Dozens Ignored a Man Dying on a Sidewalk in Queens, NY

[firetender]

thank God for no statuatory requirement to render care

Thank God I'm not in your neighborhood, or even call area.

(Can you hear what you're saying?)

 

[adamjh3]

I hope you carry all of your PPE everywhere. There's no point to unnecessarily risk your life, your health, your livlihood, and everything else you have for a complete stranger.

I don't see me "turning on my powers" off-duty, because, frankly, I'm not a super-hero. I don't have magical hands that bring people back from the dead. I'm just a guy, who happens to perhaps delay death once in a while through my (minimal, at this point) knowledge of the human body.

I do feel it's okay to use my skills arbitrarily.

Let's take this situation to another level, we'll go to the hazmat scenario, roll up on a scene with an over-turned tanker-truck. The truck is surrounded in a green cloud, you can see and hear the truck driver screaming for help - trapped in the cab. Are you just going to waltz into that green cloud for Joe Trucker?

I know I'm not. I don't have the right equipment or training to deal with that, and I know that. I'm going to call for additional resources, remember PENMAN?

It's the same situation here. The people on this forum that are saying they wouldn't render care, but would call for help as soon as possible are spot on. You can't help anyone when you're dead.

 

[firetender]

I do feel it's okay to use my skills arbitrarily.

New Breed, I guess.

Agree or Disagree?

 

[CAOX3]

"What I'm hearing is that the posters feel it's okay to use their skills arbitrarily because THERE IS A CHANCE a stricken person has a blood borne pathogen, and THEY DON'T HAVE GLOVES. Because of this? Because of that? Perhaps each medic should wear a list around their neck stating what they are NOT comfortable doing, and won't! so the patient knows what's not coming."

I dont know whats going on I cant quote firetender, I will just make it bold

------------------------------------------------------------------------

Listen, I think you a great contributer to this forum and I enjoy reading your posts but I have to disagree with you here.

When I was young and single yes I intervened at times, I now have a wife and a child to provide for, they are my responsability. I cant take the chance for their sake it isnt about me per se, its about my family.

Sure I would have picked up the phone and have many times but to get involved in a situation any further then that, I wouldnt, excuse me I cant.

 

[usafmedic45]

The fact that I choose carefully those circumstances in which I choose to intervene? We all make judgment calls, I just happen to have a codified system by which to make that decision. Most of us are more likely to aid an injured child or to tend to the elderly grandmother who is injured as opposed to someone we view as being a potential criminal.

My responsibility and duty to take care of people ends the moment I walk out the door after my shift. After that, it's the choice of the individual and the fact I want to . All of us who volunteer have laid in bed after a long night of runs and thought "I'm not getting up for that BS call. Someone else can handle it" before rolling over and going back to sleep. I am expressing nothing more than a version of that. It's not my responsibility or duty to treat everyone who crosses my path unless I am on duty. At least I am not totally disregarding everyone. I am simply applying a form of non-medical triage to the problem of deciding.

We are not beholden to live, sleep and breathe being medical professionals. We delude ourselves into thinking there is a "code" or "oath" we are held to. Non-statuatory codes of conduct, creeds, etc lack teeth and are not enforceable, especially in situations where the person supposedly held to that standard is being asked to potentially endanger him or herself in the ensuing events. Much was written about this during the review of the SARS epidemic where there was moderately high rates of failure to report and refusals to continue to work amongst health care practitioners.

It's a myth that we have to do this or do that. We have time off like everyone else. Unfortunately there is this misguided belief- the one outgrowth of volunteer EMS and fire services that I have a problem with- that if you don't live for the job, your heart is not in it. I give everything I have when I am on duty to anyone who crosses my path. The moment I am off duty, we play by the law and by my right to self-determination. One does not give that up the day you pass an EMT exam (at least in all but three or four states).

But what I suspect is I wouldn't have time, I've been trained to act.

