The Call I Should Have Been On

[Neb.EMT]

I'm going to make this short. I don't really want to get into a big discussion on this on the open forum. If anybody needs further clarification or would like to discuss this issue further with me, just PM me please.

Earlier this year we were called to an accident with a possible head injury. I was not required to respond to this call but could have. I didn't (2-3 years ago I probably would have). It turns out that the victim was a member of our department and a friend of mine. There were mistakes made on this call that reduced whatever chance the victim had in the first place. Meanwhile, I listened to this cluster on the radio rather than responding. My friend died about 4-5 hrs later at the trauma center. There's a lot more to this story but, this pretty much sums up the events.

I have been a career EMS provider for about 6 years and have dealt with crappy calls (including family members that have died) in the past. This incident though just won't leave me alone. I just don't know what to do. It's the call I didn't respond to that is giving me more trouble than any I have responded to. If anybody has any suggestions please PM me. If you need more details, I can get into that too via PM. I just don't feel like getting into all the specifics on the open forum.

Thanks in advance to anybody who responds to this.

[JPINFV]

I'm going to be blunt and I'm going to do it in the open forum because this is something that everyone who is suffering from a similar problem should see. If it has been a while from the incident and it is still troubling you this much, then you should probably seek professional help. There is absolutely nothing wrong with seeking professional counseling over this. Seeking help (real help, not forum help) doesn't make you weak, just like someone calling 911 because their having a heart attack and using your professional services as an EMS responder doesn't make them weak.

[itku2er]

I'm going to be blunt and I'm going to do it in the open forum because this is something that everyone who is suffering from a similar problem should see. If it has been a while from the incident and it is still troubling you this much, then you should probably seek professional help. There is absolutely nothing wrong with seeking professional counseling over this. Seeking help (real help, not forum help) doesn't make you weak, just like someone calling 911 because their having a heart attack and using your professional services as an EMS responder doesn't make them weak.

I agree with you JP. But I do have a question What makes you NB think the outcome would have different if you were on that call? Was the care that bad from your crew mates that resulted in this guys death? If so you should either look for another job or start blowing the whistle.

Edited December 16, 2009 by itku2er

[rdelisle]

My question is, was this your scheduled shift off? If it was then you can't truly blame yourself, we can't be everywhere all the time. As care providers we do need "me" time occasionally. I tried that life once where you show up to everything whether on shift or not and it can have a negative effect on you and your family in time. I also agree with the above posters in that it may be time to seek professional help dealing with this, both for your sake and that of your family's. Since I don't know all the details I won't claim to know what you are feeling but I will say stay strong and good luck with this.

[crotchitymedic1986]

On or off shift does not matter, the facts of the call are this:

1. You did not cause the injury.

2. If the neurosurgeons could not save this person, then it is doubtful that a paramedic/emt could either.

3. You mention mistakes were made, but again, those were not made by you; they were made by others.

If you could magically go back in time and respond to the call, I am guessing that there is a 99.99% chance the outcome would still be the same. Maybe the call would have been smoother, maybe you would know that EMS did all that it could do, but massive head injuries rarely have a good outcome no matter what is done. There is only so much that we superheros can do. A famous quote can be borrowed from the TV show MASH that relates to this issue: "1. Young men die in wars. 2. Doctor's can't change rule # 1." The same is true of EMS, definitely go talk to a counselor.

[HERBIE1]

On or off shift does not matter, the facts of the call are this:

1. You did not cause the injury.

2. If the neurosurgeons could not save this person, then it is doubtful that a paramedic/emt could either.

3. You mention mistakes were made, but again, those were not made by you; they were made by others.

If you could magically go back in time and respond to the call, I am guessing that there is a 99.99% chance the outcome would still be the same. Maybe the call would have been smoother, maybe you would know that EMS did all that it could do, but massive head injuries rarely have a good outcome no matter what is done. There is only so much that we superheros can do. A famous quote can be borrowed from the TV show MASH that relates to this issue: "1. Young men die in wars. 2. Doctor's can't change rule # 1." The same is true of EMS, definitely go talk to a counselor.

Agreed on all counts.

Guilt is also a bad thing- especially if it's unwarranted.

