Treating Patients While Off-duty

[flamingemt2011]

Here is one person who believes you do have a duty to act, take it for what it is worth:

http://www.ems1.com/...S-Professional/

Key excerpt: EMS professionals, on the other hand, owe a much greater duty to the community while on or off the job. Providers have the duty to act as would a “prudent, reasonable EMS provider with the same level of training, in the same community, and under similar circumstances.” That’s the legal description.

So if in that county they have a bunch of volunteer yahoos who stop on the side of the road, you may be found negligent for failure to assist (open to interpretation, but if the plantiff had a good lawyer, and your only defense is I was off-duty, not sure you would win).

And of course there is the EMT Oath and Code from National Registry:

http://www.naemt.org...us/emtoath.aspx

AND ER DOC is right, ABC always comes first before c-spine, only a small percentage of trauma patients have c-spine fractures, cant tell you how many times i found some volunteer holding c-spine on an apneic trauma patient, instead of bagging them.

Edited September 29, 2011 by flamingemt2011

[hatelilpeepees]

Hmmmm, making me think. I know this is crazy but hear me out. In my hood we have toll roads and are about to have toll lanes on another interstate, where most people by a transponder for your windshield so you do not have to stop and pay. So lets say there is an accident, which is visible by one of the traffic cameras, lets say the person has been ejected and is not breathing, and I just drive on by. Five minutes later, I pass through the toll booth, and my transponder is registered as going through the toll booth. A smart lawyer subpeonas all camera footage from that toll road, and you can see me on camera, looking at the wreck as I creep by, but I do not stop. What do you think a jury would say ? True, I had no supplies, but I could open an airway, or do CPR.

Or an easier scenario, I pass and do not stop, but call 911 and give a fake name. The investigators want to interview all of the witnesses to find out what happened, I am called in and it is learned that I am a medic. What then ?

I know that there is no written law about this, but that does not mean you will not be found negligent. Most corporations have been found negligent for something incredibly stupid, but they lost just the same "thats why Preparation H has a warning label that says "do not eat".

[Just Plain Ruff]

Hmmmm, making me think. I know this is crazy but hear me out. In my hood we have toll roads and are about to have toll lanes on another interstate, where most people by a transponder for your windshield so you do not have to stop and pay. So lets say there is an accident, which is visible by one of the traffic cameras, lets say the person has been ejected and is not breathing, and I just drive on by. Five minutes later, I pass through the toll booth, and my transponder is registered as going through the toll booth. A smart lawyer subpeonas all camera footage from that toll road, and you can see me on camera, looking at the wreck as I creep by, but I do not stop. What do you think a jury would say ? True, I had no supplies, but I could open an airway, or do CPR.

Or an easier scenario, I pass and do not stop, but call 911 and give a fake name. The investigators want to interview all of the witnesses to find out what happened, I am called in and it is learned that I am a medic. What then ?

I know that there is no written law about this, but that does not mean you will not be found negligent. Most corporations have been found negligent for something incredibly stupid, but they lost just the same "thats why Preparation H has a warning label that says "do not eat".

But the same could be said for stopping and rendering aid, doing the wrong thing or just doing the right thing and you can still get sued. As the plaintiff you really have to prove that my not stopping resulted in further injuries to you. If you can prove to the jury or judge that had I have stopped that I could have kept you from being further injured or not dead then by all means you will win. But with no equipment in my car other than opening your airway if it's obstructed or keeping c-spine immobilization(and you have to have a spinal injury for that one to fly) then what good am I to you?

Now for those who have that jump kit with oxygen and pulse ox and/or IV supplies, don't you put yourself at a significantly higher liability for stopping? Would love to have a lawyer that knows about these things chime in here.

There was a case on this forum a long time ago, maybe 2-3 years ago that a EMT Stopped and pulled a patient out of the car fearing fire, and did cervical spinal damage I believe leading to paralysis or some deficit. that emt was sued because she was just stopping and helping.

So again, i'm not saying you are wrong for stopping or you are wrong for not stopping. It's personal choice.

If the highway is deserted and I'm driving on it and there is an accident I'll stop and offer whatever aid i have in my car, be it a blanket, or a couple of napkins to put over the bleeding and what not and then I'll call 911. I'll tell the people in the car that helps on the way. I'll get an ETA of the responding units from the 911 operator if I can. Depending on how far out the responding units are I'll either just be there for support or do what I can do within what I have in my car.

if the ambulance is 10 minutes out and there is a person who is not breathing and pulseless I'm probably not going to start CPR. Heartless, nope, just a realist.

I have to say it's all dependent upon circumstances and whether I have other plans that I can't miss out on .

If I have my child in the car, I'm not going to stop because on a busy highway or a uncontrolled highway the danger is too great to leave them in the car unattended.

Edited September 29, 2011 by Ruffems

[zmedic]

For all the worry that people have over not stopping, I don't think I've heard of an EMT being actually sued for not stopping.