...and people wonder why our occupational morbidity and mortality is so damn high. It's this cowboy "I have to save the showgirl tied to the tracks!" attitude that leads a lot of people in this field into making very stupid decisions. I've carried the body of a very good friend of mine out of a burned out house because he didn't think it through before running into a house that MIGHT have had people in it. If he'd stopped for a split second before running headlong in there, he might have seen the people fleeing out the backdoor. Instead, he ran in just as the roof came down. Once you've stood on a widow's doorstep in a dress uniform at 7am on Christmas morning to tell this woman with whom you danced at her wedding to your friend that he won't be coming home, the illusion that we are obligated to do anything that endangers ourselves starts to crumble. We feed the families and each other those hollow words "He died a hero", "He died serving others", "he died doing what he loved"....somehow I don't think Chris loved being pinned under a collapsed roof as his airpack slowly ran out and a dead hero is still that: dead.

In the name of doing my job and helping my fellow man, I've flung myself into flooded rivers, climbed into collapsed structures, crawled into burning buildings, been mortared and shot at. I've been seriously injured in the line of duty on two separate occasions despite being cautious. My ability to rationalize and coldly make a decision to treat or to not get involved is not a lack of dedication or a lack of concern. It is simply a manifestation of the first rule of staying alive in this job: my *** before anyone else's. After that, it's a matter of what I think of them in order of importance. You'd save your wife/husband/etc before your partner, your partner before the patient, the patient before another bystander, a cop before a criminal....we all engage in social triage. The fact is most of us choose not to see it or simply do not discuss it.

Did that clarify my stance?

New Breed, I guess.

Agree or Disagree?

Disagree. I've been doing this probably as long as you have (since 1996). I'm definitely one of the "old guys" despite the fact that I regularly get mistaken for a high school student. It is just a matter of realizing the "with your shield or on it" approach to the profession does more harm than good. That is, a little less Kool-Aid, a little more rational thought applied to decision making.

What I'm hearing is that the posters feel it's okay to use their skills arbitrarily because THERE IS A CHANCE a stricken person has a blood borne pathogen, and THEY DON'T HAVE GLOVES. Because of this? Because of that? Perhaps each medic should wear a list around their neck stating what they are NOT comfortable doing, and won't! so the patient knows what's not coming.

Are you quite done being hyperbolic? We are not talking about medics and EMTs. We're talking about off-duty medics and EMTs (read as: effectively civilians). Big difference.

 

[adamjh3]

New Breed, I guess.

Agree or Disagree?

Would you have stopped for this gentleman? Would you have rolled him over, applied direct pressure, maybe even initiated CPR with no BSI? Say you did. Congrats, you're a "hero". This dude makes it to the hospital and dies shortly after. Then you find out he has hepatitis C, and HIV, and MRSA oh, and by the way, now you do, too. Cool. Was it worth it? You got to play hero for a few minutes. Awesome.

 

[Veneficus]

In NYC the EMT dispatchers don't render aid during breaks, why would anybody be shocked bystanders wouldn't?

 

[CAOX3]

If I hadnt witnessed myself numerous times how quickly good samaritans with good intentions become patients maybe my views would be different.

I wish I lived in a society where we didnt have to weigh those options, where there was no risk involved and the people who could help would. We dont live in that world.

 

[Melclin]

....we all engage in social triage. The fact is most of us choose not to see it or simply do not discuss it.

/thread.

(I was ganna say something in the same vein but this pretty much sums it up.)

 

[DrParasite]

In NYC the EMT dispatchers don't render aid during breaks, why would anybody be shocked bystanders wouldn't?

actually, there are many conflicting witness accounts of what was actually done. certain NY rags just ran with the worst opinion, and the fact that the mayor made a statement without knowing all the facts made it even worse. But who would let the facts get in the way of good old fashioned mob justice?

that all being said, it doesn't surprise me that people in NYC just kept walking. its just the attitudes of people.

