# Dozens Ignored a Man Dying on a Sidewalk in Queens, NY



## NepoZnati

*Homeless Good Samaritan Left to Die on NYC Street*


> The homeless man lay face down, unmoving, on the sidewalk outside an apartment building, blood from knife wounds pooling underneath his  body... One person passed by in the early morning. Then another, and  another. Video footage from a surveillance camera shows at least seven  people going by, some turning their heads to look, others stopping to gawk.  One even lifted the homeless man's body, exposing what appeared to be  blood on the sidewalk underneath him, before walking away.



Read the full story *here*.



*Questions Surround a Delay in Help for a Dying Man*


> One man bent down to the sidewalk to shake the man, lifting him  to reveal a pool of blood before walking away. Two men appeared to have  a conversation about the situation, one pausing to take a photo of the body  before departing. But the rest merely turned their heads toward the body,  revealing some curiosity as they hurried along.



Read the full story* here*.


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## NepoZnati

Video of that incident and crappy people who walk by, posted on NYPost site, here:  *VIDEO*


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## usafmedic45

NepoZnati said:


> Video of that incident and crappy people who walk by, posted on NYPost site, here:  *VIDEO*


If he's bleeding and I don't have gloves, I'm not getting involved so I can't fault them for not rendering first aid.  Now, I would have probably at least notified someone.

That said this is a well-documented phenomenon....people assume someone else is going to call for help or intervene. http://en.wikipedia.org/wiki/Bystander_effect


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## Akulahawk

I'm with USAF on this one. Without gloves, at the least, I'm not going to directly intervene. I will call for assistance as quickly as I can get to a phone. That being said, I do my research before I travel so that I have the local 7 digit number to the appropriate call centers so that I don't have to mess with calling 911 and getting stuck getting that 911 call routed initially to the wrong call center...


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## viccitylifeguard

usafmedic45 said:


> If he's bleeding and I don't have gloves, I'm not getting involved so I can't fault them for not rendering first aid.  Now, I would have probably at least notified someone.
> 
> i have to agree completly here   my therory is  "if its warm wet and not mine   i dont touch it" that being said  if i had  gloves ya i prob would have helped   or called for help and waited till it arrived.


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## usafmedic45

> "if its warm wet and not mine i dont touch it"


My rule is similar but I don't care if it's warm or cold.


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## Shishkabob

As USAF said, it's well known and studied quite a bit in the CJ classes I've been in.


That's why I make it a point for myself to call 911 in any situation that looks like it might benefit from it even if I'm just driving by.  Better to had dispatch get multiple calls than no calls.


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## adamjh3

I can't tell from the video, was the blood obviously visible to the people walking by? I don't know about New York, but there's some areas here where a transient lying on the sidewalk isn't that out of the ordinary.


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## bstone

Not the first time this has happened in NY. It might say something about the folks in NY.


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## spike91

I wish I could say that I couldn't believe that video, however, after my limited time in EMS, I definitely can.

And while the practical me totally agrees with USAF about BSI, at the same time depending on the severity, the bleeding heart in me might win.


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## DaniGrrl

I find that video absolutely appalling. I can't imagine walking past and injured person and doing NOTHING. People depress me.


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## usafmedic45

> the bleeding heart in me might win.



The bleeding heart in the victim may cause you to lose in the long run.  Keep that in mind.


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## 46Young

spike91 said:


> I wish I could say that I couldn't believe that video, however, after my limited time in EMS, I definitely can.
> 
> And while the practical me totally agrees with USAF about BSI, at the same time depending on the severity, the bleeding heart in me might win.



You don't know what diseases a person has. Anyway, what would you really do on the street with no equipment for a shot or stab victim anyway? If the ptis  already unconscious before any units are onscene, they're not going to make it to the hospital alive, anyway.

It's not worth it to risk contracting a deadly or debilitating disease for a complete stranger, especially if you're off duty. Same thing for stopping with your POV for an MVA. You can get yourself killed real easy. Take a step back and think about that. You turned over that guy to check him out, got blood or feces on your hands, in through a break in the skin, or maybe a blood splash on your eye. Now you have HIV or Hep, and you're screwed for life. For what?

I've been called for the unconscious, who's really a drunk (after a full assessment) that has pulled a knife on me when attempting to rouse him. Several times. This was in Corona Queens around National/Roosevelt and vicinity for those in the know, where the sleeping homeless and/or drunk in the gutter, on the park bench, or on the back step of my ambulance is not uncommon. Situational awareness.


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## NepoZnati

Being a new EMT I can only agree with BSI rule and opinions of much wiser and more experienced here, but it is not issue of one not having BSI or trauma bag with you... It is issue that people really suck and that taking the pictures or having fun with not moving human body it's really appalling. Like someone said, "I have no problems with humanity, it's people who suck".


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## usafmedic45

NepoZnati said:


> Being a new EMT I can only agree with BSI rule and opinions of much wiser and more experienced here, but it is not issue of one not having BSI or trauma bag with you... It is issue that people really suck and that taking the pictures or having fun with not moving human body it's really appalling. Like someone said, "I have no problems with humanity, it's people who suck".


I prefer Gandhi's comment when asked what he thought of Western civilization: "I think it would be a wonderful idea."


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## EMSLaw

usafmedic45 said:


> The bleeding heart in the victim may cause you to lose in the long run.  Keep that in mind.



Not necessarily - most bloodborne pathogens are effectively stopped by in tact human skin.  

I'm not disagreeing - I wouldn't want to go grabbing onto someone who was bleeding without gloves on.  But I wouldn't look askance at anyone who decided that they should take some action, equipment or no.  

Just, err, dial 9-1-1 on your cell phone BEFORE you get blood on your hands.


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## mycrofft

*"Hey, lady, toss me down your dish gloves!".*

Anyone remember Kitty Genovese?:sad:


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## usafmedic45

> Anyone remember Kitty Genovese



Ever read the research into the case that says there was at least one phone call made to the cops by a witness and there were a lot fewer than the supposed 35+ witnesses?  The story was significantly hyped up at least in the opinion of most social psychologists who have seriously looked into the case.


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## usafmedic45

> Not necessarily - most bloodborne pathogens are effectively stopped by in tact human skin.
> 
> I'm not disagreeing - I wouldn't want to go grabbing onto someone who was bleeding without gloves on.



Of course, you need to keep in mind that my decision tree for offering assistance while off duty pretty much consists of:
*1-Is the victim a kid or an animal?*   Yes:  Help them if it can be done safely    No: Go to question 2
*2-Do I know the person?*   Yes: Go to question 4   No:  Go to question 3
*3- Am I stuck in the situation/do other bystanders know that I'm medically trained?*   Yes- Help them if it can be done safely  No- Go to question 4
*4-Do I like the person?*   Yes: Help them if it can be done safely  No: Do not get involved even if it means standing idly by; thank God for no statuatory requirement to render care


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## firetender

*A World Gone Upside Down*

See, Gang, the whole thing was strangers were dying for no Galdammn reason. People _who you didn't know_ were dropping dead, getting run over, shot, choking, bleeding out, seizing, or whatever and NOBODY WAS HELPING.

So a bunch of people got together, disrupted their lives, started lobbying for things to change so people who for no reason of their own (or even if self-inflicted!) got wounded, they'd get help. It seemed to be the civilized thing to do at the time. 

Then, people started training others so they'd know what to do. And THEN, they started to train professionals so that they could REALLY DO SOMETHING TO HELP. And then you know what happened? 

These new guys, who FINALLY had the knowledge to make a difference felt like it was *a kind of sacred trust*. Walking by (as many here said they'd do) wasn't even in the equation. How could it be? It would negate the intention of ALL those people who came before to make sure that such knowledge would never be withheld from anyone again. And it means nothing to me that you'd use your cell phone to call it in.

*What I'm hearing is that the posters feel it's okay to use their skills arbitrarily* because THERE IS A CHANCE a stricken person has a blood borne pathogen, and THEY DON'T HAVE GLOVES. Because of this?  Because of that? Perhaps each medic should wear a list around their neck stating what they are NOT comfortable doing, and won't! so the patient knows what's *not *coming.

Sorry, Buddy, can't work on your heart because I ain't got a defibrillator. If you can't do something without your tools, you shouldn't be a medic.

Having come up from where no one could do anything and I sacrificed so I could, I can't turn my powers on and off at my convenience, that is a betrayal of my mission. The skills are there to use and I have an obligation to use them. 

"Not if my life is in danger!" you exclaim? 

It is never NOT in danger in this work or off-duty. I am as fragile as the people I'm called on to help. What the hell is the essence of this work? Poop comes out of nowhere and strikes people down. Helping at all, in any way puts me in danger. Just because I may see a specific danger does not mean I am justified in turning my back on someone in need.

There are things you can do to insulate yourself from (blood, sharp objects, smoke, 5150s...FILL IN THE BLANK!)  and at least do *something*. No one even looked at that option. 

The whole thing kind of sickens me, to tell ya the truth. I don't get it.

...AND, I'll be the first to admit I could picture myself withdrawing my ability to intervene because of a perception of my life being in danger. But what I suspect is I wouldn't have time, I've been trained to act.


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## firetender

usafmedic45 said:


> thank God for no statuatory requirement to render care



Thank God I'm not in your neighborhood, or even call area.

(Can you hear what you're saying?)


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## adamjh3

I hope you carry all of your PPE everywhere. There's no point to unnecessarily risk your life, your health, your livlihood, and everything else you have for a complete stranger. 

I don't see me "turning on my powers" off-duty, because, frankly, I'm not a super-hero. I don't have magical hands that bring people back from the dead. I'm just a guy, who happens to perhaps delay death once in a while through my (minimal, at this point) knowledge of the human body. 

