Bystanders..

[Household6]

This had been bothering, I'd like to ask opinions..

I responded as EMR/FR to a CA of a motorist last summer. The scene was literally a half block from my home, at the beginning of a low/no traffic rural cul de sac.

About 10 minutes in the ambulance arrived. This is a completely different ambulance company than the one who is doing my education and schooling, but it is probably one that I'm going to apply once I'm done with school. The EMTs on the rig took over pt care, the EMT told me to scram.

LEOs responded, so there was four cruisers, and the one rig with a crew of three. Quite a crowd of EMS in the ditch there..

The adult neighbor came out of his house to see what the commotion was about, I saw his daughter was at the opposite end of the cul de sac riding bicycle..

Here's my question: Who's responsible for scene safety/bystanders at this point? I'm asking because the EMT doing compressions looked up and from her pt and saw this fellow. She then began yelling at him to go back in his house because he "didn't need to see this" and a few other things. He was easily a hundred yards away, he was in no way close enough to interfere (in my opinion).. No blood, no gore, my 13yo was even there, he assisted with the extraction before medics got there..

With over a half dozen total EMS and LEOs on scene, does the attending EMT still need to be enforcing crowd control? Common sense tells me that if it was my patient I should shut my mouth, pay attention to my compressions and the defib and let the Brown Rounds handle it.. But is there another reason why an EMT would chase people back into their homes? Does NREMT say anything?

 

[Handsome Robb]

I'm assuming you were responding as part of a volunteer squad?

Did he go about it the best way? No. Is it something to consider? Yes. LEOs are fantastic at crowd control and covering our asses but they also have other duties and can get tied up in them. Especially in a crime scene or potential crime scene.

On a medical call the Paramedic or EMT in charge is the head honcho. For example, I ran an arrest on a sidewalk in a downtown area a couple weeks back. We had LEO and FD on with us but PD still came up and asked me what I needed them to do.

As far as legal responsibility of bystanders I can't answer that one for you. I'd assume it would be the police department when it comes down to it since EMS and FD are usually tied up in extrication and patient care but again, on a medical scene the provider in charge is the head honcho. Crime scene? PD. Fire/extrication/rescue? Probably FD depending on your location and agency. Medical? EMS.

From what you described this call was a cardiac arrest that just happened to be inside a vehicle rather than a traumatic arrest. For scene management involving MVAs with a traumatic arrest that we're working, for whatever reason, we will get another ambulance as well as either a light rescue or second engine/truck company to help with scene control and care of other patients.

Your main priority is your patient but scene safety comes before the patient. If the scene isn't safe you shouldn't be there. Get yourself and your partner out of there. If you can get the patient out as well that's awesome. If you can get your gear out as well even better. Most things are repeated in the ambulance so it's not a huge deal except for the Monitor or AED. So if you can only grab one piece of equipment, grab that.

I'll withhold my opinion about using your 13 year old for help in this type of situation but to each their own.

 

[Household6]

Yes, volunteer. FR/EMRs here are separate volunteer groups for each rural township. Equipment is purchased through fundraisers like meat raffles, and community spaghetti dinners.

Yes, it was a CA that happened inside a vehicle..

Once EMT/Medic has established that the scene is safe, do you think it is unwise to delegate the maintaining of that safety PD so you can focus on your patients?

 

[ItsTheBLS]

Once EMT/Medic has established that the scene is safe, do you think it is unwise to delegate the maintaining of that safety PD so you can focus on your patients?

Don't ever have tunnel vision. Your patient is your 3rd priority behind yourself and your partner. Safety first.

Not many people I know like any type of bystander running up on their scene and inputting their opinion, which is probably why you were told to go away.

 

[JPINFV]

The problem is that EMS has no right to tell someone, especially someone on his own property or on a property with the permission of the owners, to go away when he's 'a couple of hundred yards away and not interfering.' It's not the EMT or paramedic's job to decide where people off scene (and if it's not interfering with patient care, it's off scene) can stand.

 

[SanDiegoEmt7]

The problem is that EMS has no right to tell someone, especially someone on his own property or on a property with the permission of the owners, to go away when he's 'a couple of hundred yards away and not interfering.' It's not the EMT or paramedic's job to decide where people off scene (and if it's not interfering with patient care, it's off scene) can stand.

This x2. The paramedic is in control of the scene. That means everything immediately affecting his patient(s). There was no interference, and if they're dealing with a traumatic arrest surely there are more important things to focus on than a lookey-loo 100 yards away.

 

[Rykielz]

If law enforcement is on scene, ultimately they are in charge of the scene and your safety. Patient care is the responsibility of the medic who's been delegated that authority (private or fire department).

The paramedic and/or EMT has every right to tell bystanders to scram. But as long as they are not interfering with patient care they are legally within their right to stand wherever they like (which is sometimes very irritating). It's just human nature that people want to watch when someone is hurt. It's why you get those huge traffic jams on the freeway for even the most minor of traffic accidents. Should the EMT have been yelling at people to go back inside their homes? No. But that's just his/her personal preference for scene management. Unless they got physical or somehow assaulted a bystander, nothing was illegal.

