Good Samaritan - Rescue Vs. Medical

[TransportJockey]

Why keep driving? If there is something you can do, and you are trained to do it, why the hell wouldn't you do it? Why would you have spent time and money educating yourself in EMS courses if you were only going to use them for work? Seriously, I can't even begin to understand this train of thought. There are no immediate scene safety issues, besides being on what I would imagine is a dark road. If nothing else, I would try and comfort the pt who is still conscious. But I guess since you are big tough emtlife anti-"whacker" man, patient care has nothing to do with actually caring about the patient.

You wouldn't even bother to stay and try to assist rescue crews?

Forgetting the fact that he said we have basic BSI gear...

I don't carry anythign in my truck for use on another person. The little kit I have is for my use only and doesn't have any form of BSI. And you don't consider a dark back country road a danger enough? I don't carry a reflective vest and without a big red housemarker blocking off a lane for me, some extra light, and reflective safety gear, I'm not gonna stand on the side of the road. Screw that. My life is more important to me than anyone else's, and it's simply not my emergency. I would call 911. That's enough.

And don't dare accuse me of not caring about the patient. If I have a patient I put my all into taking care of them and getting them to definitive care in one piece. But I also know how to separate my work life from regular life.

And how could I assist the rescue crews? I don't have extrication gear, no medical gear, no ppe. Nothing. They are better off without a sparky little EMT on scene getting in the way.

 

[Lifeguards For Life]

Forgetting the fact that he said we have basic BSI gear...

I don't carry anythign in my truck for use on another person. The little kit I have is for my use only and doesn't have any form of BSI. And you don't consider a dark back country road a danger enough? I don't carry a reflective vest and without a big red housemarker blocking off a lane for me, some extra light, and reflective safety gear, I'm not gonna stand on the side of the road. Screw that. My life is more important to me than anyone else's, and it's simply not my emergency. I would call 911. That's enough.

And don't dare accuse me of not caring about the patient. If I have a patient I put my all into taking care of them and getting them to definitive care in one piece. But I also know how to separate my work life from regular life.

And how could I assist the rescue crews? I don't have extrication gear, no medical gear, no ppe. Nothing. They are better off without a sparky little EMT on scene getting in the way.

What about a sparky non EMT?

 

[TransportJockey]

What about a sparky non EMT?

That could possibly be even more annoying

 

[ah2388]

Im with Cory on this one, i pull out my portascope, endorectal tube, and sterile jaws of life and perform Invasive surgery on the spot

 

[Cory]

Forgetting the fact that he said we have basic BSI gear...

But that's the scenario...

don't carry anythign in my truck for use on another person. The little kit I have is for my use only and doesn't have any form of BSI. And you don't consider a dark back country road a danger enough? I don't carry a reflective vest and without a big red housemarker blocking off a lane for me, some extra light, and reflective safety gear, I'm not gonna stand on the side of the road. Screw that.

Fair enough.

and it's simply not my emergency

So someone is only worth saving if you get dispatched to save them while on duty? Please explain what you mean...

I also know how to separate my work life from regular life.

What if it was a birghtly lit road, in the middle of the day? Would you still bother to help anyone, or do you only help people on duty?

And how could I assist the rescue crews? I don't have extrication gear, no medical gear, no ppe. Nothing. They are better off without a sparky little EMT on scene getting in the way.

According to the OP, this is a very rural area. I was only suggesting that if the respone times are spread out, then the first responders may need an extra hand. Isn't it even worth checking?


Lifeguards: As always, grow up.

 

[Cory]

Im with Cory on this one, i pull out my portascope, endorectal tube, and sterile jaws of life and perform Invasive surgery on the spot

Thats exactly what I said.

 

[ah2388]

Thats exactly what I said.

glad we're on the same page

 

[TransportJockey]

If it was during the middle of the day my truck would have a fully equipped inflateable surgical suite from Galls

But nope, I don't stop when off duty. It's that simple.


EDIT: Would you think less of an MD/DO or RN that doesn't stop at an accident when off work?

 

[Cory]

But nope, I don't stop when off duty. It's that simple.

Why?

 

[Cory]

Would you think less of an MD/DO or RN that doesn't stop at an accident when off work?

No, I would be just as ashamed.

 

[LucidResq]

Cory -

Check this out.

Many an EMS provider has been hit and killed while on-duty on the side of the road. At least in that scenario, their death will likely be covered by life/accidental death insurance. I refuse to die, doing something stupid like putzing around at a scene in the middle of the night without the proper safety equipment, lights, etc and I'm not going to leave a family behind with nothing.

