Non EMS stopping to help at Accident Scenes

[vs-eh?]

Stopped at a mvc motorcycle saw the pt with two ladies, asked if they needed help, I am a Paramedic ACP they said "no they are RN's " Noticed the pt was on his stomach ,heard snorring respirations!!!!!!!!!!! I Went down and told them they must gain airway control HE'S BREATHING THEY SAID :twisted: :twisted: :twisted: I said thankyou for your help, I now need Your assistance. With all the c spine logged rolled and his helmet was chacked in half beside him ................rn's nicely removed it before I arrived, he had massive head trauma. Had my wife get my medical kit out the back as we where heading back from Sudbury Ont and suctioned him Airway was contolled, did abc's proceeded to remove clothing noticed a Hells Angles tat and patch GREAT he had 2 femur fx, 2 radial/ulner fx and when I opened the shirt 1 Rn passed out there was 2 lungs and a heart doing a bradycardic beat........his ribs were sticking lt/rt. Covered the cx the ambulace arrived I had 2 14g IV's in and they where BLS. THE LOOK OF HORROR ON THERE FACES I had my ACP TAG with me and went with them,intubated and he coded in hospital.

Yes it is nerdy to have a kit with you if you use it be prepared to go, have your tag with you, but the hospital was impressed with our scope of practice.....got a thankyou from the Hells Angles :shock: and the RN woke up after her friend pulled her out of the bullrushes.

Hmmmm....

Quite a story you have there...

1) You are allowed to do your fantastic ACP scope, while you are traveling out of province? And even in your own province, you are allowed (while off duty) to carry these things and practice to your full scope? Assuming you could (potentially) have? You are legally allowed to do what you did out of province with your own equipment? What did the doctors in Ontario say? What did they say in NS? I assume you (at minimum) have to advise your physicians in your province what you did (provided you were actually allowed to, which I doubt you are).

Educate me on Nova Scotia's allowance for ALS practice out of province (as an off-duty paramedic). Please supply references if possible.

I would simpley pass by because you do not know what the situation really is, what the patient has if any diseases Ex. AIDS or HIV and besides if you do stop you do not know how truthful they are going to be with you. I can remember one time a non EMT he is a firefighter on my company stopped at a scene and asked for the medical history the patient told him somethings but failed to mention that she was HIV positive. so when stopping on a scene like that you do not know what you are really getting yourself into

Why do I get the impression that you think that HIV can be transmitted to you by using a toilet seat or shaking hands...

[EmergencyMedicalTigger]

I would stop at a scene where no emergency workers are present yet. It would have to something where they would obviously need some assistance. I wouldn't personally stop at a scene where EMTs or medics are already present, unless it was in the jurisdiction of the service that I work for. Just b/c you have orders to do your skills at your service doesn't mean it would hold the same for the scene you're stopping at to help-too much liability. The emergency workers present should have the training where they will know how to deal with the situation and have additional units en route if needed.

[Ridryder 911]

We were on a scene one night, second unit on scene handling sign offs. The first until transported non-code 3 to the nearest factility and I was working on 2 sign-offs and out of no where this Buick comes zipping in off the highway and out runs a woman, probably mid-20's in scrubs with a stethescope around her neck (sign No. 1) she ran probably 100 yards up to the scene, looks into the car, which in her defense was pretty torn up....then runs up to me, clip board in hand, 2 patients sitting on the running board and yells, "I'M AN STNA, CAN I HELP?" Here in Ohio an STNA is a nurses assistant, I know there's a million different titles for them but basically they wipe asses and change bed pans for a living. Well, without skipping a bear I was like, "Well, if someone here needs their butt wiped I'll be sure to holler for you." The patients thought it was hillarious, the "samaritan" did not. She tried to turn me in to our department chief who laughed at her and told me to watch my mouth :roll: :shock:

Couple of things comes into mind. Wow! Talk about unprofessionalism. If you had been on my EMS unit, I would have requested immediate termination due to unprofessional conduct. Now, I know why most nurses call us ambulance drivers..

Remember, that CNA might be a RN someday and one wonders why she/he will have such an arrogant attitude towards EMT's. What goes around comes around....

Now, after we can stop beating our chest and screaming how great we are, we should start consider the "whole picture". Typical Randy Rescuers assume that "they" can only provide and know what is best.

In my thirty years in the field, I rarely accept interference with care or allow much help, however; I NEVER embarrass or degrade anyone! If it is nothing more than to hold an unattached IV bag or an end of a rope (not attached to anything) I will always appreciate and thank them (even if they did nothing). I even thank Basic EMT's for the care and help (even though majority of the time, they do nothing but get in my way).

