When Law Enforcement Prevents You From Helping A Patient.....

Again, I believe that you had a personal and bad experience, but to state that little or no investigation is conducted, or about the "good ole boy" mentality is a gross generalization. I'm frankly a little concerned about you being ashamed to be a Chicagoan, but then, I'm not from Chicago so maybe there is a reason for that. If that one bad experience is why you chose to mention it here, you need to get past it. I know of no public servant (police, fire or medic) who would allow you from treating "human beings," who need emergency medical attention. Of course, if you just wanted to do an assessment, that might not be the emergency that you imagined it to be.
 
I can see we will have to agree to disagree. I firmly believe, through my own experiences and the dozens of cases of police officers being arrested and convicted of brutality, that some (a minority) of LEOs have too big a chip on their shoulder. They hide behind the badge, gun and their departments do a miserable job in responding to complaints. Had it not been for the videos clearly showing the outrageous actions of the Chicago PD officers, the female bartender and the businessmen who were attacked for no reason at all would have been arrested, charged with bogus crimes and none of this would have ever made it to the news.

I respect Law Enforcement. My 1st cousin is the chief of the local PD. I was a Law Enforcement Explorer in my teens. But I have also seen scary, dangerous people who wield a badge and gun. More oversight and mandatory investigations are absolutely necessary.
 
I surrender. Thank God doctors are perfect or we'd be in trouble. Now, stop worrying and start studying. I'll still protect you.
 
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Okay, I have sit on the side lines and watched the comments. As one that has worked as a medic, and Police medic, I have seen both sides.

Yes, there are several gun toting, ego arse holes, that get their jollies from their job. Fortunately, there is a job that stills allows many of those characters to still be a bully. I have seen this attitude on all levels of LEO. Now, I have also seen quite the opposite as well. Personally, I don't care for many officers because of that type of attitude.

However; bstone, I am surprised that you were not arrested. It was technically still a crime scene. A felony had occurred (it was Federal property that was damaged) and it was his scene, not yours. Remember, it is common sense when an officer or something has just happened to one, to use prejudice's thinking. Emotions are running high, and that is definitely not the time be unaware of the situation.

Since this was technically a crime scene, they need to be sure that is treated as such. I don't know many troopers or officers that particularly want a "Johnny Be Good" rescuer to start impeding upon that. My troopers, local LEO, and even myself usually refuse "off duty" assistance. There is a reason! As well, they have been trained to recognize gross injuries and when and if need to call for EMS. Remember, they can determine and perform care, just as much as you can, since you are off duty (therefore, you are acting as a 1'st responder). I too once was naive. I have learned, on calls involving LEO, they will tell you when they need help. The same on fire scenes, and even medical/trauma calls with other medics... tread lightly. It is not so much ego, as it is at their discretion.. albeit good or bad, they are ultimately responsible... not you.

Now, with that saying, if you changed your outlook on LEO's on something as minor as describe, wait until you get into medicine. Unfortunately, I have seen more ego's and piss poor care that was intentionally delivered by physicians. Again, NOT all! I have seen multiple physicians and a Chief Resident refuse to treat or administer certain medications, get or obtain inadequate lab tests; perform unnecessary surgery, because of the appearance of the patient, or having poor social status, or the lack of money. If you don't think that doesn't occur, and still continues.. you need to rethink things. Medicine is definitely, not like it is on T.V. !

Again, not all physicians are so arrogant and lacking professional judgement, but I continue to see many that perform many procedures for their sake, not the patients.

Unfortunately, this is reality.. no matter where or what state you live in, it happens and unfortunately happens frequently.

Does this mean one should condone it? NO! However; one needs to know how to pick their battles and fight wisely. Reporting such behavior, has been the demise of many former[/] medical students. Change occurs within, and very slowly... like wisdom.

Remember, not education is received in the classroom... there is the school of life.

R/r 911
 
Rid,

It wasn't as if I ran into the scene. I approached the LEO at the perimeter, identified myself as an EMT and inquired if he needed assistance with those who were on the ground bleeding. (Yes, they were laying on the ground bleeding. I am not making this up.) He was enraged that I would even offer assistance and barked at me to get away. Which I did.