Like I said, my involvement would be limited to calling 911 and punching a window out if the cab was filling with smoke (I'm not going to stand by and watch someone die from inhalation/asphyxiation when the solution takes about 2 seconds)... yeah, there's a noticeable difference in the smoke from an airbag and "real" smoke because airbag smoke settles fairly quickly while "real" smoke tends to increase over time. If it was just airbag debris then I'm not getting anywhere close to the scene.

 

[TransportJockey]

Why?

Easy, my safety trumps everyone elses. I don't carry gloves or BSI, so what can I do other than call 911? I can give them all the info I see as I slow down and then keep going.

 

[LucidResq]

No, I would be just as ashamed.

Yeah, one time I watched my psychiatrist drive by an accident scene. What a jerk.


I'll tell you that the doctors I work with, who are surgeons that would knock us all out of the park as far as ALS, managing hemorrhage, etc... I can guarantee they would almost never stop at an accident scene. Does that make them bad people? No. They just recognize that there is only so much one can do while "off the job" and the risks of stopping likely outweigh the benefits. Plus they have families to go home to.

 

[TransportJockey]

Yeah, one time I watched my psychiatrist drive by an accident scene. What a jerk.


I'll tell you that the doctors I work with, who are surgeons that would knock us all out of the park as far as ALS, managing hemorrhage, etc... I can guarantee they would almost never stop at an accident scene. Does that make them bad people? No. They just recognize that there is only so much one can do while "off the job" and the risks of stopping likely outweigh the risks. Plus they have families to go home to.

What exactly would a psychiatrist do? It's like a podiatrist stopping on an MVC scene

But you nailed it exactly on the head.

 

[Cory]

Easy, my safety trumps everyone elses. I don't carry gloves or BSI, so what can I do other than call 911? I can give them all the info I see as I slow down and then keep going.

I understand, but the fact that you wouldn't even get out of your car in order to provide the 911 dispatcher with some detailed information on both pt's does no sit right with me. Clearly, these people are in need of ALS or even medevac. No one would know that if you don't even leave your car. I'm not saying that you have too spend any time there, especially if you don't have any euiptment. But for God's sake, you can't even tell the conscious pt that help is on its way?

If I were in this situation, I would stop in the safest place possible, get on the phone as I was moving to the car, check for smoke or leaking gas, check to see if they're conscious, at least try and get an understanding of their situation, relay it all to the operator, tell the man that help is on the way, return to my car. Whether or not I would leave the scene, well, I can't honestly say. I probably would.

 

[spinnakr]

I'm with Cory, completely. It's risk/benefit, plain and simple. I positively abhor the culture of danger that pervades EMS and oftentimes Fire, but there is a difference between thinking danger is "cool" and knowing that you are entering a potentially dangerous situation with the purpose of saving a life.

To put it bluntly, my impression of the vast majority of medical personnel that I have met in real life who have insisted that they would *never* stop for something, is that they do EMS because they think it makes them look cool. I'm not saying that is true of anyone here; however, in my personal experience, that's the nature of it.

Doctors, generally speaking, and again in my own anecdotal experience, don't stop for a number of reasons. Oftentimes they don't notice, sometimes they don't care. Sometimes they're just scared by situations without controlled environments. But above all, they are afraid of being sued for malpractice. You aren't covered by institutional insurance if you aren't working. Furthermore, how many doctors do you know that would actually know what to do in a true emergency as it unfolds in front of them? I know plenty of docs - even ER docs - that I wouldn't want doing pre-hospital care on me. There is a fundamental difference between hospital and ER care, surgery, and pre-hospital care. The best trauma surgeon in the world is just an over-glorified nurse without his OR, and he quite possibly does not have the experience in the field that a paramedic does, either.

Let's be honest: if you keep your brain about you, how much of a risk are you taking by stopping? Park your vehicle upstream of the crash; put on your hazards; keep your lights on; point your wheels away from the crash. Don't stand in the middle of the road. Pay attention to your surroundings. Scene safety isn't just about what it's like when you arrive; it's about maintaining situational awareness constantly. If you do that, you'll see the car coming long before it has a chance to hit you.

Human beings have a remarkable ability to inflate the unlikely but grotesque and ignore the commonplace but benign. How many people are afraid of flying? How many are afraid of driving? And yet which kills more people?