I do feel it's okay to use my skills arbitrarily. 

Let's take this situation to another level, we'll go to the hazmat scenario, roll up on a scene with an over-turned tanker-truck. The truck is surrounded in a green cloud, you can see and hear the truck driver screaming for help - trapped in the cab. Are you just going to waltz into that green cloud for Joe Trucker? 

I know I'm not. I don't have the right equipment or training to deal with that, and I know that. I'm going to call for additional resources, remember PENMAN? 

It's the same situation here. The people on this forum that are saying they wouldn't render care, but would call for help as soon as possible are spot on. You can't help anyone when you're dead.


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## firetender

adamjh3 said:


> I do feel it's okay to use my skills arbitrarily.



New Breed, I guess.

_*Agree or Disagree?*_


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## CAOX3

"*What I'm hearing is that the posters feel it's okay to use their skills arbitrarily because THERE IS A CHANCE a stricken person has a blood borne pathogen, and THEY DON'T HAVE GLOVES. Because of this?  Because of that? Perhaps each medic should wear a list around their neck stating what they are NOT comfortable doing, and won't! so the patient knows what's not coming."*

I dont know whats going on I cant quote firetender, I will just make it bold

------------------------------------------------------------------------

Listen, I think you a great contributer to this forum and I enjoy reading your posts but I have to disagree with you here.  

When I was young and single yes I intervened at times, I now have a wife and a child to provide for, they are my responsability.  I cant take the chance for their sake it isnt about me per se, its about my family. 

Sure I would have picked up the phone and have many times but to get involved in a situation any further then that, I wouldnt, excuse me I cant.


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## usafmedic45

The fact that I choose carefully those circumstances in which I choose to intervene?  We all make judgment calls, I just happen to have a codified system by which to make that decision.  Most of us are more likely to aid an injured child or to tend to the elderly grandmother who is injured as opposed to someone we view as being a potential criminal.  

My responsibility and duty to take care of people ends the moment I walk out the door after my shift.  After that, it's the choice of the individual and the fact I want to .   All of us who volunteer have laid in bed after a long night of runs and thought "I'm not getting up for that BS call.  Someone else can handle it" before rolling over and going back to sleep.  I am expressing nothing more than a version of that.  It's not my responsibility or duty to treat everyone who crosses my path unless I am on duty.  At least I am not totally disregarding everyone.  I am simply applying a form of non-medical triage to the problem of deciding.  

We are not beholden to live, sleep and breathe being medical professionals.   We delude ourselves into thinking there is a "code" or "oath" we are held to.  Non-statuatory codes of conduct, creeds, etc lack teeth and are not enforceable, especially in situations where the person supposedly held to that standard is being asked to potentially endanger him or herself in the ensuing events.  Much was written about this during the review of the SARS epidemic where there was moderately high rates of failure to report and refusals to continue to work amongst health care practitioners.  

It's a myth that we have to do this or do that.  We have time off like everyone else.  Unfortunately there is this misguided belief- the one outgrowth of volunteer EMS and fire services that I have a problem with- that if you don't live for the job, your heart is not in it.  I give everything I have when I am on duty to anyone who crosses my path.  The moment I am off duty, we play by the law and by my right to self-determination.  One does not give that up the day you pass an EMT exam (at least in all but three or four states).   



> But what I suspect is I wouldn't have time, I've been trained to act.



...and people wonder why our occupational morbidity and mortality is so damn high.   It's this cowboy "I have to save the showgirl tied to the tracks!" attitude that leads a lot of people in this field into making very stupid decisions.  I've carried the body of a very good friend of mine out of a burned out house because he didn't think it through before running into a house that MIGHT have had people in it.  If he'd stopped for a split second before running headlong in there, he might have seen the people fleeing out the backdoor.  Instead, he ran in just as the roof came down.  Once you've stood on a widow's doorstep in a dress uniform at 7am on Christmas morning to tell this woman with whom you danced at her wedding to your friend that he won't be coming home, the illusion that we are obligated to do anything that endangers ourselves starts to crumble.  We feed the families and each other those hollow words "He died a hero", "He died serving others", "he died doing what he loved"....somehow I don't think Chris loved being pinned under a collapsed roof as his airpack slowly ran out and a dead hero is still that: dead.  

In the name of doing my job and helping my fellow man, I've flung myself into flooded rivers, climbed into collapsed structures, crawled into burning buildings, been mortared and shot at.  I've been seriously injured in the line of duty on two separate occasions despite being cautious.  My ability to rationalize and coldly make a decision to treat or to not get involved is not a lack of dedication or a lack of concern.    It is simply a manifestation of the first rule of staying alive in this job: my *** before anyone else's.  After that, it's a matter of what I think of them in order of importance.  You'd save your wife/husband/etc before your partner, your partner before the patient, the patient before another bystander, a cop before a criminal....we all engage in social triage.  The fact is most of us choose not to see it or simply do not discuss it.  

Did that clarify my stance?



> New Breed, I guess.
> 
> Agree or Disagree?



Disagree.  I've been doing this probably as long as you have (since 1996).  I'm definitely one of the "old guys" despite the fact that I regularly get mistaken for a high school student.  It is just a matter of realizing the "with your shield or on it" approach to the profession does more harm than good.  That is, a little less Kool-Aid, a little more rational thought applied to decision making. 



> What I'm hearing is that the posters feel it's okay to use their skills arbitrarily because THERE IS A CHANCE a stricken person has a blood borne pathogen, and THEY DON'T HAVE GLOVES. Because of this? Because of that? Perhaps each medic should wear a list around their neck stating what they are NOT comfortable doing, and won't! so the patient knows what's not coming.



Are you quite done being hyperbolic?  We are not talking about medics and EMTs.  We're talking about off-duty medics and EMTs (read as: effectively civilians).  Big difference.


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## adamjh3

firetender said:


> New Breed, I guess.
> 
> _*Agree or Disagree?*_



Would you have stopped for this gentleman? Would you have rolled him over, applied direct pressure, maybe even initiated CPR with no BSI? Say you did. Congrats, you're a "hero". This dude makes it to the hospital and dies shortly after. Then you find out he has hepatitis C, and HIV, and MRSA oh, and by the way, now you do, too. Cool. Was it worth it? You got to play hero for a few minutes. Awesome.


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## Veneficus

In NYC the EMT dispatchers don't render aid during breaks, why would anybody be shocked bystanders wouldn't?


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## CAOX3

If I hadnt witnessed myself numerous times how quickly good samaritans with good intentions become patients maybe my views would be different.  

I wish I lived in a society where we didnt have to weigh those options, where there was no risk involved and the people who could help would.  We dont live in that world.


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## Melclin

usafmedic45 said:


> ....we all engage in social triage.  The fact is most of us choose not to see it or simply do not discuss it.



/thread. 

(I was ganna say something in the same vein but this pretty much sums it up.)


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## DrParasite

Veneficus said:


> In NYC the EMT dispatchers don't render aid during breaks, why would anybody be shocked bystanders wouldn't?


actually, there are many conflicting witness accounts of what was actually done.  certain NY rags just ran with the worst opinion, and the fact that the mayor made a statement without knowing all the facts made it even worse.  But who would let the facts get in the way of good old fashioned mob justice?

that all being said, it doesn't surprise me that people in NYC just kept walking.  its just the attitudes of people.

However, having had my share of fun times when dealing with bloody EDPs, I can honestly say I probably wouldn't have done anything either.  I would, however, have called 911, and let the cops/EMS deal with him, as they are the professionals who can do the job properly.


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## firetender

usafmedic45 said:


> Disagree.  I've been doing this probably as long as you have (since 1996).  I'm definitely one of the "old guys" despite the fact that I regularly get mistaken for a high school student.



Just to clarify, my time frame as medic was 1973 to 1985.

Having been on the first wave of medics where we truly were an outgrowth of the desire to help people who couldn't help themselves, the clarion call was "try!"

Here, what's being said is try "if". If there's no this, that or the other. I left the field right at the time when AIDS was becoming an issue, when "mugging" (mouth-to-mouth) had only been dropped only a couple years before. AIDS was the turning point. That was when gloves became an issue. That was when barriers started to get placed between you and the patient. 

That was when the first thing you had to work through was fear of losing your own life before you could begin to render aid. That translates into viewing all the circumstances of the scene and then protecting yourself first. I went through that. I was glad I quit at that time. I, being a dinosaur, did not like having to think of me first. That's not why I got into the field. 

It may seem stupid in today's world, but at the time, a lot of people were dying for no damn reason. For anyone to be able to do anything was, as I said, a sacred trust.

One of the concepts of training in First Aid and quickly on to EMT was all about knowledge allows you to step beyond your fears and into action so people don't need to die needlessly. What I'm hearing is knowledge today, in a sense, is a major factor in NOT taking action. You know there are blood borne pathogens, so you don't get involved in anything with blood.

Now I'm not saying this is wrong. In fact, it reflects my own naivety because all this time, I was assuming (there's that word!) that medics today, in part, go through the training they go through for the very reason of learning what to do and being willing to do it, should the situation arise.

This was a shock to my system, really. Since leaving the field I haven't taken the time to see just how important it is to protect yourself first. That is a reality you all must deal with every day.

I guess I was pretty lucky to have come up from a time when we felt like Gods because we could do something. Could it be true that today the God aspect is reflected in that we can arbitrarily choose to NOT do?

This is, or should be, a real moral dilemma that really gets looked at by each medic. Perhaps, like usafmedic, each of us should get real clear on our professional and personal criteria for taking action. That would make it less traumatic when being right in the middle of the dilemma on-scene, and having to "decide" while the patient is waiting.


