Stopping at an MVA out of response area?

Caspar

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I noticed a minor MVA out of my departments response area. I was in the ambulance driving but I was the only one in the bus. I stopped and asked if everyone was ok and told them I was out of my district. They said that was fine and they already called 911. It didn't look like anyone was hurt other than some cuts and bruises. Should I have stopped and rendered care?
 

reaper

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This is a question for your dept supervisor.

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Handsome Robb

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From a PR standpoint you should stop and at least check. If someone's severely injured you should probably render aid depending on your state's duty to act laws until the agency that covers that area arrives.

For us there's an agreement in place between us and our neighbors to the south that we can stop and cover a call like this for them if we wish but that's not the same everywhere.


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Caspar

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From a PR standpoint you should stop and at least check. If someone's severely injured you should probably render aid depending on your state's duty to act laws until the agency that covers that area arrives.

For us there's an agreement in place between us and our neighbors to the south that we can stop and cover a call like this for them if we wish but that's not the same everywhere.


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Yeah I stopped but didn't provide any care . It didn't look like anyone needed any care and they said that help was already on the way
 

RocketMedic

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In the ambulance, you generally have a "duty to act" if you are equipped and certified. That is not necessarily the same as transporting, but you are expected to assess and provide care within your certification's scope of practice and equipment on hand. For example, the EMS director in a marked command vehicle on the way to a conference who gets flagged down at a gas station would be expected to help with a cardiac arrest, even if they didn't have the full on kit.
 

hometownmedic5

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You say it was out of your service area, but I'm assuming still in your state. That being the case, and this is based on my state, in the absence of a critical patient already in your ambulance, you would have to stop and at least assess the scene. It's illegal, not to mention terrible PR to just drive on by.

As I said, that's massachusetts. We don't do jurisdictional EMS here. My license and that of my company is valid state wide. In other states where there are county certifications or some such limitations, perhaps the answer is different.

At the very least, stop and see what the deal is. Everybody up and walking with the AHJ en route, I'm not doing much beyond standing there until I can hand off the scene to someone else.
 
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Caspar

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You say it was out of your service area, but I'm assuming still in your state. That being the case, and this is based on my state, in the absence of a critical patient already in your ambulance, you would have to stop and at least assess the scene. It's illegal, not to mention terrible PR to just drive on by.

As I said, that's massachusetts. We don't do jurisdictional EMS here. My license and that of my company is valid state wide. In other states where there are county certifications or some such limitations, perhaps the answer is different.

At the very least, stop and see what the deal is. Everybody up and walking with the AHJ en route, I'm not doing much beyond standing there until I can hand off the scene to someone else.

Yes it was in the same state. I am in a volunteer department so I'm not sure if it is different than a paid provider. I definitely stopped but the people didn't seem like they needed any help but I didn't wait for PD to arrive.
 

hometownmedic5

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I personally would have waited until someone took the scene over from me. Being a solo, you can't really doc a refusal(not that it's a two person job, but you aren't a legal truck by yourself, at least here); so I would have waited at least for the PD, most likely the ambulance.

For sure, some of this is going to come down to regional and local differences in laws and protocols.
 
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Caspar

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Well I guess there's nothing I can really do about it now. That's something to learn for the future. I'm fairly new so I've never been in a situation like that before.
 

DesertMedic66

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It's horrible PR to just keep driving by. We will stop and render the care that is needed. If the patient is not critical we will wait for the local ambulance to arrive on scene and then we will leave or until we get the OK to transport them. If it's a critical patient and we know the appropriate hospital then we can transport before the local system arrives on scene and management will deal will any issues that arise.
 

GMCmedic

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It will be state dependent. As said its bad PR to not stop but in my state you have no duty to act till you are dispatched.

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akflightmedic

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Forget all the PR and legal mumbo jumbo....let's take this operationally for a moment.

1. Did you have a plan for IF someone DID need help or had serious injuries?
2. Did you notify YOUR company/organization where you were, what you saw and that you were stopping?
3. If above, did you ASK them for permission or advice on whether you should stop?
4. Does your company have a policy on this type of situation you could have defaulted to? If so, why didn't you?
5. Why were you out of area in an ambulance solo? If this is a regular occurrence then above mentioned policies need drafting.
6. Assuming you did not notify anyone above, what was your plan if you got out and someone was in crisis? Now you would leave them to go an dnotify the proper authorities? Did you also call 911 so you could give updates to whoever was responding?
7. Do you know who was responding? Do you know what county or service provider's area you were in?

