Off duty at a restaurant, you witness a bari+geriatric fall

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J B

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You're sitting at a restaurant, eating dinner. You hear something hit the floor. Look up to see a ~250 pound, ~80y/o F on the floor. She has a younger (~40y/o) woman with her, possibly a daughter.

The pt slurs her words slightly, has not had anything to eat in 12 hours. Possibly some dementia. Pt has what appear to be large bruises all over her face, but denies having any other falls today.

What do you do?
 
Order chips and salsa and enjoy the show :cool:

Later you QA/QI between each other all the mistakes the crew did?
 
Use 2 steaks and some napkins to secure c-spine, backboard her with a table, then wait for the praise from the arriving paramedics.
 
I can't decide which one of those answers I like better haha
 
Ecgg said:
Order chips and salsa and enjoy the show :cool:

Later you QA/QI between each other all the mistakes the crew did?
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MedicBender said:
Use 2 steaks and some napkins to secure c-spine, backboard her with a table, then wait for the praise from the arriving paramedics.
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What are you thinking? You cant mix Mexican and Continental.
 
:rofl:

I guess my main concerns are:

1) Per my protocols, I think she should technically be getting collared and backboarded... She probably doesn't need it, but it is what it is I guess. If I help her to her feet and it turns out she injured her spine in the fall, am I now liable because I didn't provide standard of care?

2) She has bruises all over her face, meaning she probably falls like this pretty regularly. Is she a danger to herself?

3) Can/should you ask the daughter if pt has a history of dementia? If pt has altered mental status after the fall, it could be cause for calling 911 I think?
 
J B said:
:rofl:

I guess my main concerns are:

1) Per my protocols, I think she should technically be getting collared and backboarded... She probably doesn't need it, but it is what it is I guess. If I help her to her feet and it turns out she injured her spine in the fall, am I now liable because I didn't provide standard of care?

2) She has bruises all over her face, meaning she probably falls like this pretty regularly. Is she a danger to herself?

3) Can/should you ask the daughter if pt has a history of dementia? If pt has altered mental status after the fall, it could be cause for calling 911 I think?
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off duty means you are a bystander not an emt so there aren't any protocols to follow. offer to call 911 if needed then go back to your meal. let the responding crew handle it. ...... besides there isn't really anything you can do anyway.
 
Medic Tim said:
off duty means you are a bystander not an emt so there aren't any protocols to follow. offer to call 911 if needed then go back to your meal. let the responding crew handle it. ...... besides there isn't really anything you can do anyway.
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What he said.
 
I'd step over her and order a beer. Then possibly ask if her daughter would like me to help get her off the floor or call 911.

No, probably would stop at the ordering a beer. Well, I'd drink the beer too...
 
Am I on a date with an incredibly beautiful woman? if so that totally changes my strategy.

Or, is the daughter hot? Im not really into the cougar thing, but hey, YOLO
 
Arovetli said:
Am I on a date with an incredibly beautiful woman? if so that totally changes my strategy.

Or, is the daughter hot? Im not really into the cougar thing, but hey, YOLO
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-1 internets for using YOLO, even in a joke
 
Arovetli said:
Am I on a date with an incredibly beautiful woman? if so that totally changes my strategy.

Or, is the daughter hot? Im not really into the cougar thing, but hey, YOLO
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I like your style.
 
rmabrey said:
-1 internets for using YOLO, even in a joke
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^This

But in all seriousness, if this happened to me I'd have someone call for a code 2 ambulance, give her a once over and go from there.

Check a quick Cincinnati stroke scale, ask about diabetes hx, determine if there is underlying head trauma or figure out why the heck her face is all bruised up. Could be a prior head injury manifesting, or maybe she is just a little too vigorous in applying her makeup?

Or maybe she's a little blitzed? Seems like half of the older folks I see are drunk as skunks.

And why would you want to c-spine this woman? Unless she took table to the neck on the way down and has a neuro complaint I couldn't ever justify putting her in c-spine. But I'm also one of those rebels who almost never puts someone on a board if I can help it.
 
Medic Tim said:
off duty means you are a bystander not an emt so there aren't any protocols to follow.
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I don't think it's quite that black and white in the USA...

Here is the good Samaritan law in my state:

Section 13. No person who, in good faith, provides or obtains, or attempts to provide or obtain, assistance for a victim of a crime as defined in section one, shall be liable in a civil suit for damages as a result of any acts or omissions in providing or obtaining, or attempting to provide or obtain, such assistance unless such acts or omissions constitute willful, wanton or reckless conduct.
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As an off-duty EMT, you can be held to a higher standard because "you should know better". It would be up to the judge/jury to decide whether or not failing to follow protocols was "willful, wanton or reckless conduct." I've heard stories about people getting screwed but I can't confirm them or find any case law on this.

Realistically, the odds she needs board/collar are tiny. If something happened, she would need to know I was an EMT and then know she could even sue me in the first place. After that it would be up to the lawyers/judge/jury. So really not worrying about, but good to be aware of what "could" happen I think.


Edit -

Actually, apparently good Sam laws don't apply at all to healthcare workers in MA:

Section 12V. Any person, whose usual and regular duties do not include the provision of emergency medical care, and who, in good faith, attempts to render emergency care including, but not limited to, cardiopulmonary resuscitation or defibrillation, and does so without compensation, shall not be liable for acts or omissions, other than gross negligence or willful or wanton misconduct, resulting from the attempt to render such emergency care.
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https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter112/Section12v
 
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You would need a duty to act to be held liable. You do not have one off duty. Do not lay a finger on the patient and you will not be open to lawsuit. How would they even know you're an emt unless you run in as Ricky Rescue to save the day.

If she doesn't need CPR or abdominal thrusts, she'll be fine until the ambo gets there; and there's nothing you could really do anyway.
 
Good Samaritan typically applies only to lay persons.

P.s., YOLO
 
Personally I think she's losing her airway (slurred speech) so I'm going to prepare for the steak knife and drinking straw crich I've always wanted to do....

Seriously, help her up, don't tell them who I am, let responding EMS take care of it and return to dinner. No muss, no fuss, no misplaced liability concerns.
 
J B said:
:rofl:

I guess my main concerns are:

1) Per my protocols, I think she should technically be getting collared and backboarded... She probably doesn't need it, but it is what it is I guess. If I help her to her feet and it turns out she injured her spine in the fall, am I now liable because I didn't provide standard of care?

2) She has bruises all over her face, meaning she probably falls like this pretty regularly. Is she a danger to herself?

3) Can/should you ask the daughter if pt has a history of dementia? If pt has altered mental status after the fall, it could be cause for calling 911 I think?
Click to expand...

My main concern is how she came to be that old while being that fat and still healthy enough to be dining out. I wanna know.

1) You're not at work and not subject to your protocols.

2) Maybe....so what?

3) That would mean getting involved. Getting involved means you could make a mistake...without the protection of you employers protocols/insurance. Seriously, if your concern is liability then surely you're more likely to get sued for running over, making yourself known, assessing/treating/making recommendations (like whether or not to call EMS), than for sitting quietly in the corner without mentioning to anyone that you're a EMT.

I'm of the opinion that if I am close enough to it that I can't politely ignore them and should, by the laws of not being an arsehole, help in some way, then I forget I am in healthcare and just go over like anyone else and say nice things, pretend to give a toss and help her up. Hopefully future Mrs Melclin sees this, mistakes me for a nice bloke and decides she might buy me a drink.
 
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