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## TransportJockey

usafmedic45 said:


> Of course, you need to keep in mind that my decision tree for offering assistance while off duty pretty much consists of:
> *1-Is the victim a kid or an animal?*   Yes:  Help them if it can be done safely    No: Go to question 2
> *2-Do I know the person?*   Yes: Go to question 4   No:  Go to question 3
> *3- Am I stuck in the situation/do other bystanders know that I'm medically trained?*   Yes- Help them if it can be done safely  No- Go to question 4
> *4-Do I like the person?*   Yes: Help them if it can be done safely  No: Do not get involved even if it means standing idly by; thank God for no statuatory requirement to render care



I'm a big fan of this thought process... Except kids isn't question 1, only animal is. I hate kids


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## mycrofft

*USAF, thanks for the Kitty Genovese input.*

SO we're both older than turtles.

Most of the press stuff is wrong, but it is a fact in many cases bystanders do nothing. If they have nothing to contribute, so be it. Nowadays, however, when something happens our local 911 gets swamped with cell calls, so they aren't doing NOLTHING, just calling in an air strike.

I've stepped around a guy passed out in his own effluvium, I've stopped and helped people, but I tend not to physically engage a street person who's "out" because they can come up swinging and the last thing I want as my "last thing" on Earth, is a steak knife in the groin.

"Five is four", we've shredded the "I don't/do treat people off duty" to molecules. I respect eveyone's personal opinion.


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## usafmedic45

> What I'm hearing is knowledge today, in a sense, is a major factor in NOT taking action. You know there are blood borne pathogens, so you don't get involved in anything with blood.



But the only choice is either:
-Carry gloves and a pocket mask with you everywhere you go (read as: impractical unless you want to look like Ricky Rescue, at least when it comes to the pocket mask)
-Be prepared to withhold care


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## mycrofft

*Grad students, here's your chance:*

moulage and post a person on the sidewalk or somewhere and record/analyze people's responses to various types of victims.


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## Foxbat

usafmedic45 said:


> But the only choice is either:
> -Carry gloves and a pocket mask with you everywhere you go (read as: impractical unless you want to look like Ricky Rescue, at least when it comes to the pocket mask)
> -Be prepared to withhold care


...or you can carry a small glove pouch with a pair of gloves and a flat face shield, which won't raise questions. And even if it will, I'll rather look like a whacker to someone than to have to make a choice between my safety any someone's life and health. Heck, you can just carry a pair of gloves in your pocket and not to do mouth-to-mouth, just hands-only CPR.
You can either look for an opportunity or an excuse.


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## usafmedic45

> ...or you can carry a small glove pouch with a pair of gloves and a flat face shield, which won't raise questions.


Those flat face shields are not very effective at protecting people, particularly if the patient has a lot of secretions, and make if very difficult to obtain a good seal.  



> And even if it will, I'll rather look like a whacker to someone than to have to make a choice between my safety any someone's life and health.



Seriously?  You make it sound like it's a terribly difficult decision.  It's not.  I have a harder time deciding what to order at Sonic for lunch.  



> not to do mouth-to-mouth, just hands-only CPR.



Have you kept up on the most recent cardiac arrest guidelines?  Who does mouth-to-mouth anymore?  It actually reduces the effectiveness of compressions and adds no benefit.  



> You can either look for an opportunity or an excuse.


...or you can be a professional and make a choice whether to get involved or not based upon the situation or be a diehard zealot who refuses to accept that we have no moral, legal or ethical obligation to do anything while off duty _except protect ourselves_.  I am not accusing you personally of being a zealot, just trying to provide a similar "all or nothing"  false dichotomy.


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## firetender

*Talk About LOADED!*

There's some great stuff going on with this theme, here. A woman who lost her 2 year old son started the ball rolling.


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## usafmedic45

The problem with that thread is we are probably not getting the truth from her.  I will take the word of the officer over her word any day of the week.  Rule #1:  When something doesn't make sense, assuming the "witness" is lying or at least skewing what happened is probably a fair assumption.  That said, if the lady really had a leg to stand on as far as her little tale goes, she would be talking to a lawyer and not us.


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## Foxbat

> Have you kept up on the most recent cardiac arrest guidelines? Who does mouth-to-mouth anymore? It actually reduces the effectiveness of compressions and adds no benefit.


Then you can do compressions only. If you wear gloves, the risk is extremely small. Even if you don't wear gloves but there're no visible fluids on patient's chest, the risk is still quite small.


> Seriously? You make it sound like it's a terribly difficult decision. It's not. I have a harder time deciding what to order at Sonic for lunch.


Well, for me it's different. I was raised differently, and if I let someone die rather than take a risk (and it may happen... I haven't been in a situation to make such choice so I don't know what I would do), I will be slowly eating myself alive for the rest of my life.


> or you can be a professional and make a choice whether to get involved or not based upon the situation or be a diehard zealot who refuses to accept that we have no moral, legal or ethical obligation to do anything while off duty except protect ourselves.


Again, I feel very differently about it. I've been raised in a country where you can go to prison if you don't render help (assuming you can do it without endangering yourself). I can't prove that it's right or wrong (if there's something I learned from my ethics class it is that ethical arguments lead nowhere).
Also, I'm not sure what professionalism has to do with it. When it comes to rendering help off-duty, I don't see, ethically speaking, a big difference between EMT, medic, doctor or John Q. Public who happens to know some basic first aid.
I can't tell you what to do. I just don't like when someone tells that people who chose to risk their lives to save others did something wrong (and that's what many seem to think).


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## usafmedic45

> When it comes to rendering help off-duty, I don't see, ethically speaking, a big difference between EMT, medic, doctor or John Q. Public who happens to know some basic first aid.



There is no difference in legal terms, which is what I have been getting at.  We in EMS (with the exception of a couple of states) have no legal requirement to get involved.   



> Well, for me it's different. I was raised differently, and



Actually, you and I were probably raised very similarly.   Working in health care hardened me a considerable amount.  If you'd asked me about this when I was 17 or 18, I would have answered totally differently than I do now. 



> if I let someone die rather than take a risk, I will be slowly eating myself alive for the rest of my life.



You'd be very surprised how easy it actually it is to justify almost anything.  It only eats you alive if you choose to let it.  It's like having to kill someone in combat...when it's you or them, it's a very easy choice to make. 



> and it may happen... I haven't been in a situation to make such choice so I don't know what I would do



I have.  I've had gloves on me and refused to become involved because I had something more pressing to go do.  Like I said, it's an almost unbelievably easy decision to make to not get involved.  What is odd is that I received a letter of commendation for helping after a tornado when I was just driving through the area and stopped to help.  Like I said...my call.  The decision depends largely on who's hurt/sick, how I feel and whether I have something else going on that I can't postpone. 



> I've been raised in a country where you can go to prison if you don't render help



I don't mean this the way it is going to sound but:  You don't live there anymore.  Also correct me if I am wrong, but I do believe most countries with such regulations stipulate that simply seeking assistance for a person in need (read as: calling for help as you keep on trucking) is sufficient under the law.  I don't believe any of them require someone to expose themselves to bloodborne pathogens or actually render direct patient care.  My understanding of this was based on an incident I was involved with in rural France while visiting the country for a conference (if anyone cares to hear the full story, just ask).  



> I just don't like when someone tells that people who chose to risk their lives to save others did something wrong (and that's what many seem to think).



Which is funny, because I'm not taking that stance at all.  I'm saying it's your call.  Those of us who say we would not get involved (directly) are the ones who are being told we are doing something wrong when we are morally, ethically and- most importantly- legally in the clear.


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## ExpatMedic0

I think I would have ripped some of my shirt off and tossed it to him, then instructed him to apply his own direct pressure (I have done this before) then called 911 and started getting a medical hx and MOI for the incoming unit. 

Depending on how nice you wanted to be you could even cover him with a jacket or something and try to find something to have him prop his feet up on and place him in a shock position. 

but.... thats just me I guess


----------



## usafmedic45

> I think I would have ripped some of my shirt off and tossed it to him, then instructed him to apply his own direct pressure (I have done this before) then called 911 and started getting a medical hx and MOI for the incoming unit.



No offense but for penetrating truncal trauma (which it sounds like was the case in the scenario initially presented), direct pressure- especially when applied by someone in the throes of hypovolemic shock and on God only knows how many drugs and/or how much ETOH- is going to make precious little difference.  Calling for an ambulance is about the only thing a bystander is going to be able to do that is going to make any difference at all.


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## NYBLS

usafmedic45 said:


> No offense but for penetrating truncal trauma (which it sounds like was the case in the scenario initially presented), direct pressure- especially when applied by someone in the throes of hypovolemic shock and on *God only knows how many drugs and/or how much ETOH*- is going to make precious little difference.  Calling for an ambulance is about the only thing a bystander is going to be able to do that is going to make any difference at all.



I agree with all your points but this. How do you know this person was under the influence of drugs/alcohol?


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## usafmedic45

I was not saying for definite that he was or was not, but call it an educated guess that there is a distinct possibility that he was (hence the "God only knows", better to assume they are than to assume they are not).  There is a high correlation between drug and alcohol abuse and being caught up in violent crime, not to mention the correlation between being homeless and having a substance abuse problem.  Like it or not, a lot (I would wager a majority) of street people are on something at any given time.


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## NYBLS

usafmedic45 said:


> I was not saying for definite that he was or was not, but call it an educated guess that there is a distinct possibility that he was (hence the "God only knows", better to assume they are than to assume they are not).  There is a high correlation between drug and alcohol abuse and being caught up in violent crime, not to mention the correlation between being homeless and having a substance abuse problem.  Like it or not, a lot (I would wager a majority) of street people are on something at any given time.



