Rollover on Freeway off-duty.

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exodus

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I asked this question in the thread where there's the video of the civilians pulling a guy from a rolled over car on the freeway. I was really wondering off-duty what should an EMT-B/I/P do. IMO. I would get some people to help hold c-spine and pull him out if I see any signs of head trauma to relieve pressure off of the brain. And this is just out of my *** - but wouldn't it be harder to breathe while your upside down, especially since after a car accident, the wind has probably been knocked out of them. And they have to work more to even get a normal breathing rhythm back? So getting them out and laying flat would be beneficial? And remember, we're on a busy Freeway, so true EMS response is maybe 10-15 minutes because of congestion.
 
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I am glad you asked this. This has never been discussed before on these forums.
 
bstone said:
I am glad you asked this. This has never been discussed before on these forums.
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Yeah, figured it would be a good discussion because of all the indications and contradictions of extrication. And this is something where it won't be do xxx always, or never do xxx. And honestly, I really want to know what to do at a roll over MVA because that's a whole new type of scene compared to a standard one where you jump in the back seat and hold their head if you're off duty.
 
bstone said:
I am glad you asked this. This has never been discussed before on these forums.
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FYI: that was sarcasism.

I would dial 9-1-1; unless there was a good song on.

R/r 911
 
This isn't a discussion of should you stop or not, this is a discussion of what is the best course of action that you could do while you are there before EMS arrives. Obviously make sure someone calls 911 and that bs, but as far as what is most beneficial to the patient, what is the best? If they have head trauma, just leave them trapped in upside down to keep the pressure on the brain way high up?

And I did search, and according to that, we have not discussed roll-overs specifically, and they are different than regular MVA's - http://www.emtlife.com/search.php?searchid=668904
 
There is likely nothing useful that you can do for these patients that is worth the risk that you are taking (both liability and otherwise).
 
There might not be anything useful you can do, but you could stop bystanders from doing something stupid.
 
Ridryder911 said:
FYI: that was sarcasism.

I would dial 9-1-1; unless there was a good song on.

R/r 911
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Hehehehe

No, really. About ten others have also dialed 911 on a busy freeway. Stay in your car and continue to your destination.
 
Only stop if you saw the accident. if not the most helpful thing you can do is keep driving and stay off the scene. one dead patient is better than one dead and one injured patient.
 
Sasha said:
Only stop if you saw the accident. if not the most helpful thing you can do is keep driving and stay off the scene. one dead patient is better than one dead and one injured patient.
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Buuuuuuut Sasha, I'm an EMT. Shouldn't I try to save the world?
 
Sasha said:
Only stop if you saw the accident. if not the most helpful thing you can do is keep driving and stay off the scene. one dead patient is better than one dead and one injured patient.
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i agree with sasha. i've only stopped, when i was off duty, at wrecks that i've witnessed. now if i was in an ambulance, without a patient, i would stop if ems hadn't made it yet and hold cspine and prevent people from doing something stupid.
 
amberdt03 said:
i agree with sasha. i've only stopped, when i was off duty, at wrecks that i've witnessed. now if i was in an ambulance, without a patient, i would stop if ems hadn't made it yet and hold cspine and prevent people from doing something stupid.
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What if your on your way back to the station and you have food waiting. Not cheapo food, but like REAL food? Then what ;)
 
I stop if I saw it happen, call 911, and prevent the other bystanders from doing something stupid, that's it. PT stays in their car unless they get themselves out, then I'll sit them down and hold c-spine.
 
It depends completely on where the accident took place. If it's a busy thoroughfare with lots of traffic, I'm not going to stop. I'll probably call it in to dispatch, but through the office line and ask them how many calls they've gotten on it already.

Often in my area, I may be the only one aware of this wreck or the only one to pass it in several hours. There was a wreck some time back where kids entrapped in a car died because the water rose and drowned them. None of the actual wreck caused injuries were fatal. But deserted highway in the middle of the night, no one saw them.

Not reporting an emergency is actually a misdemeanor in my state. Of course, it has to be proven that you did see it, did have the ability to call and didn't.

I'm not going to put myself at risk over someone else's emergency. I would have to be able to pull off the road safely and to a secure spot. I would have to have tools at my disposal that would be of assistance. I would probably set out some flares, check for injuries and call it in to dispatch. If I stayed, and what action I might take would depend on the ETA of the responding agency. If its on one of those stretches of road where the response time is a half hour plus, I'm more likely to stop and provide what assistance I could. If its closer to a station I would probably just phone it in and keep driving.

There are few absolutes in this situation for me.
 
Lets look at a scene like this.

You have an overturned vehicle. This is an unstable scene and should not be entered until vehicle is stabilized!

You have a pt that is straped in, upside down. you have no equipment. How are you planning on removing this pt, alone, without preventing more injury?

Best you can do is call 911, keep bystanders away, and keep pt calm. All without entering an unstable vehicle!
 
I would stop and assist ONLY if the scene permitted or my actions were imperative to the pt's survival. I have a moral obligation to stop and offer my assistance.
 
Just for a smidge of clarification... When I say stop if witnessed, I mean stop and wait for rescues and PD to arrive to provide information. Not to stop and provide care.
 
Our county 911 actually asks the civilians to stop.

http://www.alleghenycounty.us/emerserv/911/news.aspx

Unfortunately, many people want to dial 9-1-1 from their cellular telephone, but then cannot or will not answer the questions that are asked by the emergency call taker. Dozens of cellular 9-1-1 calls are often received for the same vehicle accident. This can overload the 9-1-1 system. Please remember the following rules for cellular 9-1-1 calls:

- Do not dial 9-1-1 if you are unable or unwilling to give an accurate location of the incident.

- If you truly want to help, stop and collect the following information.
Are there any injuries? If so, how may people have injuries? This information will determine the number of ambulances to be dispatched.
How many vehicles were involved? This information is required by the police.

- If the incident has occurred at a busy location, and you are not willing to stop, please don't tie up lines dialing 9-1-1. Let someone call who is willing to stop. If the incident is at a remote location where you may be the only caller, then you should call even if your are unable or afraid to stop.
 
Hockey9019 said:
What if your on your way back to the station and you have food waiting. Not cheapo food, but like REAL food? Then what ;)
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lol. well considering i work for a transfer service and the fact that we post at hospitals and not a station, i don't think it applies to me.
 
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