Non EMS stopping to help at Accident Scenes

[WannaBeEMT]

There was a bit of a disagreement on this topic, so I'd love to hear your opinions on it.

Q. When a car accident occurs, and someone who has some medical knowledge and training (Like an EMR, MFR) stops to help, to assist with what is needed, provided the actions are in his/her training/authorized ability to do so. EX. Keep a clear airway, hold manual C-Spine, CPR, protect from elements with blanket, update EMS, etc.

If you were responding to this emergency. How do you feel, has this person done the right thing by stopping to help, or should s/he, who has the ability to help, just drive by, and only call 911?

[vs-eh?]

There was a bit of a disagreement on this topic, so I'd love to hear your opinions on it.

Q. When a car accident occurs, and someone who has some medical knowledge and training (Like an EMR, MFR) stops to help, to assist with what is needed, provided the actions are in his/her training/authorized ability to do so. EX. Keep a clear airway, hold manual C-Spine, CPR, protect from elements with blanket, update EMS, etc.

If you were responding to this emergency. How do you feel, has this person done the right thing by stopping to help, or should s/he, who has the ability to help, just drive by, and only call 911?

First and foremost ASK THE PERSON if they want help or want 911 called. I find too many people taking it upon themselves to activate 911 when THE PATIENT doesn't want police/fire/ambulance called. People have this diluted sense of "duty" when they see every Tom or Sarah slip and fall and call 911 BEFORE talking to the patient. Or the same people that call 911 for some guy that is being carried home drunk by their buddies, WITHOUT TALKING TO THEM! Then we come and police/fire and the people are like WTF!? Then the bystandard says stuff like "I am obliged to call" :roll: Now they will be sitting on our stretcher for hours tying up an ambulance, instead of being watched at home, which most sane people would do...

I have never stopped at an accident/scene. Unless I see something that totally warrants my attention/intervention as an off-duty paramedic, I will carry on. If you have some kind of education be it first aid or doctor, please ask the person if they want help or want 911 to be called. DO NOT BLINDLY CALL 911.

You use your own 2 hands to help, nothing more. Basic ABC's and as good of a Hx as you can get to give to the paramedics. The best bystandards are the educated ones that intervene as they can, give a good concise report, ask if they are needed, and leave. Anybody that does this, gets a "Where do you work?" question from me....and it is always either a MD or paramedic and it is followed from them with a "We good? Ok, later man"...

[chevy]

My opinion is that, unless the scene obviously has sufficient personnel, to stop (if safe to do so), state your "cert level" and ask if the crew needs a another set of hands. If they say no, leave.

I am not implying that you stop everytime you see a crew by the side of the road, but if there are obviously multiple patients (multi-vehicle MVC) and only one crew, then maybe it's a good idea.

We are taught to use anyone and everyone at a scene if an extra set of hands is required to do exactly the sorts of things you mention (and also how to get the unwanted "rescue randy" out of the way).

..chevy

[ERDoc]

If I see an ambulance on scene I generally don't stop. If there is no one on scene, I'll stop but once the ambulance gets there it is all theirs. The least I can do is place a call to 911 and let them know what they might need (multiple ambulances, helicopter, FD for a washdown, etc). When I was in the field it was always nice to have an extra set of hands if they were needed, as long as they knew who was running the scene.

[vs-eh?]

My opinion is that, unless the scene obviously has sufficient personnel, to stop (if safe to do so), state your "cert level" and ask if the crew needs a another set of hands. If they say no, leave.

I am not implying that you stop everytime you see a crew by the side of the road, but if there are obviously multiple patients (multi-vehicle MVC) and only one crew, then maybe it's a good idea.

We are taught to use anyone and everyone at a scene if an extra set of hands is required to do exactly the sorts of things you mention (and also how to get the unwanted "rescue randy" out of the way).

..chevy

Oh...People are talking about stopping at an accident when an ambulance is already on scene? God no...

Listen, the paramedics can call for additional resources as needed. Knowing paramedics, the vast majority will not be that receptive to people stopping and offering help. At the very least they will think you are a "Rescue Randy" that they will have to keep an eye on. Unless there are bodies strewn everywhere or it's an 80 car pile up with one ambulance, leave the paramedics to themselves.

