Scene-Safety/ Laws protecting EMS professionals

[Maya]

I'm pretty new to EMS, just got my EMT-B License and looking for jobs. I hear a lot about the dangers that EMTs and paramedics face on calls, and what worries me the most is scene-safety, as you never really know what you're going to find on-scene. You may be told one thing by dispatch and then you find the situation is something entirely different when you walk on-scene.

In particular, 5150's, domestic disputes, alcoholics, and drug-addicts (PCP -- yikes!) worry me the most (not to mention patients falsifying claims and unjustly suing EMTs/EMS providers).

Those of you who have been in the profession for some time, do you have any advice or stories? One of my EMT instructors always emphasized CYA (cover your ***) with respect to documenting EVERYTHING and managing c-spine on patients who clearly don't even need it. This would protect against potential lawsuits. Do you have any other advice?

Do laws even properly protect us? If I get attacked by a patient, not only are my health and well-being compromised, but also, potentially, my source of income, as I may be unable to continue working in EMS. I'm rather skeptical that employers/insurance companies will sufficiently compensate me, were something to happen.

One thing that really pissed me off, when I learned about it in EMT class, was the Good Samaritan Act (I don't know about other states, but here in CA, it doesn't really protect you). We put our lives on the line when we stop to provide help in an emergency. The person you're helping can then turn around and sue you, if something goes wrong. I hate to say it, but since I'm not legally protected as a certified EMT, I wouldn't stop to help someone in an emergency when I'm off-duty. I *HATE* to say that! It just isn't worth it to me to put my EMT License on the line, not to mention, my income and every penny I own (although that's currently in the ..uhmm, negative.. lol).

Any opinions? Stories? Advice? I'm hoping to work in Oakland, and as I know it's not exactly the safest place, I'd really appreciate any info or advice, so I have a good idea what I'm getting into.

 

[Shishkabob]

You can't stop a lawsuit. Period. Even if it has no basis, they can still sue you, and you'll still have to pony up for a lawyer until the case gets tossed.


In many areas, attacking an EMS provider is akin to attacking a Firefighter or LEO--- a felony. Having said that, it still doesn't stop people. It's just part of the job, really. Not saying don't be scared because if you're not scared you're being naiive, but don't let it take away sleep or ruin your life.


Just in my clinicals, I was kicked, hit, smacked, spit on, bit, and pushed. Just for EMT class! But always your life over someone elses. Your priorities are you, your partner, the public, and THEN the patient.



If you get to a scene where you feel unsafe, or the call is dangerous in nature, you better get on your radio and call for LEO backup. They will get there and help you.

 

[Seaglass]

What Linuss said. When in doubt, call PD and wait.

I remember hearing in class that if you're on duty when you stop to help, your company should have some sort of insurance against lawsuits. And if someone's looking for money, usually they won't sue an individual EMT--there's not much money to be had.

One of my instructors also suggested not identifying yourself if you help a patient off-duty. Not sure if that was good advice or not.

 

[Sapphyre]

In many areas, attacking an EMS provider is akin to attacking a Firefighter or LEO--- a felony. Having said that, it still doesn't stop people.

In California, yes, it's akin to attacking a firefighter or LEO, but, it's not a felony unless the attack would otherwise be a felony. It does get the attacker double the sentence though.

 

[VentMedic]

It just isn't worth it to me to put my EMT License on the line, not to mention, my income and every penny I own (although that's currently in the ..uhmm, negative.. lol).

In all honesty there is not too much that a certified EMT can be sued for if you follow your protocols and document. The scope is very limited in CA.

You may be told one thing by dispatch and then you find the situation is something entirely different when you walk on-scene.

You call for PD and don't take chances for any call and patient that you believe poses a threat to your safety.

when I learned about it in EMT class, was the Good Samaritan Act

The Good Samaritain Act is intended for the lay person and not someone who holds themselves out to be a health care professional.

5150's, domestic disputes, alcoholics, and drug-addicts (PCP -- yikes!)

You will deal with these patients in whatever area of medicine you work. You remember they are being taken to the hospital for a reason and you must not just them just for their lifestyle. Their medical issues take precedence over your own emotions and you must remain professional to provide quality care.