I have found it is much easier to attract flies with honey than with vinegar. Customer service goes much farther than just with the immediate patient, remember many others are watching your demeanor, behavior and how you handle people. Remember, you control the scene, not let the scene control you. By acting as an arse, you have demonstrated you lack the ability to perform or have the knowledge to do so. I have had many confrontations by multiple levels, and even had one arrested but I did so in a professional and non-demeaning way. Usually by ignoring them they will get the hint.. (ever seen this in an ER to EMS crew?)

Another point is one better have a license to practice medicine on their own or to be placed in a "never off duty" protocols by their licensed physician, if they establish any ALS care before I arrive. In the U.S. it is prohibited by Federal Law to carry IV solutions, ET tubes, etc.. without a physicians authorization (prescription) ... read the IV bag, if you don't believe me.

Remember we represent more than ourselves on calls and how we handle the scenario may be what our whole profession is judged upon.

R/r 911

[whit72]

I have to agree, a polite " I think we are all set, thank you though." would have sufficed.

Belittling a person in front of others is an insecurity problem whatever the level or title. There is enough of that already in this field.

Remember you see the same people on the way up as you will on the way down. That might be your ass she is wiping someday. Hope you like it all the way up your back

[Asysin2leads]

As said before, it all depends really, but me being me you have to have some really extenuating circumstances for me to play the good samaritan, given the risks. I really can think of only one time when I have actually stopped off duty and rendered aid, and in retrospect, you could play "spot 1,000 things wrong with this picture" of the scene.

I'm on may to work, in uniform, on the Garden State Parkway years ago, and oh no, there are people slowing down ominously in front of me, which usually only means one thing on the GSP. A few more feet up the road, and yep, there down in the embankment, passed the twisted guard rail, facing the wrong direction and missing its front axle is a mangled pick up truck. This accident had just happened. No cops, no ambulance, nothing. I am in uniform and I actually have my med bag on me because I am on my way to work. So I do the christian thing and get out, and luckily the driver was uninjured and walking around, but his elderly female passenger is still buckled into her seat. I open the door to see if she is okay just as a very loud State Trooper shows up and starts throwing people off of the scene. He was very effective. The old lady tells me she is having some trouble breathing, and I notice some paradoxical movment in her chest. I also got a nice whiff of airbag chemical that was all over the front, which also wasn't very smart.

So I tell her not to move and prepare to take c-spine immobilization when your friendly neighborhood redneck who isn't listening to the loud State Trooper comes up to me and says "Hey dude, this thing's leaking gas!", just as I get a very strong smell of gasoline, and look to my right to indeed see gasoline pouring out of a ruptured gas tank onto a hot exhaust pipe, causing hot gasoline fumes to rise up off of it.

At this moment I made a split second decision. I didn't calculate the flashpoint of gasoline, I didn't take into account the legal ramifications of moving an injured person, heck, I hadn't even done a neuro evaluation yet, but just as well, I picked up the old lady out of her seat and carried her up the embankment to a safe distance away from the truck. No, it did not burst into flames, and no I wasn't a hero, and it may not have been strictly the right thing to do but its what I did.

The 'squad' showed up a short time later, and after a bit of cajoling, got her on some oxygen, it looked like she had a few cracked ribs, and she was boarded and collared and on her way to the trauma center.

That's really the only time I've done anything off duty at an accident scene that really was worth mentioning, and as you can see, it was really dangerous and could have gotten me in a lot of trouble.

[Coach Hohman]

Couple of things comes into mind. Wow! Talk about unprofessionalism. If you had been on my EMS unit, I would have requested immediate termination due to unprofessional conduct. Now, I know why most nurses call us ambulance drivers..

Remember, that CNA might be a RN someday and one wonders why she/he will have such an arrogant attitude towards EMT's. What goes around comes around....

Now, after we can stop beating our chest and screaming how great we are, we should start consider the "whole picture". Typical Randy Rescuers assume that "they" can only provide and know what is best.

In my thirty years in the field, I rarely accept interference with care or allow much help, however; I NEVER embarrass or degrade anyone! If it is nothing more than to hold an unattached IV bag or an end of a rope (not attached to anything) I will always appreciate and thank them (even if they did nothing). I even thank Basic EMT's for the care and help (even though majority of the time, they do nothing but get in my way).

