Using EMT Skills off-duty

[djarmpit]

So I've come to the conclusion that although I've learned good amount of BLS through my EMT program, I think I'm pretty useless when I'm off-duty/not around any equipment.

I witnessed a car accident and stopped to help the driver (who had already gotten out of the car), trying to see if he was injured or had any spinal injuries. Afterwards I was visualizing my "scenario" I was kinda confused because I wanted to grab equipment that I didn't have to further help this guy out.

I got into EMS because I wanted to know how to handle situations when my friends/family become sick or injured and without things such as oxygen, bag-valve masks, splints, and possibly a blood pressure cuff by my side I don't think theres much I could do except for call 911.


Any thoughts? Does anyone feel that they are able to use a lot of the skills they know when off-duty?

 

[mycrofft]

"With age comes wisdom, young Grasshopper".

First thing is that you were trained NOT to try stuff which could likely have further injured the victims. (Well, SECOND, after scene safety). Knowing what NOT to do is the second thing after scene safety.

Correct, equipment is needed to DO much beyond basic first aid...except evaluating severity of injuries, making a scene assessment to use when calling 911, and maybe helping take control of the scene before EMS/LE arrives (tell people to shut off their ignitions and take their keys with them, stop trying to pull their friends out of the wrecks by their heads, etc).

Confusion, especially at first, is most common. "What's goin' on here?" is the first question. But it kicks in, starting with safety safety safety.
THEN you need to know how to release to LE /FD/EMS when they arrive, or even acknowledge to your self that you do not control the scene and just do your best.

Keep some traffic triangles, a small spiral notebook and pencil, and a safety vest in your trunk, keep your cell phone charged and with you, and you have just taken the first step.

 

[Medic Tim]

So I've come to the conclusion that although I've learned good amount of BLS through my EMT program, I think I'm pretty useless when I'm off-duty/not around any equipment.

I witnessed a car accident and stopped to help the driver (who had already gotten out of the car), trying to see if he was injured or had any spinal injuries. Afterwards I was visualizing my "scenario" I was kinda confused because I wanted to grab equipment that I didn't have to further help this guy out.

I got into EMS because I wanted to know how to handle situations when my friends/family become sick or injured and without things such as oxygen, bag-valve masks, splints, and possibly a blood pressure cuff by my side I don't think theres much I could do except for call 911.


Any thoughts? Does anyone feel that they are able to use a lot of the skills they know when off-duty?

When off duty you are functioning as a first aider. There is very little you will be able to do. Most times the best and safest thing to do is keep on driving and let the responding crews handle it.

 

[JakeEMTP]

Calling 911 is first. Sometimes new EMTs who are off duty waste time running into a scene and wanting to do a body count before calling 911. This wastes minutes when all you need to do is say car wreck with x number of cars unless you can see something clearly from your approach.

Scene safety is next. Sometimes keeping yourself and others away from the scene is all you can do.
Sometimes not stopping at all is what you should do. If it is unsafe to park you can endanger yourself, your family if they are with you and anyone else driving around you. If you do not have the proper reflective wear to make yourself visible, you put yourself in danger. Causing other injuries or deaths is not helping.

You can tell others what to do if it could cause harm but don't engage in a physical confrontation if they don't comply.

The basic ABCs are next. Some newbies rush in to slap on a oxygen mask or jam hard plastic objects into the patient's face but forget about just simply opening the airway which then allows you to assess other problems like foreign body, broken teeth or avulsions obstructing the airway. Remove only what you can see and safely do without losing fingers or having a bite that breaks the skin and could haunt you for the rest of your life.

But again this is only if you can do this safely.

Sometimes compressions only CPR is what you could do.

Sometimes just a calm reassuring manner informing that help is on the way is all that you can do.

 

[EMT91]

One of my lab instructors said a lot of callers call then leave and it makes getting further info hard. It might be a good idea to stay and explain to the first responders what you saw. Also if you let the potentially injured know you are an emt they may feel more at ease.

 

[JakeEMTP]

One of my lab instructors said a lot of callers call then leave and it makes getting further info hard. It might be a good idea to stay and explain to the first responders what you saw. Also if you let the potentially injured know you are an emt they may feel more at ease.

A lot of callers don't leave a name or call back number. They wish not to get involved for a number of reasons. If they stay, chances are they will be told to leave the scene by EMS when they arrive and never get a chance to say anything.

If you witness a collision and it is not safe to pull over like on an interstate driving 70 mph and having to cross 6 lanes of traffic in your own car, you can give your name and number when you call to be contacted if more info is needed.

If you announce you are an EMT but can only do the minimum, some might question why you are not doing more. If you announce you are an EMT but have no ID on you, expect to be questioned by a Police Officer.