I don't think what I did was wrong in any way. If a civilian would approach the same LEO and ask "what's going on?" the LEO wouldn't have any grounds for arrest. What would be the charge?

It was painfully obvious that the LEO was so steamed about his car being dented and being inconvenienced by having to fill out the accident reports that he simply lost his temper and cool.

But consider the choice of evils: Assume that the patients were in really bad shape, but the LEO was so angry that he didn't care (this has happened in the past). What is an EMT to do? If you do nothing you are violating moral, ethical and possibly legal obligations to the patients. If you try to treat then you run the risk of interferring with an LEO and being arrested.

So....what to do?
 
Like I said, I have been in such dilemmas. Most states do not require off duty medics to render aid. Ethical, moral... hmmm that is a personal issue. Personally, I myself no longer stop or perform any medical care on my off duty status, nor do I know any professional Paramedics that do as well. This is usually from previous experiences such as you described or dealings from multiple rescuers of other EMT's, LEO, and nurses..

Chances are EMS is not that far away, and if they are conscious, then usually the injuries are not that severe. As well, I do not carry any medical equipment or jump bag with me either, I outgrew that years ago. I will however; call for a unit if one is not responding.

Really, other than getting tied up awaiting for help, holding C-spine or bandaging a few wounds here or there, what I am going to do? If the injuries are more severe than that, my first-aid is not really going to change the outcome.

By far, I am not condoning the LEO behavior, rather than attempting to allow you to learn off this call. There will be certain situations and predicaments, one has to swallow the bitter pill. Then there is situations, one has to be a patient advocate and fight... the decision on when and how is the hard part.

I am sure that the LEO was steamed about his cruiser being hit. Again, think of the situation.

Let me ask this scenario: If there is an officer struck by a GSW and a suspect that is shot as well, and let's say the suspect is slightly worse.. which gets transported first? ........

If you said the suspect, you need a life lesson. Rescuers and officers take priority.. Since the rescuers mind will be on their fellow comrades, get them out ASAP, that way work can continue. In regards of LEO, be street smart. Remember who covers your arse out there... not everything is black and white.

Yes, I have seen numerous of officers, yell and scream at people to get back in their car or proceed. Interfering with an investigation and producing an unsafe situation is a broad term, that can be used non-discreetly. I thought this was just the normal behavior of most LEO's. ;)

So to answer your question.. What would I do? Well, if I did so happen to stop. I would ask the officer if he needs help... If he says no and it appears to be a major trauma patient, then I would ignore him and take the chance. Deal with it later. However; if it was a non-major MVA; I would not stop. If I so happened to have to; I either would await for him to cool down, or ask another fellow officer later if they would like assistance or if EMS has been notified?

If it appears the scene is getting ugly, I much rather leave than be involved with such mess. Trust me, you may be right, but you will NOT win. He is legally responsible for them, if he is a real arse, get his name to later report him. The scene is not the place for confrontation, especially if it can be avoided. Again, use common sense and street sense instead of emotions.

There are multiple issues, that they never teach or one may never be exposed to until it happens. I know. I have been handcuffed, arrested by the Police, reported to, yelled at, spit at, had a loaded gun to my head, knife at my throat, taken hostage, etc.. None of those were ever part of my classwork or even in my job description! In many of the situations, you do the best you can and learn, and hopefully make the right decision.

Again, know when and where to pick your battles. Don't be shocked of what you might see and attempt to deal with it appropriately. Remember the long term effects instead of the short time benefits.

This job is not easy.... that is why they pay us the big bucks !:)

R/r 911
 
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Thank you Rid for making some very level headed points that I missed. Years ago, I was a certified EMT and was a first responder in most cases. I changed agencies where the fire/medics had a very fast response time and were used to handling all of the medical problems without PD assistance. I was stabilizing a patient in a MVA (crash) while awaiting the medic arrival. The very first words out of the mouth of the medic was, "get away from that guy and let us do what we get paid to do!" I was shocked and wanted to explain what I saw during my initial patient assessment. The look I got was priceless. "We do our own assessments and we'll call when we need the cops." I was insulted, but they were right. Should I have reported them for a lack of diplomacy? No. The most basic approach that every brand BLS provider is taught is, "I know first aid, can I help?"
 
