have my sar pack with me which is normally at home. But truly there not much anyone can do other than keep the pt calm and try tk control bleeding. Manual airway management. And cpr. More than that we can't do much more.. We can try to secure a scene but we all know how well that goes even when were on duty.


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## EMTBell (Feb 23, 2012)

*Scene Safety*

You said you were wondering about becoming a first responder? If you aren't trained/certified appropriately, just make sure you stick to procedures in the scope of whatever official training you have. Otherwise, stopping at accidents is a mixed bag. If you're on the highway, pull over AHEAD of the accident not behind it, and approach the vehicle from the shoulder. Think of scene safety before the patients (if any.) Just ask if everyone is OK and call 911 to report the accident, if there are life threatening injuries or illnesses manage them again keeping YOUR SAFETY in mind. Don't base whether you call 911 or not off of what the patients say, at the very least get the cops out there.


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## mycrofft (Feb 23, 2012)

Second that. Don't ask us, go get trained locally. And don't shop around for permissions, follow the guidelines. 
Rule one is don't add yourself to the victim list, rule two is don't get in the way, for all of us. Without training and education, you will likely do both.


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## Steveb (Feb 29, 2012)

musicislife said:


> I am 15 years old and I am wondering about being a first responder. If i witness a crash or some other emergency, would it be ok to place some flares in the road and go into the car and hold c spine? Assuming i have called 911, and the car isn't on fire or anything. Would it be ok to render aid to a witnessed event (following protocols of course) Also, what would happen after as far as documentation? And is it acceptable to stop at a crash (with injuries) where just police officers are on scene?


I also am 15 and am a FR go out and get it! Placing flares would be great. Also always ask if the person wants help. Holding C-spine is also great depending on where you are located you may be able to rule it out I am able to if EMS is more the 30 mins away. In terms of documentation it would pretty much be SAMPLE & PRP (pulse respiration pupils) to give to emt/paramedics.
Always remember EMCAP as a FR at a scene of a accident. 
Environment (Isit safe or not)
Mechanism of injury( How was he hurt How does he appear to be hurt.
Casualties do you have them all accounted for .
Addition resources (911)
Personal Protective equipment (gloves)


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## medickat (Mar 1, 2012)

musicislife said:


> good sam laws are no longer in my state (NJ) i think..



First of all, Good Sam IS alive and well in NJ.

I started in EMS when I was 16 in NJ and was on a "Cadet Corp" until I was 18. There were A LOT of things I wasn't allowed to do, which included getting into a car without the presence of senior members. If you're off duty and ESPECIALLY because you're a minor, I wouldn't do that for your own safety and for the reputation of whatever squad you are on.


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## Cindigo (Mar 1, 2012)

I LOVE the internets. How awesome that 15 year olds have access to all of these brains and experience.


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## Martyn (Mar 1, 2012)

OK, at the risk of getting my wrist smacked...WHY IS A 15 YEAR OLD WALKING AROUND WITH FLARES??? :wacko:

(BTW most of the EMR/FR's I work with have only done a basic 4 hour glorified first aid course, one I worked with a little while ago a) didn't even know how to hold C spine and b) didn't even know how to use a BVM)


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## CBentz12 (Mar 2, 2012)

Honestly if I witnessed a car crash I would simply put my hazards on get out my car walk up to the PT and ask them if they are experiencing any pain. If they say no I stay with them until EMS arrives just in case and if they say yes I would begin to ask where and etc... No need to be so technical about it with the road flares and reflection vest because who honestly carries these in their own vehicle. If you do cool but unless its a serious accident theres no need for flares and all you will do is back up traffic even more.

Oh and the if the car is drivable i.e. no fuel, oil or coolant leaking then tell them to pull into a plaza or on the side of the road. Nothing bugs me more then the people who get in a accident with the car still drivable and leave their car in the road while on the cellphone.


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## Cindigo (Mar 2, 2012)

Martyn said:


> OK, at the risk of getting my wrist smacked...WHY IS A 15 YEAR OLD WALKING AROUND WITH FLARES??? :wacko:



What? You don't carry flares on your person?

Weird. h34r:


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## KyleG (Mar 4, 2012)

musicislife said:


> I am 15 years old and I am wondering about being a first responder. If i witness a crash or some other emergency, would it be ok to place some flares in the road and go into the car and hold c spine? Assuming i have called 911, and the car isn't on fire or anything. Would it be ok to render aid to a witnessed event (following protocols of course) Also, what would happen after as far as documentation? And is it acceptable to stop at a crash (with injuries) where just police officers are on scene?