The problem comes mostly when it involves a crime with bodily injuries or death. Alot of people don't call and will immediately leave. Those who do call may not want to be involved anymore than the phone call reporting a crime with injuries. This could be out of fear of being harmed themselves or legal issues. Unfortunately doing the right thing when it comes to reporting a crime, especially with bodily harm, sometimes penalizes the caller with loss of work days or the fear of harm for themselves or their family. Their own lives go under a microscope. But, if it is a bloody MVC with mangled bodies expect everyone to hang around which is why the scene must be secured by EMS, Fire and the Police.

 

[EMT91]

A lot of callers don't leave a name or call back number. They wish not to get involved for a number of reasons. If they stay, chances are they will be told to leave the scene by EMS when they arrive and never get a chance to say anything.

If you witness a collision and it is not safe to pull over like on an interstate driving 70 mph and having to cross 6 lanes of traffic in your own car, you can give your name and number when you call to be contacted if more info is needed.

If you announce you are an EMT but can only do the minimum, some might question why you are not doing more. If you announce you are an EMT but have no ID on you, expect to be questioned by a Police Officer.

The problem comes mostly when it involves a crime with bodily injuries or death. Alot of people don't call and will immediately leave. Those who do call may not want to be involved anymore than the phone call reporting a crime with injuries. This could be out of fear of being harmed themselves or legal issues. Unfortunately doing the right thing when it comes to reporting a crime, especially with bodily harm, sometimes penalizes the caller with loss of work days or the fear of harm for themselves or their family. Their own lives go under a microscope. But, if it is a bloody MVC with mangled bodies expect everyone to hang around which is why the scene must be secured by EMS, Fire and the Police.

Of course prudence is needed. . I was more thinking of just in regular city streets. And of course scene safety is a needed thing. I was merely thinking that if you are able to safely provide some info, whether it be to the dispatcher or to the arriving crew. I would say something like this to the people involved "Hi, my name is EMT91; I am a certified EMT, but I am not on duty so I do not have my gear to help much, however I have called 911 and they are on the way. If you would like, I will stay here if it will make you feel better or calmer, for whatever reason." I do not recommend being a Ricky Rescue or Hubert Hero; I do recommend doing what you can if you can provide assistance, even just emotional support as long as it is safe. The point about callers is from what my instructor in lab told me was that they will call and say "There was an accident on 123 street." and the dispatcher may ask "how many cars were involved or was anyone walking around or anything?" and the caller will say "Oh, I don't know- I am ten blocks away." Again, perhaps my lab instructor is mistaken, and if so, I apologize for passing on the info.
You summed it up very well- "Sometimes just a calm reassuring manner informing that help is on the way is all that you can do." I apologize if I seemed to suggest unsafe or otherwise foolish things.

 

[djarmpit]

Thanks for all the replies! Now in cases other than a car accident (medial emergencies) what would you guys do? Obviously call 911 if you want to get involved and scene size-up but is that pretty much all there is until the on duty guys come?

 

[Medic Tim]

Thanks for all the replies! Now in cases other than a car accident (medial emergencies) what would you guys do? Obviously call 911 if you want to get involved and scene size-up but is that pretty much all there is until the on duty guys come?

There still isn't much you are going to be able to do. Don't call 911 unless the pt wants you to*.

*feel free to call if they are not breathing or anything like that.

 

[Handsome Robb]

Don't call 911 unless the pt wants you to*.

This.

If you want to help go for it but I'll guarantee most crews will be pretty agitated with you if you call for someone and that person didn't want you to. Makes more paperwork for us and runs like this generally happen while we are waiting for our food, which we have already paid for, to be finished.

 

[Veneficus]

Make a reasonable guess if my getting involved would change anything.

If yes, if it is safe perhaps some basic interventions.

If no, call 911 as I move on.

 

[the_negro_puppy]

Ahhh this is nothing new.

Person joins the world of EMS etc and suddenly has fantasies about using their skills off duty to save the world.

Let me say that if you are driving past an MVA, it seems to be relatively minor with the occupants out, walking around with no major injuries then there is no reason to stop. By stopping at a crash you are putting yourself at unnecessary risk/danger. You are not at work and will not be covered if you are hit by another rubber necking idiot. Try explaining to your family that you are a paraplegic because you topped to play EMS super hero at a minor nose-tail MVA.

Not only is it dangerous but what exactly are you going to do with no gear or equipment? take a radial pulse and GCS?

The only time I would ever stop to help in a trauma or medical call is if the person was unconscious, bleeding severly or had an immediate life threat such as airway, cardiac arrest.

As you move on in your career, you will be less and less inclined to stop and play EMS superhero while you are off duty. Once you have been in the job a while you will realise there is very little you can do other than CPR and call 911

 

[djarmpit]

Ahhh this is nothing new.