Long story short - Unless somebody collapses in front of you, is in a car accident in front of you, or some other random thing, just save your life saving skills to the pro's...No professional paramedic, RN, MD, etc... Is going to "intrude" on a scene or "offer more help then needed" when a crew is already there.

They have enough to do.

[WannaBeEMT]

Those were my thought exactly. Thank you for confirming. I don't usually pull over if the emergency crews are on site, but will stop and ask if everyone is okay, need help, or to call 911, if the needed services are not present. If everything is good, I leave. With the wintery road conditions, we have a ton of cars in the ditches. One guy was on the phone with CAA, but had no idea where he was, "uh, in the ditch!!" so I just gave him the cross streets, and was on my way.

Now this last Friday. I was going to work in the morning, when came across a 2 vehicle accident, both were in the ditch, and one was "hugging" a utility pole. A few bystanders on scene, who had no medical training, but were on the phone with the 911 dispatcher. So After checking for hazards, I identified myself as an advanced MFR, and asked if help was needed. Consent was obtained from the patient. So I had someone hold manual c-spine control, and asked the patient to not move his head. Asked questions, to assess LOA and LOC, to ensure an open and clear airway, ability to breathe without much difficulty, did a rapid body survey to check for any life threatening bleeding (with consent again). Covered with two blankets and kept talking to him, to keep him calm. His chief complaint was his neck and side of head, and a few small scrapes and bruises. The police arrived a few minutes after I stopped, then in another couple minutes, the EMS and Fire came, taking over the care. I gave the handoff report, and cleared with the cop that I was no longer needed, and was on my way.

This was my first "real life situation". Before it was only practicing scenarios, mostly with partners. So this was a big experience for me, that was somewhat on the nerve-wrecking side, but I did as trained (missing a few things, but nothing life threatening), so overall, I had a positive experience, and hope that the patient felt cared for.

[Timmy]

I’ll go with what’s already been said… Generally if there’s been an accident and EMS are already on scene I wouldn’t stop unless it looked like they needed help. Coming back from a sports trainer’s conference one night we came across an accident that had involved 3 cars and only 2 ambulances and a copper car on scene. The paramedics were busy working on the 2 unresponsive people trapped in their car so we helped the people who were sitting on the side of the road, putting on collars and reassuring them until more trucks arrived. Living in a rural area it sometimes pays to stop as it can be anything up to an hour for a second unit to arrive. Generally the SES rescue and CFA fire guys have a pretty good handle on first aid, no point in having an overcrowded scene.

[BEorP]

There was a bit of a disagreement on this topic, so I'd love to hear your opinions on it.

Q. When a car accident occurs, and someone who has some medical knowledge and training (Like an EMR, MFR) stops to help, to assist with what is needed, provided the actions are in his/her training/authorized ability to do so. EX. Keep a clear airway, hold manual C-Spine, CPR, protect from elements with blanket, update EMS, etc.

If you were responding to this emergency. How do you feel, has this person done the right thing by stopping to help, or should s/he, who has the ability to help, just drive by, and only call 911?

Even an EFR first on scene is not going to be much use. Holding C-spine, updating EMS, and putting a blanket on someone will not save their life (and chances are your CPR won't either...). I'm not saying don't stop to see if they want 911 called, but I'm just saying it's no different if it's an EFR or a random person.

Many wanna bes get their EFR certs and suddenly think that they are the greatest thing to happen to people in need since paramedics. The way I see it with stopping as an EFR is that either it is going to be pointless because the accident will be minor and you will be able to do nothing or the accident will be serious and all the pt really needs is a quick trip to a trauma centre. Also keep in mind the safety issues with stopping at an accident.

[Timmy]

It doesn’t matter what level you are, if you stop at an accident and do something as basic as control someone’s bleeding or tilting their head back to secure an airway than that can mean the difference between life and death. I’d much rather have someone come help me if I was involved in an accident instead of someone just standing there waiting for EMS to arrive.

[scratrat]

I never stop unless it's a crew I know and it looks like they need help.

I hate when people stop at my scenes. "I'm a nurse, I can help!" Please god, don't. It never fails. They are ALWAYS either a nursing home "nurse" or the ICU nurse. Neither of which is helpful on an MVC.