I look at it this way. You became an EMT to help people who are in need. If you come upon an accident or someone needing help and you can safely help them, and there are not already EMTs/FFs on scene, why wouldn't you help? And to the argument that you don't have any gear, if the goal is to make people feel better, if all you do is sit there and hold there hand and check a pulse they are going to feel much better that someone is there with them for the 10 minutes it takes for the ambulance to get there than if they are sitting in their smashed car alone.

[Just Plain Ruff]

For all the worry that people have over not stopping, I don't think I've heard of an EMT being actually sued for not stopping.

I look at it this way. You became an EMT to help people who are in need. If you come upon an accident or someone needing help and you can safely help them, and there are not already EMTs/FFs on scene, why wouldn't you help? And to the argument that you don't have any gear, if the goal is to make people feel better, if all you do is sit there and hold there hand and check a pulse they are going to feel much better that someone is there with them for the 10 minutes it takes for the ambulance to get there than if they are sitting in their smashed car alone.

Good points Zmedic.

If I'm alone, I could consider stopping but I'm rarely alone in my car, usually either my daughter or son are in the car with me. I won't leave them in a empty car so I can go and see what I can do.

We already have a set of cars that are wrecked and I'm not sure of the number of collateral crashes that occur with the lookie loo's but i'd hate for my car to be the car hit by one of those distracted drivers.

Case in point, mva on highway, the ambulances and Fire trucks closest to the wreck respond. They are taking care of the victims of the accident. Suddenly the radio traffic comes over as "Emergency traffic, need additional ambulances and response to our location, have 2 men down struck by car"

Full response, we are the next closest ambulance and we respond. Enroute were updated that there are 3 responders down and the driver was pinned underneath the firetruck.

that's the collateral car wreck that I'm talking about and my luck is that they will crash into my car, no matter how far away I park.

so if I'm alone then I probably would stop but if I'm not alone then I'll just call it in.

and if I see any blood or stuff like that, I'll just give em 2 nitros and put a c-collar on em.

Edited October 5, 2011 by Ruffems

[FNGfirstresponder]

Excuses, excuses. Yes the potential for an accident behind the first accident is possible, but statistically, how many first responders have been hit or injured in a secondary crash (I imagine less than 1%). As far as being sued for wrong treatment, most states have a good samaritan law so that excuse does not work either. Just admit it, you are lazy and/or burned out.

[DFIB]

Excuses, excuses. Yes the potential for an accident behind the first accident is possible, but statistically, how many first responders have been hit or injured in a secondary crash (I imagine less than 1%). As far as being sued for wrong treatment, most states have a good samaritan law so that excuse does not work either. Just admit it, you are lazy and/or burned out.

Your post would be funny if it were not so sad.

Why would anyone think that their personal fantasy about a "duty to act" would hold true for others other than what is clearly defined by law. That just seems a little arrogant and naive to me.

Edited October 5, 2011 by DFIB

[JPINFV]

To stop and help or not? To stop to keep idiots from making a situation worse or not? It all depends. To counter a "Stop to stop idiots from moving a patient" argument with a situation where no spinal precaution would be taken due to an imminent environmental threat is a straw man argument.

As with everything, the ultimate answer is "it depends." Stopping at an accident in the middle of Los Angeles is a different decision than stopping at an accident on the 15 in the middle of the Mojave Desert on the way to Vegas. Similarly, there's a difference between making your way halfway through a stadium and walking 3 rows back. Similarly, there's a difference between treating a patient without BSI who's a bloody mess and checking a pulse on a patient who collapsed and starting compressions (and that 3-4 minutes for the ambulance to be notified and respond is important). To further make a comment on the BSI front, I swear, EMS providers makes themselves sound like they all have a case of SCID and live in a bubble.

To treat all situations the same is the height of stupidity.

If it comes down to leaving him under a burning car or holding c-spine, get him out from under the car. C-spine injuries are not nearly as common as they are made out to be in EMT class. Most people do not end up with broken necks.

You mean the spinal column isn't weaker than a piece of uncooked spaghetti?

And of course there is the EMT Oath and Code from National Registry:

http://www.naemt.org...us/emtoath.aspx

I never took an oath when I became certified and licensed as an EMT. Furthermore, oaths are more like guidelines, or else things like surgery or palliative care would be off the table (taking the Hippocratic Oath's requirement to 'do no harm' to stupid extreme).

[Happiness]

Excuses, excuses. Yes the potential for an accident behind the first accident is possible, but statistically, how many first responders have been hit or injured in a secondary crash (I imagine less than 1%). As far as being sued for wrong treatment, most states have a good samaritan law so that excuse does not work either. Just admit it, you are lazy and/or burned out.

Ruff isnt making excuses, he is making sense. He has small kids and small kids have a habit of not listening and a higher chance of getting out of the vehical and getting hurt. There have been alot of accidents involving good samaritans getting hurt by stopping to help, and you better take a good look at your good samaritan laws, because Im not to sure if medical personel are covered under it in the states because they have a higher level of training. And to come here and call someone who infact is well respected and call him lazy and burned out is of bad form, just saying

[FNGfirstresponder]

I didn't mean ruff personally, I meant you as in the whole group