100% agreed, the statistics are high in correlation of drug problems and homelessnes. I read your original quickly and did not see the "God only knows." I do my fare share of assuming, but I do not like people being placed into a specific group due to their current economic status. Especially someone who was stabbed after assisting someone else.


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## wolfwyndd

You know, I've now read this entire thread, and I have to agree with firetender all the way.  1/2 you people should be ashamed of yourselves.  If you would walk by someone who is dead or dying in the street and just ignore them because 'he might have some disease' is *unconscionable!*  Who cares if, 'you know the person' or not!  Who cares if 'bystanders know you're a medical professional' or not!  We talk about not having a legal duty to act, but what about your duty as a HUMAN BEING to help someone else in need?  

I was on my way to a meeting last night and our squad happened to get a call for a man, unconsious and not breathing.'  I was, literally, two blocks away.  I had NOTHING on me.  No gloves, no face shield, no IV kit.  NOTHING.  I was there a good 5 minutes before the squad.  He was clearly dead (lividity, pooling of blood, very cold).  But I didn't know that at the time.  All I knew was that someone needed help.  Was I ready to start CPR if needed?  Yes!  Would I have hesitated thinking about blood born diseases?  Yes, absolutely, but I'd have done it if I'd have thought this guy had any chance of survival.  

All I can say is that I'm glad I don't need help from 1/2 of you because if I did, you probably wouldn't give it.  THAT makes me sad for the human race.


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## usafmedic45

wolfwyndd said:


> You know, I've now read this entire thread, and I have to agree with firetender all the way.  1/2 you people should be ashamed of yourselves.  If you would walk by someone who is dead or dying in the street and just ignore them because 'he might have some disease' is *unconscionable!*  Who cares if, 'you know the person' or not!  Who cares if 'bystanders know you're a medical professional' or not!  We talk about not having a legal duty to act, but what about your duty as a HUMAN BEING to help someone else in need?
> 
> I was on my way to a meeting last night and our squad happened to get a call for a man, unconsious and not breathing.'  I was, literally, two blocks away.  I had NOTHING on me.  No gloves, no face shield, no IV kit.  NOTHING.  I was there a good 5 minutes before the squad.  He was clearly dead (lividity, pooling of blood, very cold).  But I didn't know that at the time.  All I knew was that someone needed help.  Was I ready to start CPR if needed?  Yes!  Would I have hesitated thinking about blood born diseases?  Yes, absolutely, but I'd have done it if I'd have thought this guy had any chance of survival.
> 
> All I can say is that I'm glad I don't need help from 1/2 of you because if I did, you probably wouldn't give it.  THAT makes me sad for the human race.


 Just remember, the nails go through your wrists and not the palms of your hands as commonly portrayed in paintings.


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## firetender

usafmedic45 said:


> Like it or not, a lot (I would wager a majority) of street people are on something at any given time.



For clarification, being down ON the street does not make you a "street people" who, by the way, are human beings, which presumably is just like what you see when you look in the mirror.


----------



## adamjh3

Just the other day an older lady tripped in front of me in the costco parking lot, I saw it happen. She was bleeding from her mouth, but fully concious, A&O x3 +full recall. I didn't have gloves on me, but I helped her. I didn't touch her until one of the employees brought out a first aid kit with some gloves in it. I stayed there with her until the FD got there, it seemed to calm her down a lot, even though I didn't to much of anything other than running through an assessment. (good practice)

That being said, it made me think about this thread, there are ways to help, and I will help if I can, but MY safety and the safety of my family comes way before the person who had an unfortunate incident. 

If I ran across this guy down on the street with blood pooling underneath him, there's no way in hell I would have touched him, I may have tried to get a verbal response, and I would have called the emergency services. Like I said, my safety comes before everyone else, except my family. Did I help him? Yes, I summoned medical support for him. I'm not equipped to deal with the situation. Here comes that awesome mnemonic again. PENMAN.


----------



## firetender

adamjh3 said:


> That being said, it made me think about this thread, there are ways to help, and I will help if I can, but MY safety and the safety of my family comes way before the person who had an unfortunate incident.



I will never deny that, *and *there are many ways to protect yourself and still intercede for someone who can't take care of themselves. Sorry, but to look at a person down on the ground, make a mental assessment that there is the possibility of getting harmed in some way and then not using your skills (which include protecting yourself FIRST) is not thinking like a medic. 

Since I don't know what PENMAN means, I'll say any medic worth his/her salt will *Evaluate *the overall scene, *Anticipate, * what needs to be done and the dangers involved, and then* Take action*.

So, *EAT* this, though I say it with love!


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## usafmedic45

**double post**


----------



## usafmedic45

> For clarification, being down ON the street does not make you a "street people"



No, but the fact that it was clearly stated that he was homeless does.  I don't simply assume that someone is the human equivalent of detritus because they are down on the sidewalk.  It takes a few more bits of evidence before I make that call.  However, like I said, I still would not get involved if it is some random stranger down beyond calling for help.  This is especially true if I am not equipped to do anything meaningful except expose myself to whatever the beggar might have.



> who, by the way, are human beings, which presumably is just like what you see when you look in the mirror.



So let's assume the guy on the street is a known pedophile (extreme, but most homeless people have criminal records especially the ones who get into situations that get them stabbed) and you're off duty (no legal or ethical standard to compel you do anything) and unequipped. Do you still endanger yourself to help him? I mean, he looks like you in the mirror after all.  

I hate to be a **** about it, but I do believe in social value playing a role in triage especially when my safety is at risk.


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## firetender

usafmedic45 said:


> I don't simply assume that someone is the human equivalent of detritus because they are down on the sidewalk.  *It takes a few more bits of evidence before I make that call*.



Here, the only thing I can say is *listen to yourself.* 

The conclusion that some people are detritus is living inside you, just waiting for a little boost to come out ("a few more"). Be aware, that's what you bring to EVERY call you're on.

Look, usaf, I have no doubt, based on reading your posts, of your competence or concern in the field. And YES, this is under extenuating circumstances. But you weren't there. 

Do you really think you'd really walk away based on the scant information here, or is it possible that you'd actually take the time to evaluate the situation as it stood fairly, figure out what you could and could not do to possibly save a life and then take action? The picture you paint is "Uh, oh, another piece of human crap, better move on."

This isn't a set-up, I'm just asking you to bring your understanding of yourself as a medic one level deeper so we can all learn.


----------



## adamjh3

firetender said:


> I will never deny that, *and *there are many ways to protect yourself and still intercede for someone who can't take care of themselves. Sorry, but to look at a person down on the ground, make a mental assessment that there is the possibility of getting harmed in some way and then not using your skills (which include protecting yourself FIRST) is not thinking like a medic.
> 
> Since I don't know what PENMAN means, I'll say any medic worth his/her salt will *Evaluate *the overall scene, *Anticipate, * what needs to be done and the dangers involved, and then* Take action*.
> 
> So, *EAT* this, though I say it with love!



PPE, Environment (scene safety), Number of patients, MOI/NOI, Additional resources, Need for C-spine. It's a mnemonic we were taught for the scene size up. 

In my example of what I would have done for this gentleman, I did everything you just said, I _evaluated_ the situation, dude down on the ground in a pool of blood. I _anticipated_ the dangers involved, I treat everyone like they have HIV, HEP c, MRSA and everything else under the sun until proven otherwise (yes guilty until proven innocent, not going to risk my health). And then I _took action_ by seeing if he was responsive to verbal stimuli (I'm not touching him) and called for medical support. 

I will admit since the incident with the old(er) lady in the parking lot I do carry little plastic bag with a single pair of gloves in it in my back pocket now.


----------



## usafmedic45

> The conclusion that some people are detritus is living inside you, just waiting for a little boost to come out ("a few more"). Be aware, that's what you bring to EVERY call you're on.



Are you saying you don't make character judgments of everyone you meet? Like it or not, I believe those who are productive to society are more "valuable" than those who are sponging off of it.  It's a basic human characteristic to judge people.  I don't let it get in the way of doing my job.  When I am off duty, it is my decision to provide direct care and I only get involved if I can protect myself and if I view the case's life to be worth as much or more than my own.  If the situation does not meet those criteria, I simply notify the authorities and go on with what I was doing.   That is why if it were my own brother, I would simply call an ambulance and walk away.  His life is less valuable than my own because he's a drain on society and not contributing anything. 



> But you weren't there.



Neither were you.



> The picture you paint is "Uh, oh, another piece of human crap, better move on."



Actually it's more like "Eh....can't do anything about this myself and the risk is too great.  Hello 911? Yeah, you might want to send an ambulance to..."  

Just because I don't get wrist deep in someone's blood directly treating them doesn't mean I don't do anything to help them.



> Do you really think you'd really walk away based on the scant information here, or is it possible that you'd actually take the time to evaluate the situation as it stood fairly, figure out what you could and could not do to possibly save a life and then take action?



I would use the criteria I outlined earlier.


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## firetender

usafmedic45 said:


> That is why if it were my own brother, I would simply call an ambulance and walk away.  His life is less valuable than my own because he's a drain on society and not contributing anything.



If your Brother has some vile disease, easily transmitted, or something equally as threatening to your safety, perhaps. But I didn't hear you mention that, only that you consider yourself to be more valuable to society. 

Sure, you can still save lives, but with such an attitude of (self-identified) superiority, that means you make a lot of room for yourself to make judgment calls that have nothing to do with the situation and everything to do with your evaluation of the value of the life in front of you.

What I'm hearing is, if you arrive on a scene -- any scene -- you are Judge, Jury, and then, maybe Paramedic. 

I'm not attacking you, just asking for you to look a little at how you present yourself. Your words do have impact.

