Did I do everything I could have/did I do anything wrong?

[JPINFV]

Not stopping at all...I know some states might have laws forbidding health professionals from driving by without stopping (Nebraska was considering one when I left) but it is essentially unenforceable and probably unconstitutional.

...however I think this this the main point. Even stopping and putting in a phone call is not something that I'd consider creating a patient-provider relationship that opens the provider up to liability if they leave.

 

[nwhitney]

Hey Guys,

So after my second attempt at the NREMT I can now say I am officially an EMT-B.

The other day I was on the freeway heading home and I come up on traffic, it was pretty much all stopped. I look ahead and noticed traffic was clear so I knew there had to be something going on in front of me not too far up, as I got a better look I could see one car that had front end damage and the bumper was on the side of the road, I was already in the fast lane so I drove over to the left hand shoulder, and came upon the accident, I turned on my E light turned off my jeep and got out, I walked up to a young couple holding each other, they were visibly upset and both were crying. I said Hi, my name is Tasha I'm an EMT is anyone hurt? They said no, I asked what happened, the young girl said she was cut off by another car and when they connected the driver responsible for the crash took off, I asked how fast they were going the guy said about 60 mph, I said I know your emotions are high and your adrenalin is kicked in but are you in any pain whatsoever? They both shook their heads no, the young girl was very upset that the other driver had taken off. At about that time the paramedic unit showed up, I asked them if they got an LIC number or a description of the car and they couldn't recall much. I told them to hang in there I am going to go talk to the medics, the medic and the EMT-I were getting out of the rig, the EMT-I was walking towards me and I said hi, I this is a hit and run the two people involved say they are not hurt. He walked right past me without saying a word, so I went up to the medic as he was getting supplies from the side of the rig, I said Hi, I'm an EMT-B I asked them if they were hurt they said no, I told him it's a hit and run. Unless you have any questions for me I'm gonna get out of you guy's way. He said okay, thanks and walked toward the pt's. I got in my Jeep and left.

Any comments, suggestions, advice? Did I do everything I could have done?

When I noticed no medics were on scean and no law enforcement I didn't hesitate to drive up to the accident. In my EMT class they stressed the importance of duty to act, on and off the clock. After all this is why I became an EMT, this is what I love. I guess I want to make sure I did the right things.

First I applaud you willingness to stop and help.

Second, from the point of stopping and making sure the people were ok to leaving I think what you did was fine. I understand the desire to help others and even risking your life to do so. However, MVA's are dynamic and dangerous. If you were to get hurt how could you help the people who you originally stopped to help? It's very important to not let someones emergency become your emergency. How much of scene safety did you take into account? Again aside from the issue of stopping I think what you did was fine.

 

[jmh]

There are lot's of things an EMT-B can do for a patient with no medical supplies.

Some of you just get on here just to pick fights and look down your nose at people who are of a different skill set. I asked for simple comments regarding the situation as a whole not to nit pick and the fact I chose to stop to offer whatever help I could, and talk about law suits and other non-important bs. I really have to wonder why the hell some of you are in EMS at all. Is that all you care about? Then to get on here and talk a bunch of crap when YOU yourselves have posted threads asking others for basic input?

you opened the door for criticism upon yourself. you need to learn not to be so defensive and come to terms that other peoples opinions might be right. ultimately, everyone here that responded was trying to help you, not bash on you. try being a little more open-minded if you're going to ask questions.

your heart is definitely in the right place but when it comes to EMS, emotions are the first thing you should be detached from. your mind is your greatest tool you possess.

i think everyone will agree that the first things they learned in EMT training is BSI and scene safety. you had no PPE, no safety equipment. regardless of whether or not the actual scene was safe for you to enter, the reality is that it wasn't because you were not properly equipped to enter it.

personally, i think duty to act laws are bull:censored::censored::censored::censored: unless the state is willing to provide every EMS worker with the proper supplies, equipment, etc.

