Off Duty Skills

[Stevo]

well i'm amused folks

we have ems'ers here that would pass by an incident, maybe stop if it was a juicy one, or maybe not. i seriously have to wonder why some of you even got into the biz with comments like that?

out here in dogpatch it is actually an offense to pass an incident up while holding a cert. in fact my off duty skills are about the same as my on duty skills, just less toys.

i guess you metro folks have it made, big budgets, gps positioned rigs, all the bells and whistles...enough that your protocalls insist you pass by...? why bother to get a personal jump kit?

rather cocky imho....

perhaps i'm just jealous. maybe i've been hiding out in the puckerbrush a tad too long, always considered ems a good nieghbor community service, not some 9-5 profession to be shut off at the days end

then again, i will say it's a real drag responding to a bad incident when the only ambulance is out of town and mutual aid is 15 min away

maybe some of you could put in a word or two so i can rubberneck on by too?

~S~

 

[ffemt8978]

always considered ems a good nieghbor community service, not some 9-5 profession to be shut off at the days end

~S~

This point bears repeating, since it's something we tend to forget all too easily.

 

[AnthonyM83]

At almost every accident, the most your skills will be able to change medical outcome is a by holding c-spine. Now, this could be reason to stop at every accident by itself. I'll give you that.

But you also have to realize you're putting yourself at risk (depending on your area) stopping your car, running around the road, interacting with unknown individuals. Also, we're not just ignoring it, but stopping to make sure people are okay as best we can. I also call in every accident I can't stop at (other side of the freeway divider) to 911. But in most accidents that aren't critical, there's little you'll really be doing for them medically.

As a teen, I used to stop at every single accident. Once I was running late for school, but had I been on time I would have stopped for what looked like a big rig & car accident...it was actually a domestic dispute that turned into a murder (shooting). Had I been on time, I would most certainly have been in the middle of it and chances are I would have gotten hurt.

Once I almost caused an accident trying to pull over. I didn't think I was being unsafe, but a friend driving behind me told me, later.

An off-duty who stopped to help (a few cities away) was killed by a passing vehicle.

The longer you're in it, your risk analysis increases, your reasons to stay safe increase (family, etc), your excitement for the call decreases.

Also, keep in mind that I live in very busy areas. Closest emergency unit is usually 1 - 3 minutes (sometimes 5) away. So, if people are just walking around their cars talking, then I'll decide not to stop. If there's a car veered off to the side of the road, I'll stop if I safely can or even wait till the next exit, go back one exit, then turn around again so I can come up to it (while callling 911).

Least that's how I think of it. When I was younger, though, I'd stop at every single accident. Never once was were there serious injuries.

 

[Fedmedic]

Talking about responding to emergencies off duty brought to mind a sad story that gives a new perspective on this topic, at least it did to me.

A very close friend of mine and former co-worker who happened to be an exceptionally gifted paramedic was on his way to work one morning when he passed a MVA. He didn't stop because he was not on duty and had recently changed jobs and was not a paramedic in this county, in this particular state; paramedic is a county by county thing, although he was still able to practice as an EMT. Anyway, later that day he found out it was a former co-worker and paramedic that had been killed in that very same MVA, and might I add a very, very close friend to him and me. He did not take it very well that he did not stop, even though, in reality there was nothing he could have done to change the outcome, he still "what if's the situation." And he is no longer in EMS, whether this played a role, I don't really know. To summarize, I think this gave me a different attitude to responding to incidents I happen upon. Before, I just used to ignore most of the incidents, I had enough during my 24 hour shifts, I didn't need to deal withany on my off-duty time. This has changed my philosophy.

Just a thought....

 

[Stevo]

woulda coulda shoulda's abound Fedmedic

and i suppose i might have a different outlook should i know a rig is within 1-5 minutes Anthony


but for much of the rural contingent it's not

to add, there is no 100% safety net in the rescue biz, when we signed up we signed up for the inherent risks in order to help people

~S~

 

[jeepmedic]

If I am out of my Dept.'s response area and stop for a fender bender and get stuck because I am the only one there and My Dept. has an ALS call then who gets the justice? I am on of only 2 ALS providers in my Dept. it is a Volly Dept. and we only have 2 Als providers that respond. I try to provide services for the Dept. that I am in. If everyone is out walking around then I will not stop but if it just happened then I will stop and call it in.