However, having had my share of fun times when dealing with bloody EDPs, I can honestly say I probably wouldn't have done anything either. I would, however, have called 911, and let the cops/EMS deal with him, as they are the professionals who can do the job properly.

 

[firetender]

Disagree. I've been doing this probably as long as you have (since 1996). I'm definitely one of the "old guys" despite the fact that I regularly get mistaken for a high school student.

Just to clarify, my time frame as medic was 1973 to 1985.

Having been on the first wave of medics where we truly were an outgrowth of the desire to help people who couldn't help themselves, the clarion call was "try!"

Here, what's being said is try "if". If there's no this, that or the other. I left the field right at the time when AIDS was becoming an issue, when "mugging" (mouth-to-mouth) had only been dropped only a couple years before. AIDS was the turning point. That was when gloves became an issue. That was when barriers started to get placed between you and the patient.

That was when the first thing you had to work through was fear of losing your own life before you could begin to render aid. That translates into viewing all the circumstances of the scene and then protecting yourself first. I went through that. I was glad I quit at that time. I, being a dinosaur, did not like having to think of me first. That's not why I got into the field.

It may seem stupid in today's world, but at the time, a lot of people were dying for no damn reason. For anyone to be able to do anything was, as I said, a sacred trust.

One of the concepts of training in First Aid and quickly on to EMT was all about knowledge allows you to step beyond your fears and into action so people don't need to die needlessly. What I'm hearing is knowledge today, in a sense, is a major factor in NOT taking action. You know there are blood borne pathogens, so you don't get involved in anything with blood.

Now I'm not saying this is wrong. In fact, it reflects my own naivety because all this time, I was assuming (there's that word!) that medics today, in part, go through the training they go through for the very reason of learning what to do and being willing to do it, should the situation arise.

This was a shock to my system, really. Since leaving the field I haven't taken the time to see just how important it is to protect yourself first. That is a reality you all must deal with every day.

I guess I was pretty lucky to have come up from a time when we felt like Gods because we could do something. Could it be true that today the God aspect is reflected in that we can arbitrarily choose to NOT do?

This is, or should be, a real moral dilemma that really gets looked at by each medic. Perhaps, like usafmedic, each of us should get real clear on our professional and personal criteria for taking action. That would make it less traumatic when being right in the middle of the dilemma on-scene, and having to "decide" while the patient is waiting.

 

[TransportJockey]

Of course, you need to keep in mind that my decision tree for offering assistance while off duty pretty much consists of:
1-Is the victim a kid or an animal? Yes: Help them if it can be done safely No: Go to question 2
2-Do I know the person? Yes: Go to question 4 No: Go to question 3
3- Am I stuck in the situation/do other bystanders know that I'm medically trained? Yes- Help them if it can be done safely No- Go to question 4
4-Do I like the person? Yes: Help them if it can be done safely No: Do not get involved even if it means standing idly by; thank God for no statuatory requirement to render care

I'm a big fan of this thought process... Except kids isn't question 1, only animal is. I hate kids

 

[mycrofft]

USAF, thanks for the Kitty Genovese input.

SO we're both older than turtles.

Most of the press stuff is wrong, but it is a fact in many cases bystanders do nothing. If they have nothing to contribute, so be it. Nowadays, however, when something happens our local 911 gets swamped with cell calls, so they aren't doing NOLTHING, just calling in an air strike.

I've stepped around a guy passed out in his own effluvium, I've stopped and helped people, but I tend not to physically engage a street person who's "out" because they can come up swinging and the last thing I want as my "last thing" on Earth, is a steak knife in the groin.

"Five is four", we've shredded the "I don't/do treat people off duty" to molecules. I respect eveyone's personal opinion.

 

[usafmedic45]

What I'm hearing is knowledge today, in a sense, is a major factor in NOT taking action. You know there are blood borne pathogens, so you don't get involved in anything with blood.