_With the training you have (which means many tools to pull from to figure a way to intercede in a life and death situation without burning your own balls) *calling 9-1-1 is NOT enough in a life-and-death situation.*_

The part I'm most opposed to is I don't hear your *willingness *to _*take the time to figure out how*_ you could intercede in a manner consistent with and appropriate to your level of training and experience. 

I still hold to the concept that we were trained for ALL of us.


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## usafmedic45

> If your Brother has some vile disease, easily transmitted, or something equally as threatening to your safety, perhaps. But I didn't hear you mention that, only that you consider yourself to be more valuable to society.



Nothing that I am aware of on the disease front, but he is basically a lazy, self-absorbed little piece of trash I claim as my brother only in the sense that I share a significant part of my genetic makeup with the little :censored::censored::censored::censored::censored::censored::censored:.  He's the lower right corner of the Punnett's square, having lost out and picked up all the negative traits in my family (dark hair, dark eyes, a big nose, ears that stick out, the low end of normal intelligence, no reasoning ability, a distinct lack of work ethic, no artistic talent, etc). He's also the one I mentioned failing multiple times when he tried to take his EMT course.  

This is a kid who is living with my grandmother claiming to "help her around the house" but allowed her to fall face first down the concrete steps outside because he would not get up one morning after it snowed.  She went out to do it herself because she had to go to a doctor's appointment and fell.  God bless her, she wasn't seriously hurt so she got up and grabbed a dustpan full of snow. She walked into his room, grabbed his jaw to open his mouth and dumped the snow on his head and into his mouth.    

I see no reason why, unless compelled by law or by the terms of my employment I should bother getting involved if he gets hurt or becomes ill.  



> Sure, you can still save lives, but with such an attitude of (self-identified) superiority



I don't think I'm the best person in the world (far from it: I'm a total :censored::censored::censored::censored::censored::censored::censored: a considerable portion of the time).  I am however better than someone who has let life make them its :censored::censored::censored::censored::censored: (usually through their own bad choices) or someone who believes they don't have to work or otherwise contribute more than they take from society.  We can only be judged based on what we put into life, not what we get from it because it is the only thing we have control over in our lives.  All the excuses that bleeding hearts trot out whenever the poor and the lazy become a target of debate aside, we are all ultimately responsible for what happens to us (with a few key exceptions).  That is all I am basing this stance on.  Homeless people and the people who choose to suckle the teat of support programs are beneath you, me and most of the people on this forum by that measure.  




> What I'm hearing is, if you arrive on a scene -- any scene -- you are Judge, Jury, and then, maybe Paramedic.



When off duty, yes.  When on duty, no.  That seems to be where all the questions arise: I have no duty to do anything while off duty.  I'm not even obligated in most places to have the decency to call it in.  When I am working, I treat anyone that crosses my path to the fullest extent of my ability in keeping with their condition and the standard of care.  When I am off work, I get to pick whom it is I stick my neck out for.  Nothing more, nothing less.  It really is not complicated nor is it a big deal.


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## usafmedic45

> The part I'm most opposed to is I don't hear your willingness to take the time to figure out how you could intercede in a manner consistent with and appropriate to your level of training and experience.



When I am off duty, I don't have to intervene.  My "level of training and experience" when off work is that of a bystander with a cell phone unless I decide it is not.  Besides, I explicitly stated I have a decision tree that allows me to quickly decide whether/how to intercede:


> Of course, you need to keep in mind that my decision tree for offering assistance while off duty pretty much consists of:
> 1-Is the victim a kid or an animal? Yes: Help them if it can be done safely No: Go to question 2
> 2-Do I know the person? Yes: Go to question 4 No: Go to question 3
> 3- Am I stuck in the situation/do other bystanders know that I'm medically trained? Yes- Help them if it can be done safely No- Go to question 4
> 4-Do I like the person? Yes: Help them if it can be done safely No: Do not get involved even if it means standing idly by; thank God for no statuatory requirement to render care



It takes about five to ten seconds to run through it.  What more do you ask of a person?


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## firetender

usafmedic45 said:


> It takes about five to ten seconds to run through it.  What more do you ask of a person?



Please remember, when you first posted this, I was in support of your example of showing that you had thought about such things and had a personal code to follow. This is a *good *example for others.

Though I have to ask; how would you handle a life-and-death call (*while on duty*) where it was your *Brother *involved and you were the only person on the scene capable of rendering care?

You can PM me for this one if you want. I'm happy to take a look at it with you.


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## firetender

*Let's do a poll!  How do you do that?*



usafmedic45 said:


> Homeless people and the people who choose to suckle the teat of support programs are beneath you, me and most of the people on this forum by that measure.



I'm curious how many here agree and what criteria do you use to figure out where you sit in the food chain? Who is above, and who beneath you?

...and does "beneath" justify applying what amounts to differing standards of care for people ill or injured in your presence?

AND, since you've got to be beneath someone else who could be a medic, would that justify having a different standard of care applied to you? (Everybody is somebody's Scrote)

And this is NOT about On or Off-duty. Even though it appears to be a reverse example, if you recall, the SS of Nazi Germany were just doing their jobs, it all boils down to how do you make choices around intervening in a life and death situation.

Is "Social triage" a Euphemism for "cleansing"?

Just stuff to think about.


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## usafmedic45

> With the training you have (which means many tools to pull from to figure a way to intercede in a life and death situation without burning your own balls) calling 9-1-1 is NOT enough in a life-and-death situation.



So precisely what do you expect me to do when I don't carry anything with me? There are very few things that one can truly kill someone in a matter of a few minutes and can be fixed _without carrying equipment with y_ou. An obstructed airway is the only one that really comes to mind as happening with any frequency.  Without gloves and a lot of gauze, I can't safely do anything to control bleeding and short of a femoral, brachial or carotid artery injury are the only two peripheral vascular injuries that are rapidly lethal in and of themselves so the idea that one needs to intervene RIGHT NOW with other injuries or the person is going to die is a misnomer.   Calling for help is the best thing to do because short of an obstructed airway or the aforementioned vascular injuries there are few things that we MIGHT be able to do something about in the austere setting of off duty first response that are going to kill a patient within the five to ten minutes it takes to get a duty crew on scene in most jurisdictions.  One can argue that doing compressions is beneficial but it's not "fixing" the problem and if the patient isn't vomiting or bleeding, I generally have no problem doing CPR without gloves on. It is actually one of the few first aid things I will do nearly without question (assuming no obvious bleeding or vomiting or open sores on the chest) while off duty. 



> how would you handle a life-and-death call (while on duty) where it was your Brother involved and you were the only person on the scene capable of rendering care?


On duty? I would have to take care of him.  My hands are tied in that situation and I am legally obligated to take care of him regardless of what I think of him, just like any other patient. That is not the situation we are discussing here though.  I would appreciate you appreciating the difference between "on duty" and "off duty" and not trying to combine the two.


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## firetender

*usaf You're in the neighborhood...*

how about a chat on-line?


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## usafmedic45

> And this is NOT about On or Off-duty.



Yes, it is.  The debate has turned into whether we are obligated to work while not on duty.  There is no other question possible here since we are legally bound to do something while on duty.



> ...and does "beneath" justify applying what amounts to differing standards of care for people ill or injured in your presence?



It's not a different standard of care.  It's a different standard of whether I am willing to risk my life when I don't have to.  Let's phrase it this way: you're at the beach on your day off and you see your neighborhood pedophile or crack dealer being attacked by a shark are you going to jump in and pry him out of the shark's mouth as readily as you would say a child or your wife?  We all make judgment calls based on what we think of people.  I am just really open and blunt about it.   

I feel no moral or ethical obligation to endanger or inconvenience myself to do my job when I'm not, well, doing my job.   



> Even though it appears to be a reverse example, if you recall, the SS of Nazi Germany were just doing their jobs, it all boils down to how do you make choices around intervening in a life and death situation.



Yes, but we're not talking about doing our jobs (i.e., "Hey you're on duty, go kill those Jews" to run with your example).  We are talking about getting involved when you have no duty to do so.  It's a choice.  You choose to stick your neck out and meddle in cases where you are not obligated to do so because you're not on duty.  I choose to pick and choose where I get involved.  

The better example, instead of comparing me to an SS officer liquidating _Lebens unwertes leben_, would be to suppose for a second that I care about starving children in Africa.  I could do something about it, and imagine that I work for the UN food program shipping food to those same starving kids.  I spend my day loading bags of rice onto container ships bound for some cesspool on the Dark Continent.  Once I'm off duty, I come across a starving kid on my way home.  I have no moral or ethical obligation to go get the kid food.  I do have an obligation to report his state to the local authorities and nothing more.  The same applies to when I clock out at the end of my shift as a medical professional.  Why is that so hard to grasp?  

BTW, no one seriously believes the Nuremberg defense.  Anti-Semitism was a long standing characteristic of European culture (especially in the predominately Catholic areas) and it was engrained in children long before the National Socialists came to power that Jews, Gypsies, etc deserved to be destroyed.  It's a fascinating subset of history.


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## Trayos

*Seems to me*

as if we are arguing over two different points. _USAF _raises the point that nobody would want to put themselves in harms way when not required to do so. _firetender _makes the point that as health care professionals, you will have the capacity to do more in the pre-hospital setting then a civilian walking by.

Both of these are valid points.

Firetender, if you came upon a recent pt. with open wounds and unidentified fluid, without any PPE, would you feel secure to do any more then  basic triage and calling for supplied medical help?

USAF, if you were the first to come upon a scene where a pt. was lying on the ground, again bleeding with unidentified fluid, and you did have advanced PPE (say you just came from teaching an EMS/military medical class regarding them) would you render care until the local professionals arrived?

