Needing to Vent

[crazycajun]

I don't normally complain about much. I usually tend to do my job and keep to myself. But tonight was one of the worst off duty experiences I have ever had. A friend called needing some help in a neighboring county. On my way I came across an MVC that had just happened. 68 yo male driving an early 80's caprice ran into a stationary tractor in a blind curve traveling 55 mph. Quick assessment showed rapid shallow breathing, BP 170 over 100 and elevated pulse at 120 bpm. Small lacerations to the face with a chief complaint of severe neck pain. I immediately slid in behind him and manually brought his neck to neutral keeping him stabilized until further assistance arrived. First on scene was a volunteer FF for the local FD. He was in a rescue unit so I assumed he had supplies. I informed him I was an EMT in the next county and gave him a quick rundown. I asked for a c collar and spine board to secure the patient so we could begin trying to get his feet free from the brake pedal. (collapsed on top of feet trapping them). The first thing this kid tells me is that I need to get away from his scene! I was speechless at first but held my composure and again asked for the things I needed. I told him once again that I was a certified EMT and my duty was to take care of the patient. He then proceeded to tell me that he didn't care if I was the president! This was his scene and I needed to leave or he would have me arrested. I then got rather upset and against my nature I let him have a few choice words I don't normally use and told him to call whoever he needed because I wasn't leaving the patient. He then walked away and sat in his truck until other members of his department and EMS arrived about 10 mins later. Fortunately I knew both the medics on the wagon and I was able to get what I needed. Once the patient was secure I turned him over to the medics and found the kids captain on scene. I told him what had happened and all he would say is that these guys are volunteers and if he upsets them they would leave the department. My question to him was, Is this really the type of people you want in your department? His answer was he takes what he can get. I can't believe people like this are allowed in any type of community service. I can only hope another patient doesn't suffer at the hands of these idiots.

 

[mycrofft]

He should have taken control of the scene and you should have let him.

Once he was there the pt was "his". However, he could have instructed you to hold C spine.
PS: If you were he, would you take the unsupported word of a stranger sitting holding C spine on your pt and giving you orders?

 

[DrParasite]

look at it from his point of view

My question to him was, Is this really the type of people you want in your department?

http://easterniowanewsnow.com/2011/04/01/impersonator-arrested/reding/

http://communitynewspapergroup.com/...newspapers/news/doc4d4828a108a5f597812923.txt

The two above links are recent cases of people impersonating EMS people.

Maybe he went about it the wrong way, but if the roles were reversed, what would you do? how would you know that the person in the car wasn't just impersonating an EMT? you don't know him, he doesn't know you, and you are just a guy who claims to be an EMT.

anytime I stop at a scene, once the AHJ shows up, it's their call. they want me to say? cool. they want me to go? cool. either way, it's their scene, not mine.

losing your cool doesn't help the situation. if anything, it gives you even less credibility, because you go from a helpful bystander to a potentially dangerous bystander who is interfering with the AHJ's operations. if he wants to be a D bag, and tells you to GTFO, do it. it's his scene.

btw, if you stop at my scene to help out, once I arrive, if I say you leave, you better leave. if you start cursing at me, you are leaving in handcuffs. If I don't know you, than I am not going to let you do anything, because, quite honestly, I don't know you, and you could be a kook who is just pretending to be an emergency responder. I don't care if you are a fire chief in the next county, an EMT, paramedic, or flight nurse who has been doing this for 20 years, unless I know you, odds are once I arrive, it is my scene, and if I say you go, you better go. I might have you continue to hold C-spine (only so I don't have to), but i might not, it all depends on the situation. but either way, it's my call, and because I am the AHJ, you should be listening to me, because it is now my scene and my patient.

don't take it personally, it has nothing to do with you, it has to do with all the other kooks who pretend to be fellow emergency services people and really aren't have ruined it for those of us who are good intentioned and actually trained

 

[Sasha]

Dude you're lucky you didn't get arrested.

 

[foxfire]

Not to take sides or anything but, once the EMS personnel called to the scene arrive they are in charge of pt care. You were acting in the good Samaritan role and thus had no control over pt care. Instead of saying What you needed, inform the responding crew of what happened and ask if they would like your assistance. If they don't then your job is done.

 

[ffemt8978]

http://easterniowanewsnow.com/2011/04/01/impersonator-arrested/reding/

http://communitynewspapergroup.com/...newspapers/news/doc4d4828a108a5f597812923.txt

The two above links are recent cases of people impersonating EMS people.

Maybe he went about it the wrong way, but if the roles were reversed, what would you do? how would you know that the person in the car wasn't just impersonating an EMT? you don't know him, he doesn't know you, and you are just a guy who claims to be an EMT.

anytime I stop at a scene, once the AHJ shows up, it's their call. they want me to say? cool. they want me to go? cool. either way, it's their scene, not mine.

losing your cool doesn't help the situation. if anything, it gives you even less credibility, because you go from a helpful bystander to a potentially dangerous bystander who is interfering with the AHJ's operations. if he wants to be a D bag, and tells you to GTFO, do it. it's his scene.

btw, if you stop at my scene to help out, once I arrive, if I say you leave, you better leave. if you start cursing at me, you are leaving in handcuffs. If I don't know you, than I am not going to let you do anything, because, quite honestly, I don't know you, and you could be a kook who is just pretending to be an emergency responder. I don't care if you are a fire chief in the next county, an EMT, paramedic, or flight nurse who has been doing this for 20 years, unless I know you, odds are once I arrive, it is my scene, and if I say you go, you better go. I might have you continue to hold C-spine (only so I don't have to), but i might not, it all depends on the situation. but either way, it's my call, and because I am the AHJ, you should be listening to me, because it is now my scene and my patient.

don't take it personally, it has nothing to do with you, it has to do with all the other kooks who pretend to be fellow emergency services people and really aren't have ruined it for those of us who are good intentioned and actually trained

Spot on post.