But the only choice is either:
-Carry gloves and a pocket mask with you everywhere you go (read as: impractical unless you want to look like Ricky Rescue, at least when it comes to the pocket mask)
-Be prepared to withhold care

 

[mycrofft]

Grad students, here's your chance:

moulage and post a person on the sidewalk or somewhere and record/analyze people's responses to various types of victims.

 

[Foxbat]

But the only choice is either:
-Carry gloves and a pocket mask with you everywhere you go (read as: impractical unless you want to look like Ricky Rescue, at least when it comes to the pocket mask)
-Be prepared to withhold care

...or you can carry a small glove pouch with a pair of gloves and a flat face shield, which won't raise questions. And even if it will, I'll rather look like a whacker to someone than to have to make a choice between my safety any someone's life and health. Heck, you can just carry a pair of gloves in your pocket and not to do mouth-to-mouth, just hands-only CPR.
You can either look for an opportunity or an excuse.

 

[usafmedic45]

...or you can carry a small glove pouch with a pair of gloves and a flat face shield, which won't raise questions.

Those flat face shields are not very effective at protecting people, particularly if the patient has a lot of secretions, and make if very difficult to obtain a good seal.

And even if it will, I'll rather look like a whacker to someone than to have to make a choice between my safety any someone's life and health.

Seriously? You make it sound like it's a terribly difficult decision. It's not. I have a harder time deciding what to order at Sonic for lunch.

not to do mouth-to-mouth, just hands-only CPR.

Have you kept up on the most recent cardiac arrest guidelines? Who does mouth-to-mouth anymore? It actually reduces the effectiveness of compressions and adds no benefit.

You can either look for an opportunity or an excuse.

...or you can be a professional and make a choice whether to get involved or not based upon the situation or be a diehard zealot who refuses to accept that we have no moral, legal or ethical obligation to do anything while off duty except protect ourselves. I am not accusing you personally of being a zealot, just trying to provide a similar "all or nothing" false dichotomy.

 

[firetender]

Talk About LOADED!

There's some great stuff going on with this theme, here. A woman who lost her 2 year old son started the ball rolling.

 

[usafmedic45]

The problem with that thread is we are probably not getting the truth from her. I will take the word of the officer over her word any day of the week. Rule #1: When something doesn't make sense, assuming the "witness" is lying or at least skewing what happened is probably a fair assumption. That said, if the lady really had a leg to stand on as far as her little tale goes, she would be talking to a lawyer and not us.

 

[Foxbat]

Have you kept up on the most recent cardiac arrest guidelines? Who does mouth-to-mouth anymore? It actually reduces the effectiveness of compressions and adds no benefit.

Then you can do compressions only. If you wear gloves, the risk is extremely small. Even if you don't wear gloves but there're no visible fluids on patient's chest, the risk is still quite small.

Seriously? You make it sound like it's a terribly difficult decision. It's not. I have a harder time deciding what to order at Sonic for lunch.

Well, for me it's different. I was raised differently, and if I let someone die rather than take a risk (and it may happen... I haven't been in a situation to make such choice so I don't know what I would do), I will be slowly eating myself alive for the rest of my life.

or you can be a professional and make a choice whether to get involved or not based upon the situation or be a diehard zealot who refuses to accept that we have no moral, legal or ethical obligation to do anything while off duty except protect ourselves.

Again, I feel very differently about it. I've been raised in a country where you can go to prison if you don't render help (assuming you can do it without endangering yourself). I can't prove that it's right or wrong (if there's something I learned from my ethics class it is that ethical arguments lead nowhere).
Also, I'm not sure what professionalism has to do with it. When it comes to rendering help off-duty, I don't see, ethically speaking, a big difference between EMT, medic, doctor or John Q. Public who happens to know some basic first aid.
I can't tell you what to do. I just don't like when someone tells that people who chose to risk their lives to save others did something wrong (and that's what many seem to think).