Thank you both for taking the time to do this.


----------



## usafmedic45

> you will have the capacity to do more in the pre-hospital setting then a civilian walking by.



The thing is, without the equipment we have access to at work, we really don't.  



> USAF, if you were the first to come upon a scene where a pt. was lying on the ground, again bleeding with unidentified fluid, and you did have advanced PPE (say you just came from teaching an EMS/military medical class regarding them) would you render care until the local professionals arrived?



Honestly it would really depend on the factors I mentioned before.  If it was the scenario played out in the original article?  No, I would not.  I would call for an ambulance and then go on my way.


----------



## Trayos

> The thing is, without the equipment we have access to at work, we really don't.


 I would make the argument that knowledge is just as important as a rig full of equipment. Again, you cannot do as much as the responding EMT's, but you can provide them with _accurate _information, and help make their job easier.




> Honestly it would really depend on the factors I mentioned before.  If it was the scenario played out in the original article?  No, I would not.  I would call for an ambulance and then go on my way.


I would appreciate it if you could try and imagine your response to the (albeit extremely limited) situation I previously mention. This would be without deep knowledge of the pt. and their socioeconomic status, but with indicators pointing them to be nothing extraordinary, and with human faults.


----------



## adamjh3

Trayos said:


> I would make the argument that knowledge is just as important as a rig full of equipment. Again, you cannot do as much as the responding EMT's, but you can provide them with _accurate _information, and help make their job easier.
> 
> 
> I would appreciate it if you could try and imagine your response to the (albeit extremely limited) situation I previously mention. This would be without deep knowledge of the pt. and their socioeconomic status, but with indicators pointing them to be nothing extraordinary, and with human faults.



Honestly even if I've worked with you before and you're off duty turning this patient over to me, I'm still going to do everything the same. You didn't see him get stabbed, you don't know what's going on with him, you walked up to the same thing I did.


----------



## usafmedic45

> but you can provide them with accurate information, and help make their job easier.



No offense, but unless you stood and watched the person get hurt, you are not going to be able to provide any more useful information than any other person.  If it was a violent assault and you stood around while it happened, that pretty much makes you a fool in my book.  



> I would make the argument that knowledge is just as important as a rig full of equipment



Yes, but refer to my earlier points about how little there is that kill a person in a matter of minutes that we can do anything about without proper equipment.  Otherwise, you're just watching someone die up close and personal with a better understanding of what is happening and a distinct lack of an ability to do much about it.  



> This would be without deep knowledge of the pt. and their socioeconomic status, but with indicators pointing them to be nothing extraordinary, and with human faults.



Like I said, it depends on the situation.  You gave such a vague scenario that I really can't make a judgment call about what I would do.  Sorry but socioeconomic status and other things about the patient are going to affect my decision and you left those out so I picked the scenario that sparked this debate.  I don't need a "deep knowledge" of the patient (in fact, I prefer not having one for most of my patients to be quite honest; it makes it easier to remain impartial that way) to decide whether I'm going to get involved.


----------



## Trayos

Okay, so let me try and reiterate your perspective (there is a point to all this, believe it or not )

You feel that in a situation where you are given no more equipment/information then a civilian, you should behave as one when arriving on a situation that you wish to keep in your professional life. You also feel that your personal decision to do anything more then what is expected/hoped for of a civilian should be solely at your discretion, based on a multitude of factors (as outlined before)

Just trying to tie it up in a neat little package, so it can be compared to firetender's perspectives/rationale.


----------



## usafmedic45

Trayos said:


> Okay, so let me try and reiterate your perspective (there is a point to all this, believe it or not )
> 
> You feel that in a situation where you are given no more equipment/information then a civilian, you should behave as one when arriving on a situation that you wish to keep in your professional life. You also feel that your personal decision to do anything more then what is expected/hoped for of a civilian should be solely at your discretion, based on a multitude of factors (as outlined before)
> 
> Just trying to tie it up in a neat little package, so it can be compared to firetender's perspectives/rationale.


Pretty much.  My belief is that it is our choice to use our skills while off duty.  I do not feel any more compelled now to help than I did before I entered EMS.  In some ways, I am less likely to help because I am more aware of a poor risk-to-benefit ratio now than I was as a civilian.


----------



## firetender

Trayos said:


> Firetender, if you came upon a recent pt. with open wounds and unidentified fluid, without any PPE, would you feel secure to do any more then  basic triage and calling for supplied medical help?



It's very simple for me. YES, I would do everything I could without endangering myself. I'd duck the blood piss and vomit as best I could and find somewhere to intervene. I know quite well I could get caught (as easily as I could get hit by a truck while getting equipment or help or...) but I'd have to look at my personal 12 years EMS experience and say not once did I get harmed by intervening in a life and death situation either on or off duty (enough to knock me out of the game, anyway!). 

I wouldn't even waste the time to thoroughly evaluate all dangerous aspects of the situation because to this day, I completely trust my (non-equipment related) preparedness to take care of *me *moment-to-moment as well. And emergency calls live in the moment.

I'm glad I got to that point because that may be key. I have no idea of what I could pick up out there these days because I've been out of the field for 25 years. *But even then, 90% of what I dealt with was in the realm of the unexpected*. Today I wouldn't hesitate to act because what I learned to do as a medic then was observe and respond, and do it while minimizing the danger to myself. I made sure I was prepared to act.

Maybe the key is I had/have complete confidence in my ability to do what I've been trained to do while minimizing my exposure. I don't worry about the unknown, I just act with what is, as carefully as I can.

If EMS teaches us nothing else (and not everybody learns it, unfortunately) every second of our lives we are subject to disaster. Everybody (most likely reading this post) will die. All we can do, as professionals, is prolong life, we can't stop death, not even our own. Something is gonna take me out, and pain and suffering are often involved! Period.

My only point is each of us must decide what we can live with. usaf has clearly stated what works for him, I have stated what works for me. Now, I encourage all of you who read this to take the time to know who you are in this.

...and many thanks to usaf (and respect!) for taking the time to really look at his position, sharing it with all of us without restraint, and not backing down from something he has obviously worked hard to come to terms with.

This is the open sea you all (now, and me, then) are being asked to navigate through. (Tough waters!) Key to it is coming to terms with the unavoidable fact that it doesn't matter what you do, you're a human being doing it; and each of us has to come to terms with that in his/her own way.

I'm satisfied, usaf, Thank You! and thanks to TRAYOS for seeking clarity.


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## usafmedic45

> but I'd have to look at my personal 12 years EMS experience and say not once did I get harmed by intervening in a life and death situation either on or off duty



You've gotten lucky.  Do you really want to bet your life on your luck holding out?  Also, you know what they say about relying on experience alone.  It simply means you keep making the same mistakes with an ever increasing level of confidence until something comes up to bite you on the butt.



> I wouldn't even waste the time to thoroughly evaluate all dangerous aspects of the situation because to this day, I completely trust my (non-equipment related) preparedness to take care of me moment-to-moment as well. And emergency calls live in the moment.



No offense but your attitude scares me a little.  May I suggest you read a book called "Darker Shades of Blue: The Rogue Pilot" by Tony Kern?  It's aimed at the aviation community but it has a lot of good information that can be applied in EMS about exactly why the cowboy sort of attitude that is pervasive in both EMS and aviation is really detrimental not only to individuals but entire organizations.  Fascinating read and I recommend it to everyone on the list.



> Today I wouldn't hesitate to act because what I learned to do as a medic then was observe and respond, and do it while minimizing the danger to myself. I made sure I was prepared to act.



Pardon another aviation reference, but one of the first lessons in dealing with crisis that new pilots are taught is what is called "winding the clock".  It stems back to the days when the instrument panel mounted clocks had to wound up and the action took a few seconds.  Telling new pilots that if you encounter a problem, wind the clock, gave them a few seconds to think about what was happening and what to do about it.  Rushing into a problem seldom fixes anything.  In fact, more often than not, it makes things worse by compounding the problem.  There are few situations in aviation (at least for non-test and non-fighter pilots) that truly require split second reaction to fix or you are screwed.  This is even more the case in first aid.   



> Maybe the key is I had/have complete confidence in my ability to do what I've been trained to do while minimizing my exposure. I don't worry about the unknown, I just act with what is, as carefully as I can



So you're prepared to die rather than follow accepted practices (i.e., bloodborne pathogens, etc)?  Once again, I worry for your safety my friend.  It's one thing to want to help, it's another to throw caution to the wind out of hubris and concern for your fellow man.


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## Trayos

Firetender, Im going to be the human compactor again.

You feel that because of your experience, you should enter the situation as quickly as possible, in order to most effectively render care. You also feel that it is detrimental to consider all the various problems you could have, when your experience has  kept you safe in reasonable situations. You are not stating that you disregard basic scene safety, or would engage in efforts that pose a clear and present danger to your health or those around you.
feel free to edit ^_^


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## firetender

adamjh3 said:


> I will admit since the incident with the old(er) lady in the parking lot I do carry little plastic bag with a single pair of gloves in it in my back pocket now.



...and because of this thread, more than just this poster are looking at themselves, their preparedness, and making moves to be more effective.


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## firetender

Trayos said:


> Firetender, Im going to be the human compactor again.
> 
> You feel that because of your experience, you should enter the situation as quickly as possible, in order to most effectively render care. You also feel that it is detrimental to consider all the various problems you could have, when your experience has  kept you safe in reasonable situations. You are not stating that you disregard basic scene safety, or would engage in efforts that pose a clear and present danger to your health or those around you.
> feel free to edit ^_^



Because of my training I have been prepared to intervene in a medical emergency. If I come across one, in the absence of professionals or those better trained than myself (which does not necessarily include other health care professionals!), I will take action. Before taking action I will assess the level of danger that the situation presents (that's "winding the clock") but with my experience that takes place very quickly, if not instantaneously. The degree to which I slow down in that evaluation is proportional to my lack of preparedness. I am not stating that I disregard basic scene safety, or would engage in efforts that pose a clear and present danger to my health or those around me. 