I have to ask, why are you going into EMS? You seem to so far have complaints about the pay, education, expense, lawsuits, safety, alchoholics and drug addicts for patient and I'm sure I have left out something from your posts.

Have you truly devoted some time to seriously think about EMS being something you really want to do?

 

[Maya]

VentMedic, that's why I'm on here! I haven't been in the field yet, so that's why I'm asking questions from you guys who do have experience. I just got offered a job though (yay!)

I don't mean it to sound like I'm complaining, they're more concerns about things I've heard and would rather find out about on a forum than find out first-hand. I'd rather go out into the field prepared than go out there not knowing what to expect and either getting injured or doing something that would put my EMT license at risk.

I've also found that my first impression of EMS was very different than the reality, in terms of how private companies are run and how EMS is run through the FD. I'm still trying to figure it out, but the impression I get from some people is that they don't tell you the *whole* truth because it's not PC. I think there's still a lot I don't know and will have to find out by experience.

The thing about the Good Samaritan Law (it may be different in other states), does apply to EMS professionals, when they are off-duty. Because you have an EMT or paramedic license, you are *not* protected in the same way that a civilian is, so essentially, the law does not protect you from an illegitimate law suit.

All in all, I think EMS is fantastic and I'm really excited to start my career! I really admire what you guys do. I just want to make sure that I avoid any stupid mistakes or anything that could jeapordize my health, safety, wellbeing, or my future career.

I appreciate the advice from all of you

 

[Maya]

The thing about the Good Samaritan Act, also, is something I was warned about by my teachers and other paramedics. I'm not making that up. Multiple people have told me that they would not stop at the scene of an accident, because of fear of litigation, so I don't think it's just me who's concerned about that.

 

[VentMedic]

The thing about the Good Samaritan Act, also, is something I was warned about by my teachers and other paramedics. I'm not making that up. Multiple people have told me that they would not stop at the scene of an accident, because of fear of litigation, so I don't think it's just me who's concerned about that.

There are many of use that may not stop at every accident scene but will use our cell phones to dial 911. There are also many reasons and most of them have to do with our off duty safety. Few of us are dressed appropriately or have equipment on us to be of much use. As well, our own POVs may create more problems at scene. We may also not want to put our family who might be in the car in harm's way by parking along an interstate or some narrow highway. It is not always about the litigation. However, I am also not going to run up yelling I'm a Paramedic either if I'm off duty and do decide to stop. I will identify myself only to those that need to know which may be LEOs. I will do only what I am capable of without equipment. I will not do anything invasive or move any patient unless absolutely necessary. Essentially I will be acting as a layperson. As long as I stay within those guidelines and don't try to play hero, I do not fear lawsuits.

 

[Maya]

Oh, I guess I didn't really answer your question about why I want to go into EMS. I've put *a lot* of thought into it, and I guess me inquiring about things might seem like complaining, because it's hard to express intentions or emotions when you're writing without putting smiley faces all over the place.

My concerns, though, are because I'm going to be working in Alameda County -- hopefully, eventually in Oakland, which has twice the incidence of violent crimes, as compared to any other city in CA. I would be pretty naive if I thought EMS was all puppy-dogs and rainbows.

I want to work in Oakland, in particular, because I'll hopefully get more experience, more quickly. I have no intention of prejudging someone or giving them a lesser quality of treatment based on their lifestyle. It's exactly the opposite, I am a strong advocate for equal rights and community service. I lived in an apartment in LA that was run by a slumlord, so seeing how people lived there has made me feel very strongly that I need to get involved with community service, helping those who have less advantages in life than the rest of us. Trust me, I'm the last person to judge others! I was actually seriously depressed when I lived in that place and was pretty crushed by the fact that I was completely helpless to help the people who lived there and had recurring nightmares about it for a year-and-a-half afterwards, but that's an extremely long story. Essentially, it's almost impossible to do anything about slumlord-managed properties. But that's why I really feel like I need to be in a job that allows me to be involved in community service.

I love medicine, I love EMS! I'm done with my long-winded rant now, but I think you're reading what I said the wrong way.