 

[JPINFV]

In general, the only person who's going to be allowed to take over care is a physician, and that's normally done with online medical control and plenty of identification. Unless you're a doc, give report, ask if you can help. If told to get lost, hand over manual c-spine and leave.

 

[Scott33]

How and where did you park and secure your vehicle at the scene, and at what point did you release manual c-spine stabilization to take his BP and pulse?

Regardless, egos do tend to run riot in these situations and they make for a common theme on these forums. But how many times have we also read scoffing posts about the persistent off duty nurse, who just so happened to be first on scene at an MVC? "How did I know she was a nurse?"..."I bet she was an HCA"..."you should have seen the look on her face when I told her to fetch me the KED"..."It didn't seem like she had trauma training, so I took charge"...etc, etc [yawn]. Was your situation really any different from the responding crew's point of view? How about from a legal standpoint?

Fact is, you were relying on the crew not only having to take your word as to your credentials, but also having a genuine need for you to be there. If they didn't want you on (their) scene, you should have been on your way. Period.

It's been said before - if a provider is going to stop at witnessed or near-witnessed MVCs, not only should they be crystal clear as to what duty of care means when off duty, but they should also be prepared to stand down when asked to do so by the responding crew.

 

[the_negro_puppy]

More reason not to stop and just keep driving. Why run the risk of personal injury, getting sued or being abused by on duty personal.

 

[CAOX3]

The first attempt I make is always polite, I thank them for stopping and we can take it from here, It could escalate from there if need be but it really never has.

Of course I could act like a douche, tell everyone to beat it, get lost because Im in charge and this is my scene but I like to think Im more professional then that.

 

[truetiger]

This may sound cold but its great advice. It's not your emergency. You have nothing to gain and everything to lose. Call it in and keep driving. You also failed to recognize two major scene safety issues. You entered a scene before it was secure and a vehicle before it was stabilized. I bet the odds are much higher someone hits that vehicle a 2nd time on that blind curve than your taking c-spine makes a difference.

 

[Sandog]

In all fairness to the OP, once he responded to the incident he had a duty to act, and as such he had an obligation to continue care and not turn over care until a provider of equal or higher level reported on scene. One could argue that just being a vollie FD is not sufficient to validate EMS credentials as many vollie FD's are not EMS trained. One could further argue that if the OP just left his patient to the vollie after rendering care, that he failed in his duty to act if he did not ensure the vollie crew had the proper credentials. The patient belongs to the first responder until he or she turns over care to a provider and that first responder is not obligated to leave just because someone has a set of Nomex.

The oncoming vollie FD crew member should have approached the scene in a way such that they identified themselves as EMT/P such and such and ask for a quick briefing, not "Hey, get lost".

 

[Sasha]

As a good samaritan he only functions as a first responder meaning the vollie fd is equal or greater.

 

[Sandog]

As a good samaritan he only functions as a first responder meaning the vollie fd is equal or greater.

No, once he responds as a Good Samaritan and if he performs duties as an EMT, he has a duty to act as an EMT, and one can not assume that vollie FD has equal or greater training. The OP would be in his rights and obligations to request credentials from the vollie if he so found it warranted. If he was arrested, the case would never had made it to court.

 

[Sasha]

No as a good samaritan you function as a first responder.

He does not have a right to request the credentials of the responding units. They have the equipment to treat the patient, he doesn't. It's the responding FR/EMTs scene and they have every right to tell him to back the eff off.

 

[Sasha]

More reason not to stop and just keep driving. Why run the risk of personal injury, getting sued or being abused by on duty personal.

Why is it always a black guy eating popcorn?

 

[crazycajun]

Just to clarify some things. I got vitals when I first arrived on scene due to approximate age of patient and the fact he was wearing an emergency alert bracelet. The patient starting complaining of neck pain as I was finishing BP and that is when I put him in c spine. My POV was parked at a 45 degree angle with flashing strobes (gift from wife) approximately 300 ft from the scene. Patient vehicle was off roadway due to impact and in a safe area and I am trained (mandatory) in extrication. I had been at my EMS department most of the day getting ready for an upcoming event that I am working so I was in a county EMS t-shirt and my jump bag (issued by county with their logo) was on scene with me in plain view. The vollie (according to the medic on the wagon) has been in the FD for a couple of months and is currently in FR training. (my opinion is he shouldn't be in a rescue unit if he is not trained) In South Carolina according to DHEC who oversees EMS scene control goes to the highest ranking officer either on or off duty without regards to county as we are state certified. Many of the rural FD's here have issues with EMS for a number of reasons. Mostly due to them being volunteer and we are paid. This kid knew full and well (as he admitted to others on the scene) that I was an EMT. His problem with me? I was from another county. BTW, call in an MVC here and/or just pass by and not stop will get you in some pretty deep water if DHEC finds out.

 

[crazycajun]

Also, my ID badge is clipped on my jump bag which was on scene and the vollie was standing next to it.

 

[Sasha]

BTW, call in an MVC here and/or just pass by and not stop will get you in some pretty deep water if DHEC finds out.

If you're off duty in South Carolina, you don't have a duty to act.

 

[crazycajun]

No as a good samaritan you function as a first responder.

He does not have a right to request the credentials of the responding units. They have the equipment to treat the patient, he doesn't. It's the responding FR/EMTs scene and they have every right to tell him to back the eff off.

Sasha this may be true in your state but not here. Anytime either on or off duty without regards to county I stop at an MVC I must act in official capacity.