Person joins the world of EMS etc and suddenly has fantasies about using their skills off duty to save the world.

Let me say that if you are driving past an MVA, it seems to be relatively minor with the occupants out, walking around with no major injuries then there is no reason to stop. By stopping at a crash you are putting yourself at unnecessary risk/danger. You are not at work and will not be covered if you are hit by another rubber necking idiot. Try explaining to your family that you are a paraplegic because you topped to play EMS super hero at a minor nose-tail MVA.

Not only is it dangerous but what exactly are you going to do with no gear or equipment? take a radial pulse and GCS?

The only time I would ever stop to help in a trauma or medical call is if the person was unconscious, bleeding severly or had an immediate life threat such as airway, cardiac arrest.

As you move on in your career, you will be less and less inclined to stop and play EMS superhero while you are off duty. Once you have been in the job a while you will realise there is very little you can do other than CPR and call 911

Obviously I am still new to all of this and have much to learn, but it's only natural for me to offer my hand to someone when I feel like I can help (regardless of whether or not I was an EMT) . The reason why I started this thread was just to see learn how others approached situations whether medical or trauma during their non-working hours.

I appreciate all of your responses and do know better now that it's always best to go back to the basics and start by protecting the most important person, yourself.

 

[DrParasite]

as a 911 operator, I say this: CALL 911!!!! I would rather get a dozen calls about an MVA than 0. If I send a cop, great. If I send an ambulance, great. if I send a fire truck, helicopter, SWAT team, great. you give e the information, let me do my job as I am trained to

The reason I want everyone to call is to make sure I know where the crash is.

if you want to play Ricky Rescuer (and yes, i have, turnout gear and all), go for it. just do it after you call 911, so I, the dispatcher, can get the appropriate resources started to the scene while you are doing your thing. Holding c-spine, basic assessment, even telling the cop to start a chopper (or not in my case) when he asks, you won't be able to do much without the proper assistance.

and of course, once the local authorities say they got it, give them a quick report, and let them do their job, and get out of their way (unless they ask you to stay).

The other thing that would benefit the 911 operator is saying what is going on (2 car mva, 1 entrapped, 4 injured, 1 overturned, bus involved, etc), after identifying yourself an off duty EMT. it might not change my response, but there are times where I would upgrade a response based on a callers information.

 

[CANDawg]

There still isn't much you are going to be able to do. Don't call 911 unless the pt wants you to*.

*feel free to call if they are not breathing or anything like that.

I don't agree with this. I think it is best if you use your discretion, rather than blindly follow the directions of someone that just went through a physically and mentally stressful incident.

Remember that calling 911 doesn't necessarily mean the calvary will come. Let the 911 operator know what you see, and let them make the call. In most cases there should definitely be LE on the scene to help manage the incident and direct traffic. (Except in maybe a minor fender bender as long as the vehicles can move off the road.) If an EMS crew gets dispatched, c'est la vie. They'll blame the dispatcher, not you, and maybe even see something you missed.

 

[Medic Tim]

I don't agree with this. I think it is best if you use your discretion, rather than blindly follow the directions of someone that just went through a physically and mentally stressful incident.

Remember that calling 911 doesn't necessarily mean the calvary will come. Let the 911 operator know what you see, and let them make the call. In most cases there should definitely be LE on the scene to help manage the incident and direct traffic. (Except in maybe a minor fender bender as long as the vehicles can move off the road.) If an EMS crew gets dispatched, c'est la vie. They'll blame the dispatcher, not you, and maybe even see something you missed.

My quote above was in regard to a medical call. For a mvc 911 should be called.

 

[emtCstock]

There is really not much anyone can do without proper equipment. I've been in this situation, and unfortunately had nothing at my disposal. It sucks, especially if you know what to do and what you need for the particular scenario.

 

[NYMedic828]

If I pull up alone on an MVA, I will hold C-Spine until an ambulance arrives. Even if that means for 25 minutes!







not serious.

 

[mycrofft]

Remember : "check-call-care"!

 

[EMDispatch]

The reason I want everyone to call is to make sure I know where the crash is.

I cannot emphasize that point enough...Working dispatch in an area with heavy tourism traffic, and lots of long empty stretches of road it's a total nightmare. We often get locations for accidents 5-10 miles away from the actual location.

Pt info is also great, in our system it can allow us some discretion on pre-alerts for helicopters,etc. I tend to take reports from first responders more seriously, but the caller may also be lying (normally easy to tell by the jargon used). Also when we're flooded with calls for the same incident I may have to be less courteous than I like, just know that it's nothing personal.

When it comes to stopping... listen to your gut. In portions of our county it can take hours for accidents to be discovered. Whenever I come across an accident or a car in a ditch I stop (when safe) just to make sure everyone is ok.