There are a few problems here. One a TC is a very unstable scene, if your on or off duty a TC is not the safest scene with or without flairs. If you feel comfortable and you can then I would say go for  it. But just don't mess up. As for officers most cops have basic first aid and can help, unless you are an EMT (Im assuming not cause out here in SD, CA you have to be 18) then just leave it be. h34r:


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## Steveb (Mar 11, 2012)

Martyn said:


> OK, at the risk of getting my wrist smacked...WHY IS A 15 YEAR OLD WALKING AROUND WITH FLARES??? :wacko:
> 
> (BTW most of the EMR/FR's I work with have only done a basic 4 hour glorified first aid course, one I worked with a little while ago a) didn't even know how to hold C spine and b) didn't even know how to use a BVM)



Wow Four Hours where I live It's a total of 56 hours and we know how to use BVM. It sucks that person gave you a bad impression of MFR.


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## Jon (Mar 11, 2012)

KyleG said:


> if your on or off duty a TC is not the safest scene with or without flairs.






Click if you need explianation

I personally don't think flair belongs on a MVC scene at all... but to each their own.


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## rwik123 (Mar 12, 2012)

Monkadelic said:


> As a general rule of thumb IMO, ( I'm studying scene size up and the assessments module right now)  if you come into an area of an MVC, you should look and smell for fuel leakage- as throwing flares down would not be the greatest of ideas in that scenario, plus you also have the possibility of downed power lines that could ignite fuel as well. I'd say if you were off duty or whatever the best bet would be find something reflective if you have it or just use a flashlight to direct traffic around the incident.  even if you are uphill from it. You would be covered under Good Samaritan Laws; just make sure you stay there until someone shows up, otherwise you can still be liable for abandonment. Watch out for maintaining the c-spine too; you might do more damage to the patient than you are helping them without a KED extrication .  If there are LEOs on the scene already; that is just an ethical judgement by you to stop or not; 9-10 times they are gonna tell you to move along anyways.
> and also- just because the vehicle is not on fire when you arrive does not mean it wont catch fire later- constant scene size up. There wouldn't really be any documentation involved on your behalf other than stating your observations and procedures you did to the ones in charge of the scene.
> 
> veterans- am i right on this?



How would you do more damage by holding c-spine..and how would a ked prevent this damage created by initiating c-spine precautions?

Oh and i know how basic classes have a hard on for the ked but its hardly ever used in real life.


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## Jon (Mar 13, 2012)

rwik123 said:


> How would you do more damage by holding c-spine..and how would a ked prevent this damage created by initiating c-spine precautions?
> 
> Oh and i know how basic classes have a hard on for the ked but its hardly ever used in real life.



Why is it that EMS in your area  doesn't use the KED? Laziness? Is it required equipment for your rig?

Then again, the lack of science on spinal immobilization means we don't have a good reason either way.


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## Mountain Res-Q (Mar 13, 2012)

Jon said:


> Why is it that EMS in your area  doesn't use the KED? Laziness? Is it required equipment for your rig?
> 
> Then again, the lack of science on spinal immobilization means we don't have a good reason either way.



Yes, but if people are going to preach backboarding for anything fitting a predetermined MOI, then the "spinal immobilization" sure as hell should be done with 100% dedication.  The KED is underused in many of the systems I have seen, a fact that I can only attribute to to a culture of laziness and ignorance that has been perpetuated.  Research has shown that backboarding in general potentially causes more harm than good, so if the argument of EMS Folks is that "it is better to be safe than sorry" than use the damn KED, or else go with the research and find any way to "clear the spine".


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## Bosco836 (Mar 13, 2012)

rwik123 said:


> Oh and i know how basic classes have a hard on for the ked but its hardly ever used in real life.



We use the KED quite a bit here, assuming the pt. meet's c-spine protocol and is hemodynamically stable.  

The KED isn't very difficult to use, and arguably provides better c-spine control when extricating a pt. from a vehicle 
(or virtually any other location where the pt. is seated).  Overall, I think its an excellent tool - which, from the sounds of it, appears to be underused by many EMS services.


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## Tigger (Mar 13, 2012)

Jon said:


> Why is it that EMS in your area  doesn't use the KED? Laziness? Is it required equipment for your rig?
> 
> Then again, the lack of science on spinal immobilization means we don't have a good reason either way.



Laziness for sure. Even when a supervisor or chief is on scene it does not get used which speaks volumes. I know that there is not a lot (if any) data supporting spinal motion restriction but anyone that's ever been in a KED knows damn well that it does a far better job limiting total body movement in an extrication, which to me is justification enough.


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## Steam Engine (Mar 13, 2012)

I've always wondered if somehow securing the pt to the stretcher sitting upright, or to another seat in the ambulance with the KED in place, rather than transferring to a backboard wouldn't be a better approach in some cases. It would limit movement, and arguably keep them more comfortable. I know that personally I'd rather be KEDed than boarded any day.


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## Mountain Res-Q (Mar 13, 2012)

Steam Engine said:


> I've always wondered if somehow securing the pt to the stretcher sitting upright, or to another seat in the ambulance with the KED in place, rather than transferring to a backboard wouldn't be a better approach in some cases. It would limit movement, and arguably keep them more comfortable. I know that personally I'd rather be KEDed than boarded any day.



Been there, done that, for a claustrophobic patient getting combative.  Comfort in a KED sure beats thrashing around on a hard board.


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