[Richard B the EMT]

I was off duty, when I monitored, on a scanner, a report of a bus crash, with possibly 30 injured. Also heard reports on local full time news radio stations, both reporting the incident, and in the traffic reports. In my Personal Owned Vehicle with me, was my girlfriend, Lady J, and she is not even a Certified First Responder. We were not too far from the accident, geographically.

A) Me:

1) Off duty.

2) "Scanner" responses discouraged.

3) Different station's area, although same agency (I work Queens, the action was in Brooklyn).

4) POV, no patient transport capabilities.

5) With all the radio chatter monitored on the scanner, on the EMS (both municipal and local VAS), FD, and PD dispatch frequencies, obviously they had enough help, I wasn't needed.

6) I do carry equipment in the POV.

Incident:

1) The bus hit a telephone pole.

2) The bus driver suffered a sudden cardiac arrest, and probably was dead before the bus veered off the roadway and into the telephone pole.

3) The incident happened just after nightfall, on a local street, so the bus was probably going less than 30 MPH.

4) This was a chartered bus, taking a group to an Atlantic City casino for an overnight gambling jaunt.

5) The trip was supposed to benefit a local political club.

6) The group leader was standing in the isle, selling raffle tickets, and was thrown against the inside of the windshield.

7) Everyone aboard was transported to be, minimally, checked out at nearby ERs (Agency policy is, in a vehicle accident where there is even 1 death, all must be seen, preferably at the trauma centers).

8) The trip leader was the "executive member" of this local political group, meaning an elected official, from my residential area.

9) I, Lady J, and Momma B all hold unpaid offices in the political club (Momma B is President, Lady J is a VP, and I'm a board [bored] member at large).

10) It was not until the next day I found out that it was my political club's bus that had crashed.

11) Only one of the bus passengers was kept overnight in a hospital, "for observation", but everyone else was a minor injury case.

C) Rational:

1) Legally, I had no duty to act, as I was off duty, not in uniform, and "technically" "outside" my response area (as already stated, I work a section of Queens, this call was in a section of Brooklyn, although the duty uniform patch says "City of New York", which includes both).

2) As there were so many units, and associated crews, on the scene, per what I was hearing on the monitored frequencies, I felt justified in not having a moral duty to act, while the incident was ongoing.

I had, and have, no problems that I didn't go. I felt bad for the victims, and worse for the driver, but have a clear conscience.

Keep it polite, people.

Would you have done anything different, given the description given here?

[ewfc19]

Neb.EMT:

I've never been in your situation. I've been in a similar situation where I didn't respond, it ended up being a friend. I knew the folks that did respond, and I know they did everything they could. Therefore I was happy to NOT have to carry the burden of seeing a friend in arrest.

Anyway... If there were mistakes made by your agencies crews - perhaps you can turn this into a positive and address the mistakes in a positive way, though training to prevent the same mistakes in the future?

Richard:

You are in NYC. I don't know how close you really were... but unless you'll beat the first in units... I don't see how you are gonna really help. Further, You'd be bringing non-trained folks to the party, and you might be putting a loved one in danger. I can't see how you would have done anything different.

Edited December 26, 2009 by ewfc19

[firemedic37]

Neb.EMT:

Anyway... If there were mistakes made by your agencies crews - perhaps you can turn this into a positive and address the mistakes in a positive way, though training to prevent the same mistakes in the future?

I could not agree more, if you think there perhaps was a mistake made and make it into a teaching moment. Perhaps your service can sponsor a PHTLS course that can improve the outome of future calls.

Perhaps they (your fellow co-workers) too were good friend of the victim and they just froze and could not think what to do.

I understand that you made a choice and that you cannot change, nor can you change the outcome of the accident.

Please seek help that can offer you closure and assurance that you did not do anything wrong by not choosing to respond to this call.

[Richard B the EMT]

EWFC19: Before the NY State DoH created the title of "First Responder", my VAC had them as an "In House Only" title. Lady J held that title, but left the EMS field prior to the NYS DoH instituting the statewide title. Therefore, she would have been a knowledgable person without cert or licence onscene, and presumably MIGHT have been able to render some care under my direction and control. Notice I say "MIGHT", as I have no idea of what the state says about something like that.

(Afterthought: Back in 1974, my first EMT Instructor/Co-ordinator told us to learn our craft, that if on a scene we became injured, we could direct a bystander in treating ourselves.)