These are just a few of the MANY more questions I have, I literally could go on for pages and this is all OPERATIONAL planning and procedural stuff. Again, omitting discussion of legal liability, scope and PR.

Do you think or understand how woefully under prepared you were for this situation? In hindsight after reading these questions and the other comments, is there anything you have learned or would have done completely different?

If I were to get to the legal liability part, let's say one of those "noninjured" folks becomes an opportunist. What documentation do you have to support what you saw, what you did, what you asked? Sure, you rolled up on it and stopped as a "good sam", however you are there representing your organization as well. They will bear some liability in any claim made especially if a shrewd lawyer is able to convince them you were unprepared, uneducated, untrained to the extent where you did not do what you were supposed to do. There are so many things that could go sideways from this event.

At a minimum, I would call 911 so you get the county or service area you are in, state who you are, who you represent and you are stopped at a MVC located at XYZ Junction. Inform them you will ask a few questions of the involved parties and you will call back and update them or remain on line while you do it. It is all recorded.

Just a lot of food for thought amigo.
 

DesertMedic66

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Forget all the PR and legal mumbo jumbo....let's take this operationally for a moment.

1. Did you have a plan for IF someone DID need help or had serious injuries?
2. Did you notify YOUR company/organization where you were, what you saw and that you were stopping?
3. If above, did you ASK them for permission or advice on whether you should stop?
4. Does your company have a policy on this type of situation you could have defaulted to? If so, why didn't you?
5. Why were you out of area in an ambulance solo? If this is a regular occurrence then above mentioned policies need drafting.
6. Assuming you did not notify anyone above, what was your plan if you got out and someone was in crisis? Now you would leave them to go an dnotify the proper authorities? Did you also call 911 so you could give updates to whoever was responding?
7. Do you know who was responding? Do you know what county or service provider's area you were in?

These are just a few of the MANY more questions I have, I literally could go on for pages and this is all OPERATIONAL planning and procedural stuff. Again, omitting discussion of legal liability, scope and PR.

Do you think or understand how woefully under prepared you were for this situation? In hindsight after reading these questions and the other comments, is there anything you have learned or would have done completely different?

If I were to get to the legal liability part, let's say one of those "noninjured" folks becomes an opportunist. What documentation do you have to support what you saw, what you did, what you asked? Sure, you rolled up on it and stopped as a "good sam", however you are there representing your organization as well. They will bear some liability in any claim made especially if a shrewd lawyer is able to convince them you were unprepared, uneducated, untrained to the extent where you did not do what you were supposed to do. There are so many things that could go sideways from this event.

At a minimum, I would call 911 so you get the county or service area you are in, state who you are, who you represent and you are stopped at a MVC located at XYZ Junction. Inform them you will ask a few questions of the involved parties and you will call back and update them or remain on line while you do it. It is all recorded.

Just a lot of food for thought amigo.
For #5 that is a very frequent occurrence here. Our VSTs and mechanics often drive the ambulances as a solo person out of the county. Same thing with the medics and EMTs. We will drop ambulances off at the main mechanic area which is several counties over or pick up/drop off supplies at other areas
 

akflightmedic

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I am aware of that type of scenario, however I was asking OP why he was doing it in this instance....guides a lot of my future questions/logic/feedback.
 

hometownmedic5

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Ak has made some very salient points.

Absolutely, appropriate notifications must be made, both your dispatch and dispatch for the AHJ. That ideal takes place before you're even out of the truck, with a detailed scene size up to follow.

In the absence of regulations that prohibit you from stopping under those circumstances, doing so presents limited liability. A well equipped solo emt is better than nothing. If you accomplish nothing more than triage and reporting, at least the responding ambulance will have a scene report and be able to activate additional resources if needed. In a rural area with call/volley coverage, this alone could save a considerable amount of response time.

Even alone, an emt can provide care that could be potentially life saving. Let's say just for example the application of a tourniquet. There are few bls skills that are immediately life saving, but that is one. Extending beyond the hero stuff, even just being a calming, official presence can be of monumental benefit at a chaotic scene.

Bottom line, you need to familiarize yourself with your state/county etc laws, then your agencies specific protocols, along with any mutual aid procedures. Abide by those, within those confines utilize your best judgement, and try at all times to do the most right thing and you'll be fine.
 