 

[dixie_flatline]

Well... this conversation certainly spiraled out of control rather quickly.

It does bring up something that has really been bugging me. My EMT class did go over the idea of being on the clock/in uniform to "act as an EMT" - but I've never been clear on the details of what the heck that actually means? Where is the list of things that are OK for a "layperson", and the things that are verboten?

There isn't much in my scope as a Basic that I wasn't taught to do in the Boy Scouts, and in that capacity I certainly wasn't acting under any medical direction. I was taught to apply pressure, bandage, even tourniquet hemorrhaging (actually back then we learned elevation and pressure points too). We did burn and blister care, we were frighteningly well-practiced in the art of tick removal, and came close to dealing with some nasty venomous snake bites. We even went over how to give an epi because we had kids in our troop with bee allergies and were out hiking the AT. We were all CPR/AED certified, practiced in the Heimlich, and splinted like champs. Frankly, I can't think of anything other than administering O2, charcoal, nitro, and glucose that I wasn't already doing before I became an EMT.

That said, to the OP - the first (and second, third, and fourth) things we learned in class were safety - and ours trumps everyone else. There are a bunch of reasons - first and foremost is that putting yourself in unnecessary risk increases the likelihood of adding another patient (which will tie up even more resources). One of the axioms we lived by at the academy was "Risk a little to save a little; risk a lot to save a lot". It wasn't wrong of you to stop and assess the situation, but judging by your description of the vehicular damage and state of the victims as you rolled up, there was nothing you could do other than palliative emotional support. On the other hand, you were placing yourself in danger (as evidenced by the linked threads) - you were effectively risking a lot to save very little. If it had been a rollover crash, with massive damage, people ejected, etc and no one on-scene, then by all means stop if you are comfortable with the danger.

There are 2 major types of people in EMS as I see it - those who view it as a calling/honor (mainly us volunteers), and those who view it as a paycheck (and yes there is overlap between the two groups). If your job is to do EMS 24 hours a day, every 3 days, it absolutely does not make sense for you to give that skill up for free every time you see a fender bender. And as was pointed out, if Sasha stops to render aid on her day off and gets clipped by a car, she most assuredly will not be covered by workman's comp. Now there are 2+ patients to deal with on that scene, and Sasha has to figure out how to pay her new hospital bills and feed little Sashette. Please don't judge others for their pragmatic approach to these things, nor question their motives or reasons for being in EMS. To a lot of people, it's just a job (albeit an important one), and a job isn't worth risking your family and your life over.

 

[MrBrown]

Bloody ricky rescue gung ho over zealous Americans

Brown is going to slow down and have a squiz, and would stop only to try and drag some bloke out from his burning car or put pressure on his massive arterial bleed but other than that, no there is nothing that Brown can do except sit there and wait for the Fire Service or Ambulance to arrive so why bother stopping?

 

[dixie_flatline]

Bloody ricky rescue gung ho over zealous Americans

Brown is going to slow down and have a squiz, and would stop only to try and drag some bloke out from his burning car or put pressure on his massive arterial bleed but other than that, no there is nothing that Brown can do except sit there and wait for the Fire Service or Ambulance to arrive so why bother stopping?

Other than the fact that I had to look up the word squiz, Brown basically just summed up my wall o' text.

 

[Shishkabob]

There are lot's of things an EMT-B can do for a patient with no medical supplies.

Please, do tell?

 

[jmh]

Well... this conversation certainly spiraled out of control rather quickly.

Please don't judge others for their pragmatic approach to these things, nor question their motives or reasons for being in EMS. To a lot of people, it's just a job (albeit an important one), and a job isn't worth risking your family and your life over.

totally agree... and Blessed, i wasn't trying to be mean. just trying to explain where everyone else is coming from. do what you think is right, but do it smart and safe

 

[fast65]

Please, do tell?

