Duty to Act while on duty

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Sunsetter37

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Hi everyone,

I'm a fairly new EMT in southern CA, LA county area, and I had a question about Duty to Act...while on duty. I'm sure this has been covered many times regarding off duty/good Samaritan, but I haven't been able to find any info specific to my situation. I work for an ambulance company that does primarily IFTs, but is working to get a 911 contract. They recently tried to install a new policy that essentially states that we cannot stop at emergencies or render aid unless directed by a law enforcement officer or our dispatcher. Regardless of what kind of emergencies. One of our units was on scene at a serious car accident, stopped and assisted until the paramedics arrived, and was reprimanded by our supervisors for doing so. I can understand not stopping if we already have a patient (I guess it makes sense), but they don't want us to do anything whether or not we have a patient. And if there is no law enforcement or we can't get a hold of our dispatch, we are supposed to just continue on our way and inform our dispatcher whenever we can. I've been looking for somewhere where this is spelled out as being legal or not, but I haven't been able to find anything specific. If someone knows or could point me in the right direction, I would be very grateful.
Thanks, Sun
 
I don't know where you could find that but I have heard of that policy before. You have to be cleared by your dispatch to stop and render aid. I wanna say that question was on the CA ambulance certificate exam but I'm not 100% sure. Or it could have been on my companies exam.
 
firefite said:
I don't know where you could find that but I have heard of that policy before. You have to be cleared by your dispatch to stop and render aid. I wanna say that question was on the CA ambulance certificate exam but I'm not 100% sure. Or it could have been on my companies exam.
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It's not in AMR's policy, other than to notify dispatch. Obviously if you are attached to another call or transporting a patient then you cannot stop. It seems like a liability check for the owners, being that you most likely have EMTs who may have never seen a collision scene outside of their ride-along, running around like chickens with their heads cut off.
 
Sunsetter37 said:
Hi everyone,

I'm a fairly new EMT in southern CA, LA county area, and I had a question about Duty to Act...while on duty. I'm sure this has been covered many times regarding off duty/good Samaritan, but I haven't been able to find any info specific to my situation. I work for an ambulance company that does primarily IFTs, but is working to get a 911 contract. They recently tried to install a new policy that essentially states that we cannot stop at emergencies or render aid unless directed by a law enforcement officer or our dispatcher. Regardless of what kind of emergencies. One of our units was on scene at a serious car accident, stopped and assisted until the paramedics arrived, and was reprimanded by our supervisors for doing so. I can understand not stopping if we already have a patient (I guess it makes sense), but they don't want us to do anything whether or not we have a patient. And if there is no law enforcement or we can't get a hold of our dispatch, we are supposed to just continue on our way and inform our dispatcher whenever we can. I've been looking for somewhere where this is spelled out as being legal or not, but I haven't been able to find anything specific. If someone knows or could point me in the right direction, I would be very grateful.
Thanks, Sun
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So what your wanting is the ability to jump calls? Not likely to happen. Our policy is stop if it's in our response area, notify dispatch if it's not.
 
I admit to not knowing all the ins-and-outs of how things are done on the street, but from this angle, it sounds like a decision that came from the bureaucratic side of the business rather than the medical side.
 
steveshurtleff said:
I admit to not knowing all the ins-and-outs of how things are done on the street, but from this angle, it sounds like a decision that came from the bureaucratic side of the business rather than the medical side.
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Not opening your company up to unneeded liability and keeping your unit available for calls that actually pay is indeed bureaucratic, but also keeps a paycheck coming.
 
I can see both sides. I'm just looking at it from the standpoint of the TA victims as those who are conscious watch a medic unit approach and keep going.

Put another way, suppose a cop and his partner were to witness a mugging but were unable to do anything about it until dispatch told them to go ahead. That agency would be looked upon with no confidence in short order.
 
steveshurtleff said:
Put another way, suppose a cop and his partner were to witness a mugging but were unable to do anything about it until dispatch told them to go ahead. That agency would be looked upon with no confidence in short order.
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Different situation, they're obligated to act within a particular area. Similar to how if I happen upon one in my contracted response area I'm obligated to stop. However, you'll also notice LE from out of jurisdiction doesn't usually do traffic stops.
 
I stop regardless of where I am.
If it's in one of the counties my company is licensed in, and FD hasn't arrived on scene by the time I've assessed, treated, and (if needed) packaged the patient, then I transport.

If I'm outside of the counties, and FD hasn't arrived on scene by the time I've assessed, treated, and (if needed) packaged the patient, then I transport. :)

I've yet to run into a problem.
 
usalsfyre said:
Different situation, they're obligated to act within a particular area. Similar to how if I happen upon one in my contracted response area I'm obligated to stop. However, you'll also notice LE from out of jurisdiction doesn't usually do traffic stops.
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May be a slightly different situation, but look at it from a layman's point of view. Until I got involved in EMS, an ambulance was an ambulance as far as I cared. I didn't know the difference between a paramedic and an EMT, nor did I even really consider that some ambulances were part of companies that just did transport between facilities (IFT).

Back then if I was involved in an accident (or stopped as a citizen to render aid) and I saw an ambulance go by, I wouldn't take note of what agency/company it was affiliated with. I would just remember that an ambulance failed to stop at the scene of an accident and direct anger/frustration/loud complaints wherever I thought someone would listen.