Generic

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IMO, "cuts and bruises" is a complaint which makes them a patient. I would not have necessarily done paperwork but I would have made sure the appropriate agency was responding and waited until they arrived on scene.
 

Jim37F

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While it's not necessarily a regular occurrence, it has happened where you're half crew (partner called off without coverage, picked up OT and no one else picked up, etc), you can get sent on detail for various things like driving to our various hospitals to pickup backboards, shuttling supplies to/from stations, or even sent to a hospital with a bunch of units holding the wall to relieve them, and take over patient care so you're holding the wall instead (oh,trust me, that's a fun detail lol) so I can see someone by themselves in an ambulance "still alarming" a TC out of our companies service area (heck, thanks to that Harbor Gateway finger of LA City that stretches down to the ports, bisects our service area, so if I hop on the 110 freeway returning from a neighboring district I'm now out of our service area).

Anyways, if you're going to do more than creep up and shout out the window "y'all ok?" I'd have to go over the radio with dispatch and advise that I'm on scene of a still alarm, brief description (2 vehicle t-bone in the intersection of........) and that I'm out investigating for any injuries. Or if it looks bad enough I can "request fire" (virtually everyone here where I'd be driving around is a fire based system, so it's synonymous with requesting the jurisdictional 911 provider).

If I determine non injury,no medical aide requested, well then, I just advise that over the radio. If no one had called 911 and I didn't request anyone, and they're not like out in the middle of traffic or anything, that's it, I go available over the radio and continue on my merry way.
If I determined non-injury, but 911 had already been called or I had requested PD/Fire, I'd just stick around the couple extra minutes for them to show up, give them the lowdown, and then bounce "Dispatch, LAFD (or whoever) on scene handling, I'm clear, continuing enroute to detail".

Now if there are injuries, it all depends. Obviously if there are serious injuries and you're tournament-ing or suctioning an airway etc, take care of it, but try to get to the radio and advise dispatch that it is injury and you need a jurisdictional response if one hasn't been started already. You're a trained EMT in a (well presumably) fully stocked ambulance, even if you're out of service because you're by yourself doesn't mean you can't treat what you can. Now if it's something like shoulder pain and no other DCAP-BTLS I might hold off sling and swathing, but sure i can use up some 4x4's to bandage something up while waiting,it all depends on the specific scene/injuries (or lack thereof). Just use your common sense, and you'll be fine. When in doubt, call your supervisor (while doing what's least likely to make someone call and complain in the meantime, and you're good to go)
 
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Caspar

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I am aware of that type of scenario, however I was asking OP why he was doing it in this instance....guides a lot of my future questions/logic/feedback.

To answer what I was doing : yes, it was to receive supplies from somewhere right outside our boundary lines. So it's not like I was miles away, but close by. I didn't notify or call 911 because the bystanders had already done that and PD was on their way. They did not want an ambulance so only they were reesponding
 

akflightmedic

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FYI, not in this case in particular and I think you missed the point of why I said to call 911 yourself....but, there have been times where I have rolled on a MVC out of my area therefore I had no radio contact and the parties involved stated they have already called 911. Sometimes there were injuries, other times there were just road hazards.

Do you agree that a phone call from someone in a MVC and possibly excited and/or tunnel visioned is sufficient enough or do you think a follow up call from someone identifying themselves as EMT Joe from X Volley Dept, no injuries, but the cars are in the road or are leaking fluid is a better size up? Especially in a rural area where there could be delays or not all or not the right resources deployed initially based on the limited first 911 call?

What's your input on that?
 
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Caspar

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FYI, not in this case in particular and I think you missed the point of why I said to call 911 yourself....but, there have been times where I have rolled on a MVC out of my area therefore I had no radio contact and the parties involved stated they have already called 911. Sometimes there were injuries, other times there were just road hazards.

Do you agree that a phone call from someone in a MVC and possibly excited and/or tunnel visioned is sufficient enough or do you think a follow up call from someone identifying themselves as EMT Joe from X Volley Dept, no injuries, but the cars are in the road or are leaking fluid is a better size up? Especially in a rural area where there could be delays or not all or not the right resources deployed initially based on the limited first 911 call?

What's your input on that?

Yeah that makes sense. In hindsight I should have waited for the cops to arrive and ask dispatch if they received a call for the incident. At least now I know what I should do if the situation arises again.
 
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