 

[WuLabsWuTecH]

I would have serious doubt about stopping to help at the sceen of an accident that I am no involved in and do not know the people involved in. Let the people on duty do their job. Nowadays, the litigation is so out of control it's usually not worth it. Remember, as someone already mentioned, take care of yourself first, then your partner, then the others responding at the scene, then the patient. Don't turn a scene with one victim into a scene with more than one victim.

An option is also to get personal malpractice insurance. I don't think its that expensive, and it would allow you to help neighbors, friends, acquitances, they lady behind the counter at the gym you workout at, etc. without fear of being stuck with the bill of litigation. You may still get sued, but most if not all of your expenses will be covered. They'll provide a lawyer, and they also give you liability coverage up to $x amount if you are found liable. Among other things they also provide lawyers to help you if your license is ever suspended or if there are professional hearings against you. I'm not really sure of all the details, but while you may still have to spend some time being dragged to court, they'll protect you as best they can b/c it then becomes the insurance company's money on the line and they'll fight to keep it.

One thing though, if you do get insurance don't let anyone know about it, not your friends, and definately not your employer. People won't go after EMTs since they don't think they have deep pockets, but once they find out you have a 10 million dollar insurance policy, they might come after you. I heard its about 10 bucks a month paid a year at a time--it might be well worth it for your peace of mind.

Finally, a word about scene safety. You'll get a feel very quickly about what scenes are safe and what feels wrong. If you start out doing IFTs, then you don't have to worry about this and you can focus on getting the basics down a bit more. Otherwise, listen to the dispatch--for me and the rest of my department, there are calls that automatically cause us to stage until the PD get there, no exceptions. These are usually: Injured from assault, stabbing, shooting, attempt. There are a few others but its obvious. Then there are those that you'll need extra help to control the scene--in a large crowd like an amusement park, at a festival, at a concert, auto accidents and freeway assignments, anything at a school etc. These are generally not inherently dangerous calls, but are only dangerous because of the environment they are in. Especially at the scene of an auto accident, make sure you block off enough lanes and enough real estate of the intersection to be able to move around comfortably and not have cars wizzing by you.

Other enviornmental factors: fire-stay out, let the guys from the engine get the victim out to you, lines down: we wait for the rescue and the power company to come in.

Lastly, as stated, use your common sense and determine what could possibly a dnager in the situation. For example: Dispatched for "Animal bite" ask where the animal is. can't figure out where Fido the pit bull is? call for PD or Animal control. If you get there and the scene looks weird or out of place, stay away until you get more people. Dispatched for "Man down" and when you turn on the street theres yelling between two groups of young males. Let's get some help before we go in huh?

There will be plenty of ways to kepe you safe, ballistic vests, BSI equipment, bright yellow street jackets for visibility, helmets and gloves for MVAs, more BSI equipment, Hazmat protection equipment, yet more BSI equipment. Learn how to use these, but remember that none of them are more helpful than your intuition and common sense.

 

[Maya]

That's really good advice about the personal malpractice insurance. I didn't even think about that. Especially if it's only $10/month, that's nothing. Definitely worthwhile, if only for the peace of mind. Thanks

Oh, one of my teachers gave us pretty good advice, I just remembered it. He said you should try to remove the patient from a crowd as soon as possible. People take pictures and videos, also crowds can turn ugly if they don't understand what's happening. He told us a story about 2 people who were in a really bad accident and one of them was already dead, so they were working the other patient. Bystanders saw that they weren't helping the dead guy and thought it was a racial thing, starting getting violent against the EMTs. They had to load and go cause they thought there was gonna be a riot.

 

[WuLabsWuTecH]

Yep!

All that advice is good, but don't try to study it all and memorize it. If you payed attention in class, your instructors voice will be in your head when you need him there.

There are multiple other reasons you don't want people to crowd around. The fewer the people the better. that's why at nastier scenes its good to have PD there to cordon off an area so you can get to work. Same thing for accidents. The last MVA I ran on was a Motorcycle Vs Van right at the intersection leaving a neighbourhood. There must have been 50 or 60 bystanders, but because of the waywe parked the trucks, they knew to keep their distance and where the perimeter was even though PD did not block off the entire scene. The only people in the incident zone were the bystanders that were first on scene to help, the responders from FD and PD, the victims, and the family of the victim when they got there.
When there scene is well controlled, everyone is safe and the responders can do their jobs.