It's not really a situation that has a one-size-fits-all solution. Reminds me a little of the Mel Brooks quote, "Tragedy is when I cut my finger; comedy is when you walk into an open sewer and die." My suffering is always greater and more urgent than Yours. So what if you have a guy coding in the back of your rig? He's already dead, stop and set my broken finger wouldn't you?
 
Logic dictates that if you come across the scene of an accident or injury while on-duty, you would call in to dispatch, advise them and request permission. If you need to speak with a Supervisor in your company then do so. It's really not your call -- someone else may already have it, nor is it your call to make; you're a foot soldier, remember?

What that means is be ready to JUSTIFY why you want to/need to stop and be ready and okay with being turned down.

It's kind of like a "Duty to Act" when dispatched thing.
 
firetender said:
Logic dictates that if you come across the scene of an accident or injury while on-duty, you would call in to dispatch, advise them and request permission. If you need to speak with a Supervisor in your company then do so. It's really not your call -- someone else may already have it, nor is it your call to make; you're a foot soldier, remember?

What that means is be ready to JUSTIFY why you want to/need to stop and be ready and okay with being turned down.

It's kind of like a "Duty to Act" when dispatched thing.
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I don't ask. I tell dispatch. "Dispatch: 24 is out at an accident on NB I-75 at exit 1234 on the right shoulder. Two vehicles involved. Contact Fire and PD." Then I just get out of the truck, and do what I need to do. :)
 
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Sacramento County basically takes this out of the individual company's hands. Here's what I mean...

From SCC EMS 2055.07 On-Viewing Medical Emergencies...
If no EMS responders are on scene and the on-viewing unit is not enroute to
another emergency, or not transporting a patient, the crew of that unit must stop
and render aid including transport, if appropriate, or wait until other EMS
resources arrive.
Click to expand...
 
Are you asking if you can disobey your company policy? Sure but you can also get fired and/or reprimanded. Basically the company is covering its *** by having this policy.

Lets for example assume that you driving down the road and come upon head on collision between two vehicles. You're just IFT ambulance and only have basic supplies. After everything is said and done one of the person is paralyzed for life. Guess what that person will be doing? That is right he/she will be suing everyone they can including you asserting that because of your lack of experience/skills you were negligent which resulted in that person becoming paralyzed.

Basically unless your dispatch directs you stop and/or emergency dispatcher or someone else with authority to order you to stop you notify your dispatch and maybe call 911 to report the accident and continue on your way.

A lot of companies have similar policy simple because of extra liability.
 
usalsfyre said:
Different situation, they're obligated to act within a particular area. Similar to how if I happen upon one in my contracted response area I'm obligated to stop. However, you'll also notice LE from out of jurisdiction doesn't usually do traffic stops.
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I have some bad news for you but cops are not obligated to stop or even help. US Supreme Court had ruled that cops have no obligation to protect citizens.

Basically unless there is specific law that requires non contracting ambulance to stop without being directed to do so by authorized personal they are required to follow the policy of the company. If that policy says contact dispatcher for permission to stop that is what they must do or face being reprimanded and/or just fired for violating company policy.
 
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looker said:
I have some bad news for you but cops are not obligated to stop or even help. US Supreme Court had ruled that cops have no obligation to protect citizens.

Basically unless there is specific law that requires non contracting ambulance to stop without being directed to do so by authorized personal they are required to follow the policy of the company. If that policy says contact dispatcher for permission to stop that is what they must do or face being reprimanded and/or just fired for violating company policy.
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Correct. Though I do know of 2 EMTs that got their certs pulled back in 2000-ish for failure to stop and render aid... required by a County Policy that was similar to what Sacramento has. This was in Santa Clara County. I clearly remember the EMTs being asked by County Comm for their cert numbers... over the air. As to whether or not they got their certs back, I do not know.
ffemt8978 said:
Before anyone asks, here are a couple of cases pertaining to this:
Town of Castle Rock v. Gonzales


Warren v. District of Columbia


DeShaney v. Winnebago County
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Basically, those and a few other cases, law enforcement can not be held liable for injury or death to someone for failure to provide adequate police protection unless they extend that Police Protection to you specifically. You'll rarely hear a dispatcher actually promise a response by their Police/Sheriff/Troopers because of this. Similarly, unless you have a specific duty to act, you do not have to... Sacramento County is creates this duty to act (stop and render aid & transport if necessary) by policy, as long as you're on duty. There's also a requirement that the unit contact Fire Dispatch about the incident as well. This is to prevent poaching of system calls by private non-contracted companies.
 
Akulahawk said:
Sacramento County basically takes this out of the individual company's hands. Here's what I mean...

From SCC EMS 2055.07 On-Viewing Medical Emergencies...
Click to expand...

How on earth did you find that? I would like to check that out for San Diego county but have no idea what search terms to use.
 
Sandog said:
How on earth did you find that? I would like to check that out for San Diego county but have no idea what search terms to use.
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I found it because I used to work in this system. That was one of the policies I had to be intimately familiar with.

If a county will have a policy about that, it'll be usually pretty obviously titled. Santa Clara County's policy is found in Policy 607 "BLS Ambulance Utilization" but since they authorize private ALS now, the "still alarm" policy used for BLS providers applies to non-911 ALS providers. Until a few years ago, the only ALS providers Santa Clara County had were 911...

Here is theirs:
Still Alarms
In the event that a private ambulance, other than the County-contracted provider, arrives on the scene of a collision, illness, or injury by coincidence; the crew shall provide appropriate care and immediately dial "911" or notify County Communications.
Click to expand...
 
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