But remember that in this day and time with Cell phones a 911 center can get about 10 to 15 calls on any accident in the first min. so you can do harm by calling it in by delaying the dispatch. If you stop and render care and are not in your area covered by your OMD then you are practicing medicine without a Lic.

In some states and agencys if you stop and render aid and something happens and you get hurt then you are not covered by any Ins. So guess how has to foot the bill. I have a family that does not need me working to support a medical bill that I could have just let the responders who have the ins. cover.

 

[Summit]

Since a lot of areas can have extended response around here, I certainly would stop at an MVC IF:

1. There was no help on scene
2. The crash was severe enough to suspect someone needed help
3. I could help safely

And then I am acting at the level of a FR (unless one of the various agencies I belong to is responding)... and in *most* cases the biggest difference I could make would be *about* the same as the most effective care offered by another *onscene* for trauma: ABCDs.

The same goes for accidents I've come across in the wilderness, on the river, or even on a ski hill.

I wouldn't feel right walking past a person in need regardless of my job or education.

From the other direction, when I ran way out into rural areas I was on more than one MCI where I was pretty stoked to have an offduty EMT or medic who was already on scene with a report and vitals for 5 patients when the next unit is 25 minutes out. The same goes for showing to a scene half way up a mountain to find a passing WFR has controlled the bleeding, taken a history (on the now altered patient, nice to have that info), and applied more clothes.

 

[Stevo]

so we're going to foist licensure and insurance concerns to hide behind Jeepmedic/b] ?

mighty thin

in fact anorexic....

sure, next time i see someone in pain w/o apparent help, i'll keep that in mind....

~S~

 

[jeepmedic]

so we're going to foist licensure and insurance concerns to hide behind Jeepmedic/b] ?

mighty thin

in fact anorexic....

sure, next time i see someone in pain w/o apparent help, i'll keep that in mind....

~S~

In todays world you better. If someone can sue McDonalds and win for spilling coffee on themselves then you can bet they can and will sue you. It is not that I want to watch someone die or be in pain but when things go wrong a lawyer will look for anyone he can to get money from because he doesn't get paid unless he wins money so he will come after you. Like I have said before Take up Golf

 

[Stevo]

i really never could see the point of wacking a small object around the lawn Jeepmedic, other than one is allowed to get a good buzz on at $8 a brew (although i suppose having them served via golf cart bars by scantily clad help makes it worth it for the viagra crowd)

and surprising enough, lawyers merely do the bidding of what any given populance asks of them

as such, my mates are my best CYA for those twilight zone calls

at the end of the day, sorts like me and you can only rubberneck to a certain point

that's why we're in this crazy biz...

peace out brother

~S~

 

[jeepmedic]

i really never could see the point of wacking a small object around the lawn Jeepmedic, other than one is allowed to get a good buzz on at $8 a brew (although i suppose having them served via golf cart bars by scantily clad help makes it worth it for the viagra crowd)

and surprising enough, lawyers merely do the bidding of what any given populance asks of them

as such, my mates are my best CYA for those twilight zone calls

at the end of the day, sorts like me and you can only rubberneck to a certain point

that's why we're in this crazy biz...

peace out brother

~S~

Golf is a good 3 to 6 hour trip away from everything (read: wife)


And no I don't want a lawyer bidding on my house

 

[Stevo]

(read: wife)

to be honest, after 2 of them rippin' me a new a**hole , i would have fared much better out on the green

can i get a Cap & Coke out there?

~S~

 

[jeepmedic]

Cap and Coke would go good with a round of golf.B)

 

[Stevo]

come to Vermont and it's on me Jeepmedic

~S~

 

[jeepmedic]

To d@m* cold. We have to meet at the beach and play around.

 

[ffemt8978]

If I am out of my Dept.'s response area and stop for a fender bender and get stuck because I am the only one there and My Dept. has an ALS call then who gets the justice? I am on of only 2 ALS providers in my Dept. it is a Volly Dept. and we only have 2 Als providers that respond. I try to provide services for the Dept. that I am in. If everyone is out walking around then I will not stop but if it just happened then I will stop and call it in.