Interesting. The few times I have stopped to help the local rescue was relieved and thanked me profusely. Once I stopped to help a guy who face-planted from his motorcycle at 75mph on the highway, not wearing a helmet. Turned out to be a cop and his chief was my 1st cousin. I got mucho thanks then.

Some states do have a law that if you are certified anywhere you must stop. Vermont is one of them and I drive through Vermont on a pretty regular basis. It's also a pretty rural state and EMS might be an hour away, so you just might save a life if you get involved.
 
Not to pop a bubble, but as of yet.. I have never seen a traumatic patient saved with just basics. Unless it is an oddity of an airway obstruction or a single external hemorrhage. Realistically speaking, and even scientifically trauma is a surgical disease. We only identify wounds, hopefully maintain an airway and somewhat .. possibly slow down shock syndrome (this is even debatable). If you are an hour away and truly a real trauma patient (category I & II, with a severe TRISS Score) let's face it, your screwed. It does not matter, how many EMT's and medics are there. Hopefully your homeostasis will sit in and one can maintain permissive pressure.

For as states mandating EMS to stop, that would have to be their state EMT's and as well, someone would have to know that your a medic. Whom to say it is not a family member driving my vehicle? etc... It has been around for a long while, yet poorly enforceable.

I believe we get to "wrapped up" in a hero syndrome. Research has shown that we actually do very little (ALS and BLS alike) to change most outcomes. It is more we prevent further injuries and damage from occurring than actually treating and curing any injuries or illnesses. As well , we appropriately triage and making sure that patient is sent to the best and most appropriate facility in a timely manner.

Remember, we have than a 10% success rate on getting anyone back and less than that as a true survivor (mental functions). In trauma the numbers are worse...

So yes, our job is needed but we have a long way to go before we acclaim success or fame as "saving anyone".

I am by far not saying not to stop or don't get involved. Just realize the realistic outcomes as well as not to criticize those that do not get involved.
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Trivia time: FYI: How many law suits does one think there was to bystanders and medical professionals for aiding at a MVA, prior to the Good Samaritan Act? ....






Actually, there were none. Reader's Digest did an article in the 1950's describing physicians were not stopping at MVA's for being worried about litigation. It was not until after that was published, attorneys got the idea to start suing...thanks!

R/r 911
 
Rid, how do you feel about stopping for MVAs and such in *really* rural areas where you know EMS is a long distance away? More specifically, would that factor influence your decision to get involved?

I hear all the things you say, but a part of me can't simply drive past an accident with no assistance on scene. Know what I mean? I became an EMT to help. I am becoming a physician to really help.
 
You know, Rid, Back in the 1970's, during the transition from Basic Red Cross First Aid to Emergency Medical Technician standards, an eighty-hour course at that time, and even to the transition over to paramedic level of service I saw a hell of a lot of people die out of neglect, ignorance, improper training, and out and out stupidity.

This was all while I was a medic, and most of what I saw was with medics themselves! -- not tending to the basics.

I really ask you to re-evaluate your stance that...

>>>I believe we get to "wrapped up" in a hero syndrome. Research has shown that we actually do very little (ALS and BLS alike) to change most outcomes. >>>

There is a profession of EMS now. Standards have really improved from the "load and go" days. Even the crappiest of medics today, Basic or Advanced, is light years ahead of a medic back then in terms of immediately identifying life-threatening situations and doing something without thinking.

The mastering of that simplicity means lots of people get to live today who wouldn't be able to with the level of (or lack of) care available back then.

You're forgetting just how hugely important it is to remember to sweep the airway, lay a patient down who's in shock, immobilize the spine and look for an exit wound. Unless there's trained people around to do it, it won't happen and those guys'll be dead. And all that's only one small aspect of "changing outcomes."

I also ask you to not minimize the huge importance, both in the quality of life and the economic impact of what you, yourself admit:

>>>It is more we prevent further injuries and damage from occurring than actually treating and curing any injuries or illnesses. As well , we appropriately triage and making sure that patient is sent to the best and most appropriate facility in a timely manner. >>>

This is HUGE, Rid! Remember when NONE of this used to happen?