Nor am I saying this is about a "Savior" complex. I would try; and YES, absolutely YES, I would try just so far and _*stop *_when I decided there was no use or danger to me was imminent.


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## firetender

*firetender is a hypocrite!*

Having gone through these threads, admittedly self-righteously, let me share with you all this firetender guy in action:

Post-medic, I was walking along a deserted beach one day with a buddy of mine, a Psychiatrist, a real skinny guy. There was a form sitting at the edge of the seashore. As we got closer we saw a woman, about three-hundred lbs. sitting in the sand. The water lapping up a bit beyond her feet, the tide was coming in.

When we got close, obviously upset, she looked up at us imploringly, fear clearly in her eyes. "I'm stuck!" She pleaded, can you help me get up?"

I didn't ask if she was injured. A quick visual scan showed nothing obvious. I got in position to help, only to look up and see my buddy continuing to walk down the beach. He called out, "Not ME! I'm not getting involved!"

So there I was, alone, with the woman and, as I presented myself here completely flabbergasted that someone would just walk by a woman who, if she didn't move or get moved would soon be up to her eyebrows in water. I looked at her, her weight, its distribution, how deep she was in the water and immediately decided I'd probably get hurt if I helped. It was sunset, there was NO ONE around.

Before I even knew it, I said, "Sorry," sheepishly,  and walked to catch up to my buddy. I didn't look back nor did I challenge his choice. I could have rolled her on her side and probably rolled her up further into the dunes, I could have gone for help, I could have done any number of things with maybe wrenching my back a little but I walked away.

To this day I have no idea what happened to her. Sure, if she got TO the beach she probably was mobile. I was off-duty, and there were no claims of injury, but do you think I would have brought this up if I felt "clean" about it?

That woman may very well have lost her life because I did not have the proper tools to work with, in this case, my friend, or EASY access to help or communication. I did my bit of social triage. Trust me, my thoughts ran along the line of, "Well, if you're stupid enough to put yourself in this situation then it's God's will now!" and to this day I feel like :censored::censored::censored::censored: about making a judgment call that her life was less valuable than my back and not trying.


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## usafmedic45

> That woman may very well have lost her life because I did not have the proper tools to work with, in this case, my friend, or EASY access to help or communication.



That's a bit extreme I think.  I mean the incoming tide would have made her efforts to stand up easier (fat is buoyant after all!) and she could have stood up.  To say she could have died is a bit of hyperbole.  It's like saying I could die falling out of the chair I am sitting on now.  It could happen.  Is it likely to happen?  Not really. 



> Well, if you're stupid enough to put yourself in this situation then it's God's will now!" and to this day I feel like ____________  about making a judgment call that her life was less valuable than my back and not trying



That's the problem with taking the "never off duty, always in service of my fellow man" approach:  it always leaves you gnawing at yourself for those times where you have to simply walk away or stand idly by.  I used to take that approach.  It ate me alive.  Once I realized "off duty is off duty", life became much sweeter and there were far fewer nights spent sleeplessly wondering "What if I had...".


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## firetender

*Can't resist, even tho I thought I was through!*



usafmedic45 said:


> It's like saying I could die falling out of the chair I am sitting on now.  It could happen.  Is it likely to happen?  Not really.



I pretty much feel that way, today, about taking action around a bleeding person. If I do what I need to do to protect myself, with what is available right there, then I'm not likely to get killed, either.

Here's a good recent one I just thought of:

I'm a tour guide. While up on the top of Mt. Haleakala, a guy in his 80's, not on my tour, unsteady in gait (and also dealing with about 10% LESS O2 in the air because of the 10,000 foot elevation) stepped behind me, tripped and fell. He hit the ground and just above his ankle was a gash from a lava rock outcropping. He nicked an artery because blood came spurting out in one-foot streams. No one else was around who knew what to do.

I know what you'd do; call 9-1-1 with a one 1/2 hour response time? Or maybe walk to the Ranger Station, only 20 yards away, and find someone who may or may not be qualified to help? How long does it take an old guy struggling with lack of O2 to bleed out enough to throw his life force out of whack?

What I did was stick my hand in my pocket, pulled out a handkerchief (clean? no idea.) folded it over until it was thick, plop it on the wound and pressed hard. I caught it before the fourth spurt. I washed my hands well afterward (of course blood got on one!) and didn't even inquire if there were any other problems I should worry about. I recognized a potentially life or death situation, certainly considered the risks of blood borne pathogens and, figuring it had the same odds as for me to "die (while) falling out of the chair I am sitting on now." Acted.

Maybe we just have different cost/benefit ratios.


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## usafmedic45

> How long does it take an old guy struggling with lack of O2 to bleed out enough to throw his life force out of whack?



I see your point.  An extreme circumstance like that and a relatively low risk patient would spur me to take action. Now if it had been a homeless guy or a twentysomething, they would be on their own. In the setting of a younger hiker far from the trailhead and no gloves, he's getting a tourniquet well above the wound site. The risk is just too great in those populations to resort to unprotected direct pressure.  In the case of the homeless guy, I probably would take my chances notifying someone at the ranger station. I simply don't value the life of a homeless person anywhere near enough to put myself at ANY risk beyond what I'm mandated to do as a requirement of my employment.


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## usafmedic45

> "die (while) falling out of the chair I am sitting on now."



Would it not be "after falling out of the chair"?  Normally it's the sudden stop at the bottom and not the fall itself that kills.  

(Nice catch on the poor sentence structure.)


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## wolfwyndd

usafmedic45 said:


> There are very few things that one can truly kill someone in a matter of a few minutes and can be fixed _without carrying equipment with y_ou.


You must not be much of a paramedic if you can't even manage to do BASIC LIFE SUPPORT without 'equipment.'  I don't know about your basic (or intermediate or paramedic) classes, but in my basic class I learned all about DIRECT PRESSURE on a wound.  Yeah, that one requires a LOT of equipment.


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## adamjh3

wolfwyndd said:


> You must not be much of a paramedic if you can't even manage to do BASIC LIFE SUPPORT without 'equipment.'  I don't know about your basic (or intermediate or paramedic) classes, but in my basic class I learned all about DIRECT PRESSURE on a wound.  Yeah, that one requires a LOT of equipment.



If they're bleeding at a rate in which they are going to die within a few minutes, usually you need more than direct pressure.


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## Veneficus

wolfwyndd said:


> You must not be much of a paramedic if you can't even manage to do BASIC LIFE SUPPORT without 'equipment.'  I don't know about your basic (or intermediate or paramedic) classes, but in my basic class I learned all about DIRECT PRESSURE on a wound.  Yeah, that one requires a LOT of equipment.



Withot taking sides could I point out that just because you stop external bleeding, doesn't mean you stop the flow of blood. 

"Direct pressure" will stop about 90% of all bleeding, but that doesn't translate into diffuse external pressure. If you have bleeding from the trunk or neck, your external pressure will simply redirect the bleeding. Direct pressure to the artery could be effective, but you are definately going to get dirty doing that.

There is also a considerable risk/benefit. If this person arrests from their trauma, their chances of survival are very small if everything goes right. So how to you live the rest of your life with Hep B Hep C or something else? Who pays for your care?  Who retrains you to work in another profession when you can't get a job? What will it be like to never have intimate contact with loved ones without a barrier between you? What will it be like when you worry whether or not you can safely help your bleeding child for fear of infecting them? How about even having a child who may start life with a communicable disease? How do you pay for the life long care? How do you explain to them they have to be careful whoever and how they touch forever?

You are going to risk that over a person who will most likely die? Maybe you will get a plaque or a citation for your efforts, but nobody is going to step up and pay your medical bills.

Personally I think there is a moral obligation to do the best we can to help somebody in need. But the best we can means safely. with objective thought and rational logic not emotion.

But my morals also do not impose decisions upon others, and that includes their will to get involved or not.

For many years and hopefully for many to come, most if not all of my patients have been socially "undesirable." It is a rewarding experience. But it is not for everyone. It doesn't make me a greater provider or somebody else a lesser one.

Maybe watching people drink their urine like beer or be so drunk they lay in their own excretions until they wake up and find some more alcohol has hardend me a bit, some would call it experience. But some of that same experence has harshly pointed out that I cannot save everyone. 

Most EMTs and paramedics will never look a patient in the eye and tell them no more can be done while they are still awake and capable of rational thought. They will not be asked "how much longer is there?" when they simply cannot afford care or medication. Even the most well paid physicians cannot afford to support everyone who needs. 

I bring that up because it is the real face of medicine, not lights and sirens and flag drapped ceremonies and awards. It is not CPR and AEDs with a happy ending. It is important to come to terms with what medicine is, and what your individual role, contributions, and limitations are. 

"he who fights and runs away, lives to fight another day."

EMS is not about being a hero or glory. Medicine is a choice and a lifestyle. But what that means to you is not the same as me, and you cannot measure the value of others by standards you set for yourself.


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## TransportJockey

wolfwyndd said:


> You must not be much of a paramedic if you can't even manage to do BASIC LIFE SUPPORT without 'equipment.'  I don't know about your basic (or intermediate or paramedic) classes, but in my basic class I learned all about DIRECT PRESSURE on a wound.  Yeah, that one requires a LOT of equipment.



Actually he's not a medic  He's an intermediate. 