I have found it is much easier to attract flies with honey than with vinegar. Customer service goes much farther than just with the immediate patient, remember many others are watching your demeanor, behavior and how you handle people. Remember, you control the scene, not let the scene control you. By acting as an arse, you have demonstrated you lack the ability to perform or have the knowledge to do so. I have had many confrontations by multiple levels, and even had one arrested but I did so in a professional and non-demeaning way. Usually by ignoring them they will get the hint.. (ever seen this in an ER to EMS crew?)

Another point is one better have a license to practice medicine on their own or to be placed in a "never off duty" protocols by their licensed physician, if they establish any ALS care before I arrive. In the U.S. it is prohibited by Federal Law to carry IV solutions, ET tubes, etc.. without a physicians authorization (prescription) ... read the IV bag, if you don't believe me.

Remember we represent more than ourselves on calls and how we handle the scenario may be what our whole profession is judged upon.

R/r 911

I missed the part where I bragged about my amazing level of training? I'm an EMT-Basic, and I realize the level in which I can provide care. Do I think that I was acting in the right? Absolutely not. In fact, I acted unprofessionally. It was a Freudian slip...I forgot to mention that I did apologize to her a couple minutes later. however, my reaction was based primarily on her EXTREME over reaction. Did I over react...yeah, probably. However, it should be evident to any bystander that if an EMT (or medic for that matter) has 2 patients sitting on the back bumper of the ambo, that there isn't an emergency. In fact, I was laughing and joking with the patients prior to the arrival of said STNA/CNA. So, in hindsight, it wasn't a smart thing to do. However, you can drop the "greater-than-thou" attitude off at the door. In your 30 years you've never made a single mistake? If I ever consider getting into paramedicine, let me know where you went to school. If they teach you to be THAT phenomenal, I need to get into that program.

Remember, you control the scene, not let the scene control you. By acting as an arse, you have demonstrated you lack the ability to perform or have the knowledge to do so. I have had many confrontations by multiple levels, and even had one arrested but I did so in a professional and non-demeaning way. Usually by ignoring them they will get the hint.. (ever seen this in an ER to EMS crew?)

Please paraphrase in my original post where you feel that I lack the ability to perform or lack the knowledge to write two AMA refusals? You're judging my level of competance in patient care based on my sarcasm? Some of the best doctors I've ever met were the biggest asses to ever walk to the face of this earth. Good bedside manner? Not necessarily. Good physicians? absolutely. I'm not in any way trying to compare my level of training to the of a doctor (which would be asinine) but rather I am questioning your ability to judge my performance as an EMT based on....what? Like I said. I should have handled the situation differently, and I appreciate QI you just provided. But brash generalizations without substantiated information to support them are nothing more than a fancy way of taking a shot at me without the evidence to support your claim.

[Asysin2leads]

Dude, you seriously needed to be taken down a peg. How would you feel if you came onto scene and asked if I needed assistance, and I said, "no thanks, I can hold my own oxygen bag?"

Yeah, bystanders can be annoying, yeah, they can get in the way, but geez, the girl was trying to help. And as for those amazing doctors you know, I'm sure I know a few doctors who are both better clinicians than them and not super deluxe dicks. So, what does that say about those doctors you know?

[BushyFromOz]

How would you feel if you came onto scene and asked if I needed assistance, and I said, "no thanks, I can hold my own oxygen bag?"

Ha! Thats a funny line right there, the only thing missing from the end of a line like that is the words "you tosser" 8) :wink:

[Coach Hohman]

Dude, you seriously needed to be taken down a peg. How would you feel if you came onto scene and asked if I needed assistance, and I said, "no thanks, I can hold my own oxygen bag?"

Yeah, bystanders can be annoying, yeah, they can get in the way, but geez, the girl was trying to help. And as for those amazing doctors you know, I'm sure I know a few doctors who are both better clinicians than them and not super deluxe dicks. So, what does that say about those doctors you know?

I don't argue the fact that there are better doctors. However, I took that as a personal attack on me as an EMT, by basing my patient care on my (then) attitude. That was roughly 2 years ago. I told that story kind of in jest, but I've came a long way since then. So, when it comes to patient care, EMS operations, or anything patient, EMS, or hospital related....I yield to the floor and learn. But when you get called out, you should defend yourself. So..DUDE, as I keep saying, it was a joke, it was stupid, and I'm admitting a mistake, so get off it.

[steph1030]

we have had nurse's,off duty emts,medics stop and help out during an mva.i have done it myself a few times.there isnt anything wrong with it as long as they can produce their credentials.

i dont know of any medical personnel that doesnt carry their id(emt,fr card etc)with them.

maybe some dont but in my area we are required to have it with us in some way at all time