Dial 911, wait for first responders, do the EMS dance, the list goes on

Sent from my mobile command center

 

[DesertMedic66]

Dial 911, wait for first responders, do the EMS dance, the list goes on

Sent from my mobile command center

Yep that's about all. I've stopped at 2 accidents. I somehow always forget to mention that I'm an EMT. I do a quick look while driving. If it looks really bad then I might stop and help a little bit. If it doesn't look bad then I keep driving and call 911.

 

[medichopeful]

I'm just baffled by that, I have no problem risking the unknown to help someone in need. I assumed that's the whole point of being in the EMS field, wither your on or off the clock anything could happen in any type of situation, your gonna let someone possibly die on the side of the road when you could possibly save their life.....? I guess I just don't understand that type of thinking... I just wanna help where I can, when I can.

While I applaud you for wanting to help, and that's something to be admired and that you should be proud of, consider the fact that if you get hurt or killed, you may not get to ever help anybody again. You'll probably do more for people over the long run than if you stop to help someone and get injured or killed.

 

[rmabrey]

The state I live in, you are covered by the good Samaritan law. Also if you come up on an accident and you are in the EMS field and do nothing and you leave you can be sued for not giving medical attention. Just thought I would throw that out there. Not every state has the same rules for EMS, just keep that in mind.

Same here, I am protected by Good Samaritan law when off the clock, but I also do not have a duty to act.

 

[firetender]

What can you live with?

Coming across a situation where someone's life is in danger and you have the luxury of choice to intervene or not happens in an instant. My experience is that you have a moment of opportunity to take advantage of and -- especially in life-or-death situations -- it's a now or never thing.

The time taken to assess your risk (or liability, because let's face it, many who speak of their safety also include fear of lawsuit) stands between you and taking action. That could mean that the moments during which you could get something done and do it safely pass and danger is compounded.

Once the decision is made to, for example, notify EMS and wait, what's left to do is watch what happens as nature takes its course.

What could you stomach? And were you to choose to stand by as someone dies needlessly, would you not go over and over again the actions you chose not to take and the way they may have affected the outcome?

Every action, or inaction, carries with it consequences. Living with yourself, and protecting your future as well, has as much to do with the actions you choose NOT to take as it does with the actions you choose to take.

I'm thinking of an earlier thread by abckidsmom about her coming across a guy whose car had just jumped the jacks and pinned his head under it. She took action, the guy got out okay which would have been unlikely without her intervention, and, yes, he was an ungrateful SOB, as could be predicted.

My guess is abckidsmom stepped in and then, moment by moment, choice by choice, took specific actions each of which were directed by her overriding desire to not be harmed.

In many of the responses here, I don't see as much decision-making (including assessments of the odds) as I see the setting of arbitrary boundaries. "I would never" does not speak about the reality of the moment one is thrust into.

Has anyone here been in that situation where, choosing to NOT intervene, they watched as the affected person died?

I bet not.

And whoever may have probably has a lot to teach us.

 

[Sasha]

Good Sam law only prevents a lawsuit. Who is going to take care of your hospital bills? Who is going to supplement your income and support your family when you got yourself hit on scene?

 

[abckidsmom]

Has anyone here been in that situation where, choosing to NOT intervene, they watched as the affected person died?

I bet not.

And whoever may have probably has a lot to teach us.

Last week, I was riding on the Engine when a cardiac arrest was dispatched. We were the closest unit by far, just happened to be returning from a fire call. We pulled up, a crew of 3, with me and another medic, and our driver was a BLS provider.

Went in the EMS compartment and there. was. no. equipment. None. We had left for a house fire, and the EMS equipment was on the other unit that we usually staff.

So we looked at the dead guy on the porch, pulled him down on the ground and started hands-only CPR. We actively chose NOT to do any kind of ventilations, continuing compressions until the medic unit arrived.

He started breathing on his own during the CPR anyway, so we just kept on. When we finally got him on the monitor (prob after 4 minutes or so) he was in vfib, so we shocked and converted him to NSR. Score!