And if I had something to throw them so they can put pressure on their own wound I would. But I ain't touchin them if they're bleeding and I have no form of PPE. 
Either way I'd call for help on a phone, but if they can't put pressure there themselves they'll have to wait for someone else to show up. Maybe I can use the sparky wacker to do it for me.


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## usafmedic45

How about you try actually reading what I said?  I said there are few things that will rapidly kill someone that are amenable to first aid.  Direct pressure does- to be done safely- require gloves.  I'm not sticking my hands of the blood of anyone I'm not particularly fond of (and even then...) without gloves on.   There are very few circumstances where you get that degree of bleeding that do not meet: 



> If they're bleeding at a rate in which they are going to die within a few minutes, usually you need more than direct pressure.



Any more smartass comments or have you realized how foolish you sound?



> He's an intermediate.



Yup.  That's right. I never said I was a paramedic.  I was a "medic" in the military and an EMT-I before and after my service.


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## CAOX3

It seems pretty simple to me.  Off duty its personal decision.  I wouldnt look down upon anyone who decided against stepping in.  I also commend people who choose to get involved ultimatly its personal choice.

Rare occasions a bystander will have the ability to "save a life."  The truth is not that many emergencies are life threatning or at least whithin the reach of a bystander.


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## DrParasite

*Hypothetical situation*

Lets play a game:

you are a cop.  you are off duty.  while you are walking home, you walk past a bodega, and when you look inside you see two men armed with guns (one shot gun, one handgun) robbing the place, demanding money from the clerk. You are not in uniform, don't have a sidearm on you, no vest, all you have is your ID/badge in your pocket.  Would you intervene?  or would you just call the on duty people who are properly equipped to handle the situation?

second game:

you are a firefighter.  you are off duty.  while walking home, you walk past a taxpayer (store on 1st fl, apartments on 2nd), and find a lot of smoke puffing out of the store.  when you touch the door/windows, they are really hot.  the lights are on on the second floor, indicating that there are occupants, and they are unaware of what is happening on the first floor.  you have no equipment, no PPE, all you have is your ID/badge, are you going to make entry into the 1st floor to get to the second floor to notify the occupants?  or would you just call the on duty people who are properly equipped to handle the situation?

Inquiring minds want to know


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## firecoins

DrParasite said:


> Lets play a game:
> 
> you are a cop.  you are off duty.  while you are walking home, you walk past a bodega, and when you look inside you see two men armed with guns (one shot gun, one handgun) robbing the place, demanding money from the clerk. You are not in uniform, don't have a sidearm on you, no vest, all you have is your ID/badge in your pocket.  Would you intervene?  or would you just call the on duty people who are properly equipped to handle the situation?


A cop is a cop 24/7.  If they are unarmed, the only choice is to call for back up and stay out of the way.  




> second game:
> 
> you are a firefighter.  you are off duty.  while walking home, you walk past a taxpayer (store on 1st fl, apartments on 2nd), and find a lot of smoke puffing out of the store.  when you touch the door/windows, they are really hot.  the lights are on on the second floor, indicating that there are occupants, and they are unaware of what is happening on the first floor.  you have no equipment, no PPE, all you have is your ID/badge, are you going to make entry into the 1st floor to get to the second floor to notify the occupants?  or would you just call the on duty people who are properly equipped to handle the situation?



Yes you would call 911 and try to alert the occupants.  

What would PPE do in either case?


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## adamjh3

DrParasite said:


> Lets play a game:
> 
> you are a cop.  you are off duty.  while you are walking home, you walk past a bodega, and when you look inside you see two men armed with guns (one shot gun, one handgun) robbing the place, demanding money from the clerk. You are not in uniform, don't have a sidearm on you, no vest, all you have is your ID/badge in your pocket.  Would you intervene?  or would you just call the on duty people who are properly equipped to handle the situation?
> 
> second game:
> 
> you are a firefighter.  you are off duty.  while walking home, you walk past a taxpayer (store on 1st fl, apartments on 2nd), and find a lot of smoke puffing out of the store.  when you touch the door/windows, they are really hot.  the lights are on on the second floor, indicating that there are occupants, and they are unaware of what is happening on the first floor.  you have no equipment, no PPE, all you have is your ID/badge, are you going to make entry into the 1st floor to get to the second floor to notify the occupants?  or would you just call the on duty people who are properly equipped to handle the situation?
> 
> Inquiring minds want to know



First scenario: Hell no, I'm not going in. What am I going to do with my badge? It's not one of those cool video game invincibility upgrades. I'll call 911 and get out posthaste. Hang around an obtain a description if I can, but probably not. But I'm not a cop, so I don't know what a cop would do. 

Second: If I knew enough about fire to deem it was safe enough to enter I would _after_ calling 911. Otherwise, call 911 and try some way to alert the occupants. Yelling fire, maybe? Throwing rocks at the windows while yelling fire? I don't know. I'm not a firefighter, so I don't know what a firefighter would do.

EDIT to add: A cop going ANYWHERE without his gun is a cop I never want to be around. They have the "right" to carry (which I believe is a right of man, but that is a discussion for another time) so they should be armed ALWAYS. In those life or death situations where a dude's coming at you with a crowbar and the seconds really count, the police are only minutes away.


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## firetender

Bottom line, those who are trained to act must figure out when and how much, according to the circumstances, and then live with their decision.

No one has written the definitive Rule Book.


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## adamjh3

firetender said:


> Bottom line, those who are trained to act must figure out when and how much, according to the circumstances, and then live with their decision.
> 
> No one has written the definitive Rule Book.



[/thread]

Should have happened a long time ago.


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## DrParasite

so in response to my scenario (which received fewer responses than I had hoped) both people say that as trained professionals in other public safety fields, they would call for the properly equipped and on duty personnel to deal with the life threatening situation, and not place themselves in undue harm.

So, if that is the general consensus, what makes EMS so different that they should do something different than what the other public safety agencies would do?


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## Trayos

DrParasite said:


> so in response to my scenario (which received fewer responses than I had hoped) both people say that as trained professionals in other public safety fields, they would call for the properly equipped and on duty personnel to deal with the life threatening situation, and not place themselves in undue harm.
> 
> So, if that is the general consensus, what makes EMS so different that they should do something different than what the other public safety agencies would do?


I think the only difference is that dangers may not be so readily apparent at the time of the incident. While the police officer runs the risk of being shot, the FF runs the risk of burning up, the EMT runs the risk of contracting a pathogen. In the heat of the moment, the lack of an immediate danger might be all that some people look for. I don't feel this is a good excuse, but it seems like a plausible one.


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## usafmedic45

> what makes EMS so different that they should do something different than what the other public safety agencies would do?



Firefighters don't fight fire or (unless insane) run into the burning or smoke filled part of buildings to pull people out when not properly equipped or off duty.  I would have suspended any of my firefighters I caught doing something that stupid. 

Most LEOs are required to carry guns with them while off duty.  When they are not carrying, they notify the local dispatch and remain safe until other officers arrive.  *No *public safety profession encourages its members to respond unless properly equipped.  Since we are not required to carry our gear with us 24-7, we can not be expected to respond, especially when we are not carrying PPE with us.  Our utility, as much as we like to believe to the contrary, in the minority of cases where a five to ten minute delay is going to make a significant difference in outcome is in large part due to the equipment on board our ambulance or rescue truck.  

We are not different from any public safety agency.



> In the heat of the moment, the lack of an immediate danger might be all that some people look for.



In the heat of the moment, a lot of us don't look at all before rushing head long into "helping" apparently.

BTW, I actually assisted at the scene of a car accident today.  It was a fender bender next to the location of an outdoor wedding I was attending and the worst injury was a little kid with a busted lip, but I still offered assistance.


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## kermit

Granted this Is Moscow but this situation is worse.They wont even stop till they have too,and then veer and punch it its sad.

http://www.youtube.com/watch?v=oZ8JQhBNNww

PS no hijack intended but thought it relevant


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## VirginiaEMT

DrParasite said:


> actually, there are many conflicting witness accounts of what was actually done.  certain NY rags just ran with the worst opinion, and the fact that the mayor made a statement without knowing all the facts made it even worse.  But who would let the facts get in the way of good old fashioned mob justice?
> 
> that all being said, it doesn't surprise me that people in NYC just kept walking.  its just the attitudes of people.
> 
> However, having had my share of fun times when dealing with bloody EDPs, I can honestly say I probably wouldn't have done anything either.  I would, however, have called 911, and let the cops/EMS deal with him, as they are the professionals who can do the job properly.



*I agree that we should not touch blood that is not our own without the proper precausions in place, and believe me, I wouldn't, but this man laying on the street is an example that we, as a society, are losing our humaness. 

Somebody, Joe Blow or Mr. Paramedic, could have at least stopped to offer comfort that someone was on the way to help*


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## usafmedic45

> but this man laying on the street is an example that we, as a society, are losing our humaness.



  It's nothing new.  It's been done for a long time.  We are just more aware of it because of the media and the pussification of American society.  










> could have at least stopped to offer comfort that someone was on the way to help



:lol:  Dial 911 and move on, newbie, before you get stabbed because of your compassion. 

I know what you're thinking.....





...but seriously, in situations like this....





...so you have to be willing to potentially sacrifice the human detritus to protect yourself.   It's pretty obvious.






You should learn very quickly that I don't respond well to emotional BS attempts to guilt me into doing something pointless and stupid.


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## Trayos

I think far side cartoons should be required in heated discussions, they certainly have a nicer way of saying things


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## sunbee

this is also known as the bystander effect or pluralistic ignorance, learned in psychology, so generally speaking, can't really blame ppl for not helping bc it's human nature and the mechanisms that underly why ppl don't help is very complex


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