And here's where you're falling for one aspect of the Hero Syndrome yourself...

>>>Remember, we have than a 10% success rate on getting anyone back and less than that as a true survivor (mental functions). In trauma the numbers are worse...

So yes, our job is needed but we have a long way to go before we acclaim success or fame as "saving anyone".>>>

The bells and whistles of a "save" aren't what we're here for. It's not at all about braying about success. But we really do have the right to acknowledge ourselves and each other for the incredible impact that we do have. Here, you're forgetting all the hugely important things we do even in the most minor of situations which facilitate healing during pivotal moments of human beings' lives.

Being trained to and capable of influencing the course of the rest of someone's life is not small potatoes. It's an Art, backed by Science.

And as far as the accident scene topic goes: I came up from a time when I noticed most people don't know how to hold their cool in a traumatic situation, that most don't know how to spot other situations of danger or injury, that most people don't know the basics of first aid, and even fewer can recognize that you may look good now, but in ten minutes you'll probably be doing the Tuna! I don't know that that's much different today.

That's why, when I come across an accident that's got "that look" I'll stop. I'm much more discerning now than in the past, but I will at least pause to scan an ugly scene for potential. I'll ask cops if they need medical assistance. If I see an important gap need filling, I'll step in.

Maybe I've seen too many people die from stupid mistakes.

My intention behind this response is to remind all of you just how far your work reaches, and how important it is. Saving lives is one aspect, and Rid's right, it don't happen much (not in the grabbing-from-the-Jaws-of-Death way, anyhow), but let's not forget how working with the subtleties of the profession can do something just as incredible; CHANGE lives.

The essence of the profession IS changing outcomes!
 
My apologies if this seems like I am tooting my own horn (which I am to a certain extend). The article below describes quite well how the Forest Service and Parks Service LEOs are over the top. Take special note of how the Parks Service LEOs pulled over the county sheriff in her POV and treated her quite rudely and unprofessional. Emphasis added.

Published on Capitol Hill Blue (http://www.capitolhillblue.com/cont)
American gestapo
Created 07/28/2007 - 4:02am

The last place you expect to run into a federal government goon squad is the Blue Ridge Parkway, the scenic highway that runs through Virginia, North Carolina and Tennessee.

But the abuse of power spawned by the Bush administration and the rights robbing USA Patriot Act runs rampant throughout the federal bureaucracy, as I learned this week while traveling the Parkway to get to an assignment photographing a summer music festival for my newspaper.

The festival, FloydFest, draws thousands of people each July to a picturesque patch of land just off the Parkway not far from the Blue Ridge hamlet of Floyd, VA. Now in its sixth year, the festival enjoys a national reputation. It also provides an opportunity for the National Park Service police to harass patrons of the festival.

For the last two years, the Park Service has brought in its "CIT" (Criminal Interdiction Team) from Asheville, North Carolina, to police crowds that use the Parkway to reach the festival. The team, composed of swaggering young officers with little regard for due process or civil rights, is the embodiment of federal excess.

< Moderator snip. >

On Wednesday night, the CIT cops pulled over a car driven by Shannon Zeman, the sheriff of Floyd County, VA. Zeman later told Virginia State Trooper Andrew O'Connor that the parkway cops were rude and abusive, even to a fellow cop.

< Moderator snip. >

Source URL:
http://www.capitolhillblue.com/cont/node/3020
Click to expand...

It is fortunate that the political mechanism was able to stop this from occurring, but it is quite clear that there are significant issues and abuses which are ongoing.
 
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My final point is this: believe it or not, police officers are trained to administer first aid. They know how to stop the bleeding, open an airway and treat for shock while awaiting the medics. You point out a few bad apples and decide that you have a much more respected and professional position in life. You have said several times how you have respect for the police, but you refer to isolated incidents with Forest Rangers as indicative of law enforcement. You can't have it both ways. So, post your overly dramatic last word and get back to your calling of being a doctor some day. As I said, I'll still protect you when you need it.
 
I'm closing this thread for 48 hours to allow everyone to take a deep breath before responding anymore.
 
This thread is open again, provided that everyone remains calm and civil.
 
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