Duty To Act Questions

[ADyingBreed]

Hey All, This is my first post!

(I searched other threads before posting this, so don't tell me to look them up)
I'm in emt-basic class and my instructor just keeps saying there are gray areas in duty to act,
So I had some specific questions.


When you're off duty, you never have a duty to act.. right?


When you're on duty, but already have a pt, and witness a crash... what do you do?


What about if you're on duty in an ambulance, but in another jurisdiction? Do you help anways?

I know there are different laws and protocols but any help would he appreciated!

So, what would you do?

 

[Medic29]

My morals won't allow me let someone in need of help go without it whether I'm on duty or not.

As far as with a patient and we come across a MVA we stop do a window check and call our dispatch who'll in return send the appropriate people. If they're ok we'll tell them help is on the way. If they need help the driver will get out and assist until appropriate care arrives. That's also pending our transport isn't a code 3.

 

[Wes]

These questions are absolutely filled with grey areas. Combine various state's laws, regulations, and the policies/procedures of each individual employer and the answer will almost always be, "It depends."

My advice to you would be to get guidance from your state's EMS regulatory body and/or an attorney well versed in the EMS laws and regulations of your state.

And remember, the "legal" requirements on duty to act may well be different from your personal moral or ethical base.

 

[Jim37F]

Personally, speaking for myself and myself only, if I was off duty and out of uniform I'd at least call 911 if someone really needed help and no one else had already. I doubt I'd jump in unless the patient had a clearly life threatening injury (say uncontrolled bleeding).

If was off duty but in uniform (which is pretty much limited to going to and from work) I'd call 911, explain I was off duty with no medical supplies/equipment so I'd prob be limited to counting pulse and breaths and just trying to calm the patient until the 911 medics arrive.

On duty, no patient in the ambulance out policy is to immediately notify dispatch (who is supposed to immediately call 911 since we are not a 911 service provider) and provide care within the limits of our scope of practice until the 911 medics arrive who will either transport themselves or in some cases may decide to go ahead and have us transport. County policies do allow us to use clinical judgement to initiate immediate transport, particularly if the patient was critical and the ETA to the MAR is less than ETA of arrival of 911 units.

On duty with a patient in the back. Pretty much if our patient is stable we're supposed to stop, notify dispatch and the driver will evaluate and alert the 911 system if necessary and provide care as best as they can. If our patient in back is unstable/critical/otherwise worse off than the scene we rolled up on we are encouraged to let bystanders know we've alerted 911 (if needed) but let them know we can't stop and stay due to our worse off patient and continue transport (mainly to help counter angry phone calls to the county EMS Agency that we ignored a medical emergency)

 

[Dwindlin]

1. Call 9-1-1 as I drive on by

2. Call it in and continue on. I have a responsibility to the patient already in my care.

3. Render whatever aid I can while waiting for responders from the district.

 

[Akulahawk]

I'm going to post inline and in bold so that it's easier to follow...

Hey All, This is my first post!

(I searched other threads before posting this, so don't tell me to look them up)
I'm in emt-basic class and my instructor just keeps saying there are gray areas in duty to act,
So I had some specific questions.


When you're off duty, you never have a duty to act.. right?
This one is complicated easily could vary from state to state.

When you're on duty, but already have a pt, and witness a crash... what do you do?
Call 911 as you drive by. Your already have a duty to your current patient.

What about if you're on duty in an ambulance, but in another jurisdiction? Do you help anyways?
I would stop, notify dispatch and the local jurisdiction and provide aid as needed on scene until the on-duty EMS crew from that local jurisdiction arrived.
I know there are different laws and protocols but any help would he appreciated!

So, what would you do?

Get to know your state and if you're going on long-distance transfers, try to learn the local policies along the way. Chances are pretty good that they'll have you render aid and turn over care to the arriving crew.

 

[ADyingBreed]

Thanks everybody for the feedback.
I'm not sure if I have to tag you to get this, but hopefully you do


& Mostly, thanks for not ignoring the probie.

 

[Chris07]

County policies do allow us to use clinical judgement to initiate immediate transport, particularly if the patient was critical and the ETA to the MAR is less than ETA of arrival of 911 units.

I want to say that that is not correct.
This is true if you are BLS level 911 provider and there is an extended ALS response time, or if your company received a call to do an non-emergent transfer on someone who is actually really sick (assuming that there was no reason to believe the individual was in any immediate distress when the call was received).
I'll have to dig around for the county reference on it but I am almost certain that if the 911 system has been activated, you may not transport unless your company has the permission of the local 911 transport agency (whether it be a contracted private company or the local FD if they have their own ambulances). Essentially it was a policy put into place to keep unauthorized companies from jumping 911 calls.

EDIT:
Found it!
http://ems.dhs.lacounty.gov/policies/Ref500/517.pdf
Principles 2 & 3. Stupid? Yes. Welcome to LA :rofl:

 

[mycrofft]

5 is 4

Know your company rules, your protocols, and your applicable laws. Send your EMSA a letter.

I'd say don't wear your uniform on the way to and from your job to preserve your secret identity as a superhero.

Earlier someone hypothesized what you are to do if a law officer orders you to pick up a patient. Don't have the URL on me here.

 

[medic741]

If I help it's "I'm trained in first aid can I help?" NEVER "I'm a paramedic, can i help you?" If off duty. Witness a crash with a pt? So much depends on that question...

 

[TransportJockey]

Hey All, This is my first post!

(I searched other threads before posting this, so don't tell me to look them up)
I'm in emt-basic class and my instructor just keeps saying there are gray areas in duty to act,
So I had some specific questions.


When you're off duty, you never have a duty to act.. right?
here that's true unless you are identifiable as an EMT. Like shopping in your uniform or some other stupid idea.

When you're on duty, but already have a pt, and witness a crash... what do you do?
Call dispatch and let them know. If its a stable patient and you can safely pull over, stop and try to render assistance

What about if you're on duty in an ambulance, but in another jurisdiction? Do you help anways?
On duty in a truck with no patient means I have to stop if I see a wreck. No matter where it is.
I know there are different laws and protocols but any help would he appreciated!

So, what would you do?

Generally if I'm off duty I don't stop. I'll call 911 as I'm driving by the wreck.


Sent from my iPhone using Tapatalk 2