Maintaining scene safety is critical, and you need to know when to cut your losses and run. But we must be careful not to throw the baby out with the bathwater: a little risk to save a savable life is, like it or not, the nature of the game. Anyone who says otherwise - anyone who claims to keep themselves 100% out of risk by only entering a "100% safe scene" - is either lying to themselves, or has never set foot in a vehicle.

25% of firefighter line-of-duty deaths occur in an apparatus. EMS is no different. The risk you take by stopping off-duty is the same you take every day when you go to work, for the same purpose. It's calculated risk management, and REALISTIC risk assessment, that should dictate whether or not you stop, and not some set-in-stone personal rule. And what if you were the driver of that car? What would you have me do?

 

[Trayos]

Maintaining scene safety is critical, and you need to know when to cut your losses and run. But we must be careful not to throw the baby out with the bathwater: a little risk to save a savable life is, like it or not, the nature of the game. Anyone who says otherwise - anyone who claims to keep themselves 100% out of risk by only entering a "100% safe scene" - is either lying to themselves, or has never set foot in a vehicle.

25% of firefighter line-of-duty deaths occur in an apparatus. EMS is no different. The risk you take by stopping off-duty is the same you take every day when you go to work, for the same purpose. It's calculated risk management, and REALISTIC risk assessment, that should dictate whether or not you stop, and not some set-in-stone personal rule. And what if you were the driver of that car? What would you have me do?

+100

In a similar note, has anyone here actually been in a situation where they rendered more care then a civilian/MFR in an emergency incident?

 

[DV_EMT]

Alright alright, We know that there are many EMT, and Medics alike on this forum that wouldn't stop, but instead call 911. Likewise, there are the others that would stop to assist. Lets not thread-jack here as there are many other threads that discuss stopping vs. not stopping.

The purpose of this scenario was merely to see everyone's response to how they would "deal" with a situation provided that they were the only medical personnel on scene and it would take a long duration of time for EMS authority to get on scene.

Furthermore.... the thread was named "Good Samaritan - Rescue Vs. Medical" for a reason. I discovered that there was an instance similar to the one in this thread. An EMT, stopped his vehicle, attempted a rapid extrication (though there was no imminent threat to the vehicle) in order to "save the life" of the passenger. Now, the driver (though not impaled) did sustain a neck injury and ended us suing the EMT... even though the EMT was attempting to save his life. The court boiled it down to this

RESCUE VS. MEDICAL

If the car was a blazing inferno and death was imminent, and the EMT risked his life to save "both lives" because he knew they'd both die. A rapid RESCUE extrication would be covered under "Good Samaritan".

Due to the circumstances I presented, it would have been in ALL parties best interest to treat, but DO NOT extricate because it would have breached the Rescue vs. Medical Argument. The passenger should be triaged as a "DRT" due to the fact that there was limited information, and he was not able to be reached. The scene I painted was not that the car was ablaze, but moreover, had airbag smoke and a radiator/windshield wiper fluid on the ground -- not a Life or Death situation.

Therefore, leaving the PT's in the vehicle and treating as much as possible to maintain airway, control bleeding, and immobilize the impaled object. As negligent as it may seem, the Pt in the passenger seat is probably a goner. gotta remember your 30-2-can do's!.

Any comments or questions?

 

[spinnakr]

Any comments or questions?

Just one that I forgot to ask before -
What color underwear was the good Samaritan wearing?

 

[DrParasite]

some of you guys are really funny. sterile jaws? remove the penetrating object? extricate the patient? wow.

call 911, get the AHJ there pronto. give the 911 dispatcher (which I happen to be) the best possible location, and a call back number. whether you are in an urban city with many many roads, a long winding back road where you are miles from anyone, or an interstate, giving the exact location for help to arrive is the best thing you can do. then waiting as said location until the first arriving unit arrives, to confirm help did make it, as well as allow dispatch to call you back i case the AHJ units have trouble finding the place is the best practice.

you want to control the bleeding until help arrives? sure, I won't hold it against you, and you might save someone's life. maybe even do a prelim scene assessment so you can tell dispatch (I need fire/rescue/blsx2/ALSx2/PD for traffic or AI/helicopter/etc) what is needed, great, even though they may listen to you, or they may ignore and follow their protocols as a layman calling 911.

but getting super involved in the scene once help arrives? or before help arrives? nah, let the AHJ handles patient care, documentation and deal with everything once they get on scene