 

[Chris07]

If law enforcement is on scene, ultimately they are in charge of the scene and your safety.

An EMT/Medic is responsible for his or her own safety. Just because PD is there doesn't mean they'll be able to keep you safe. Scene safety is EVERYONE's responsibility.

I think the EMT yelling at the bystander, while arguably good intentioned (protecting patient modesty), loses some points in the style category. In my opinion it's bad public image to yell at someone who is, as the OP put, at least 100 yards away (I have a feeling 100yds is a little exaggerated). I doubt they will interfere with patient care/crime scene management or get a good view of anything from even 100 feet away.

I don't really see how you can tell someone to buzz-off if they are at a distance and not interfering with the management of the scene. Doing so is a little ridiculous.

 

[Rykielz]

I'm going off the legal standpoint. Yes, everyone needs to have situational awareness no matter what. But if PD clears you to go in and you end up getting hurt, it's PD's fault if it goes to court. Not yours.

 

[the_negro_puppy]

You cannot win be screaming at bystanders.

Sure gawkers get annoying but you can always ask them politely to leave if needed, then escalate. It hard to escalate once you have already screamed at them

 

[Handsome Robb]

I'm going off the legal standpoint. Yes, everyone needs to have situational awareness no matter what. But if PD clears you to go in and you end up getting hurt, it's PD's fault if it goes to court. Not yours.

Sounds great, lets just start pointing fingers at everyone.

Even if you've been cleared into a scene by PD you damn well better have your head on a swivel. If you stop paying attention because pd "cleared the scene" and you get hurt it's your own damn fault. If they say it's clear and I see something I don't like I'm not going to walk into the scene, no matter what the call is or what the cops say.

 

[Household6]

An EMT/Medic is responsible for his or her own safety. Just because PD is there doesn't mean they'll be able to keep you safe. Scene safety is EVERYONE's responsibility.

I think the EMT yelling at the bystander, while arguably good intentioned (protecting patient modesty), loses some points in the style category. In my opinion it's bad public image to yell at someone who is, as the OP put, at least 100 yards away (I have a feeling 100yds is a little exaggerated). I doubt they will interfere with patient care/crime scene management or get a good view of anything from even 100 feet away.

I don't really see how you can tell someone to buzz-off if they are at a distance and not interfering with the management of the scene. Doing so is a little ridiculous.

I didn't think of it from the modesty standpoint. I don't know if the crew could see the gut's little girl at the end of the street..

Just to add the rest of the story: During treatment of the pt, (after the screaming by the EMT) there was a secondary accident at the intersection where our dead end meets the highway. A minivan was rear-ended in the turning lane by a truck. Squealing brakes, then that huge collision sound of breaking glass and crunching metal. No injuries, the van had two properly restrained children, the mother still had their seats rear facing.

I wish more people would rear-face their children..

 

[STXmedic]

I'm going off the legal standpoint. Yes, everyone needs to have situational awareness no matter what. But if PD clears you to go in and you end up getting hurt, it's PD's fault if it goes to court. Not yours.

How is it PDs fault? Including from a legal standpoint? Just because they secure a scene doesn't mean it will stay secure. Calls are dynamic. People are unpredictable. :censored::censored::censored::censored: happens. You stay alert and pay attention to everything, all the time. If you take PD to court because you were careless and get hurt, good luck proving it was their fault. Again, dynamic, not static.

 

[Handsome Robb]

I'll ask was it hotel security's fault then when I got sucker punched then worked over pretty good by the patient they roughed up who then had a "seizure" and was "unconscious"?

No, it was my own.

Poetic worded it much better than I did.

 

[Rcoddington]

How is it PDs fault? Including from a legal standpoint? Just because they secure a scene doesn't mean it will stay secure. Calls are dynamic. People are unpredictable. :censored::censored::censored::censored: happens. You stay alert and pay attention to everything, all the time. If you take PD to court because you were careless and get hurt, good luck proving it was their fault. Again, dynamic, not static.

In general when PD arrives on scene (before or after medics) their responsibility is to secure the scene in the case of an MVA they will tend to focus on traffic control. Generally if PD arrives after the medics they will back all the bystanders up to what they deem to be a safe distance. It sounds to me that the medic in this case was overstepping her bounds. Since it seems the EMS crews personal safety was not in jeopardy they should have been focused purely on patient care.

Incidents like this put a bad face on EMS personnel.

 

[Handsome Robb]

Since it seems the EMS crews personal safety was not in jeopardy they should have been focused purely on patient care.

Back to the whole scenes are dynamic thing...

I will agree that the personnel involved in this could've handled it better though.

 

[cruiseforever]

The EMT/Medic could be one that is full of self importance and wants everone to know it.