What's the difference if you're out of your response area shopping or stopping to assist at an accident? Either way, when you're out of your area, you're removing 50% of your ALS coverage.

 

[trauma1534]

What's the difference if you're out of your response area shopping or stopping to assist at an accident? Either way, when you're out of your area, you're removing 50% of your ALS coverage.

I think what Jeep is trying to say here if I may add, here where we are, in Virginia, it is policy that when you are outside of your OMD's area, then you are no longer working off of his licence. Thus, if you practace any skill out of is licence area, it is viewed as practacing medicain without a licence. Sad, but true. We in Virginia have to be careful about that. I live in a different area than my OMD now, so if I stop at an accident here, I am practicing without a licence, until I can become affiliated with an agency here locally. Where I work EMS, is 1 hour and 15 min away.

Another way to look at it, and this is absolutly no disrespect ment, but it is a difference in the way that you look at things when you are a career provider, verses a volunteer. For alot of reasons. In this case, our certification is our livelyhood. If we do anything to loose it, we loose our jobs. No offence toward volunteers by any means, but they don't have as much to loose as we do. If they loose thier certs, they can still eat, stay warm, and have a roof over thier heads, they just can't volunteer anymore.

There should be no difference in the professionalism between volunteers and career providers when it comes to the public eye... they should not be able to tell the difference. However, alot of times it is. I know I tend to be a little extra attentive to how I handle things involving my certification.

That is a big reason why I am not so eager to run up on a scene that I am not dispatched to. Am I guilty of it? Sur I am at some times, we all are. When I am in my OMD's area, I'll stop some. But, outside the area, it has to be pretty bad for me to stop. I've done it, but I put myself and my livelyhood out on the line when I did.

 

[jeepmedic]

If a Dr. from Hospital A is visiting his wife in Hospital B, and there is a major MCI do you think he will just "stop" by the ED and help out? Nope he does not have privalges in hospital B then he can not practice there and he will not. Because he will lose his Medical Lic. Same thing here.

 

[Summit]

If a Dr. from Hospital A is visiting his wife in Hospital B, and there is a major MCI do you think he will just "stop" by the ED and help out? Nope he does not have privalges in hospital B then he can not practice there and he will not. Because he will lose his Medical Lic. Same thing here.

If a Dr. from Hospital A is visiting his wife in Hospital B, and then someone collapses in the parking lot as he drives in, do you think the Dr is just going to call 911 then just stand there and watch?

Who freaking cares what letters are after you name. Nobody is telling you to break the law. ARE YOU A GOOD SAMARITAN OR NOT?

 

[AnthonyM83]

to add, there is no 100% safety net in the rescue biz, when we signed up we signed up for the inherent risks in order to help people

I'm guessing you're on the young side. I don't say this as an insult in anyway, but when I was younger and a police explorer, this was my exact mentality. But when you get on the job, they pound it in your head the whole extreme imporance of putting your safety first. The result is you still put yourself at risk, but a lot less.

Also, with age, I don't know what it was exactly. Maybe just getting over the indestructable teen phase (not that I thought I was indestructable, I just didn't mind taking chances)...but then you get older and something clicks. Not sure what it is, but you now value your safety more. You think about the grief you'd give your own family if injured or all the different ways you could be permantently injured (but not dead).

I'm still relatively young, though, and I know I'm willing to do things older guys aren't...because I still crave a bit of the adventure. But I bet when I get marrried and have a kid, something else will "click" and my mindset will change.

Not to say you don't put yourself at some risk to help people, but you keep safety and consequences more at the front of your mind. It's hard to explain...but I remember myself once arguing that it'd be ridiculous not to help a lady on the street getting her purse stolen. People tried to explain that the guy could just turn around and shoot you....all over some stupid money, but I didn't get it...now I do. (Of course, if she were being harmed, it'd be different...but just an example of mindframe shifts and why some people might be replying with posts that surprise you).

But of course I really doubt anyone's going to just drive past someone whose seriously injured...but it's not worth it to stop and run around at each accident if it looks okay just from you slowing down and looking at it and everyone's calm walking around and little body damage seen.