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

[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.

 

[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.

 

[NYBLS]

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?

 

[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.

 

[NYBLS]

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.

 

[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.

 

[usafmedic45]

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.

 

[firetender]

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]

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!

 

[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.

 

[firetender]

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]

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.

 

[firetender]

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.

 

[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.

 

[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?

 

[firetender]

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.