Anyway. I would have made the same decision and been satisfied with it even if he died. He looked about 70, had a PEG tub and a zipper scar on his sternum. If his time had come, he had too many risks for having something communicable for me to risk any sort of mouth to mouth. Here's me laying down an "I would never."

I really would never do mouth to mouth on a stranger if I could possibly avoid it.


And about your actual question, firetender, I think that choosing to do nothing has a lot to do with turning your back, so the people who make that decision don't typically watch the person die.

I've decided not to get involved because of my own reasons plenty of times: pregnancy, babies, small children and being late can really wreck a samaritan's day. Each time, and in each situation, I've ultimately been comfortable that I did all that was reasonable. I think people get to decide on their own whether to get involved, with no guilt needed if they don't want to.

There is a lot of sense in the question though: What's an EMT-B going to do at the basic traffic accident while they wait for the ambulance? Not much, really. I typically don't stop, either...but I'm usually travelling heavy.

 

[mycrofft]

Threefer..good Sam and unequipped EMT

1. Good Samaritan will NOT prevent your being sued, it is intended to protect you from liability. That means it may go to court if the judge allows it, because there may be a question as to whether the conditions of being a "Good Samaritan" were met. (If I stopped and put a traction splint on the wrong leg while telling you I'd seen it on "EMERGENCY!" once, wouldn't you want to be able to sue?
2. Things an unequipped EMT can do...divert traffic, tell folks to turn off their ignitions and pocket the keys, call it in, get license number and description if anyone starts leaving the scene, stop self-extrication from wnadering into traffic, stand by with an extinguisher, get first aid supplies from your trunk or from neighbors/passers-by and start treating self-extrications, stop other people from getting into danger by being heroes...a lot of things to do.
3. If you sniff around too much and someone steals something or it is missing (and that DOES happen) then you are a suspect.

 

[Shishkabob]

Has anyone here been in that situation where, choosing to NOT intervene, they watched as the affected person died?

DNRs count?


If so, yes.

 

[firetender]

DNRs count?

If you get to the house and they are dead and you don't resuscitate them, then you didn't watch them die, you just didn't intervene.

If you get to the house and they are conscious, and then they go pulseless and apneic, and you don't do anything, then, yes, technically you're watching them die.

But the scenario described is about coming on to a scene, off-duty and acting or not acting with life and death in the balance...horse of a different color.

We're paid to live with the reality of DNR's in our work. Here, we're talking about what it's like to stand by and watch as someone dies with the possibility that your inaction hastened it.

Ever lived through that one?

 

[abckidsmom]

If you get to the house and they are dead and you don't resuscitate them, then you didn't watch them die, you just didn't intervene.

If you get to the house and they are conscious, and then they go pulseless and apneic, and you don't do anything, then, yes, technically you're watching them die.

But the scenario described is about coming on to a scene, off-duty and acting or not acting with life and death in the balance...horse of a different color.

We're paid to live with the reality of DNR's in our work. Here, we're talking about what it's like to stand by and watch as someone dies with the possibility that your inaction hastened it.

Ever lived through that one?

One of my favorite hens got some kind of respiratory infection and we made the decision that we needed kill her. The hubby was at work, and I needed to control the spread of the infection among my flock. It was my responsibility to wring her neck, and I just couldn't do it. Instead, I put her in a feed bag and, well, let's just say it was a more gruesome end.

It sucked. And that was only a chicken.

 

[bstone]

When I first became an EMT I kept a BLS trauma bag in my trunk and had a few EMS decals on the car. I stopped once for a motorcycle vs ground on the interstate and ended up keeping the guy alive until an ambulance arrived. The guy turned out to be a cop and my cousin the chief of that department. I didn't do much other than keeping his C-spine stable and bleeding control, but it was more than enough to calm all the bystanders and (most importantly) the injured himself.

Now, 10 years later, I no longer carry a BLS bag or any EMS decals. I do carry a CPR mask and gloves on my keychain, but that's about it. I'd still stop at a true emergency, but won't when it's just a fender bender.