MVC's on the interstate

[+medic]

If you act in good faith and with in your scope of practice for the level of training held, I seriously doubt a court would even take it to trial or file charges.

Now if you act out side of your scope of practice or do something stupid like interfere with the emergency responders once they arrive then you deserve whats coming to you. The way I see it is its best to do what you can do to the best of your ability then do nothing at all. If its holding C-Spine fine, if its giving basic care/First aid thats fine as well but when you step outside of what you know you should be doing then thats a problem.

But like every thing in life you need to use common sense but alas common sense ain't so common for some people.

I'm no super hero but I believe in helping out someone in need.

Edited June 7, 2010 by +medic

[crotchitymedic1986]

Lets change the scenario just a bit, and see if anyone has a different attitude. You are on a cruise to some 3rd world country, you dock, and start enjoying the many amenities and activities that are available. You and your child decide to rent some jet skis, and are having the time of your life when another jetskier (drunk) collides with your jet ski and gives your child a serious head injury. The local hospital is a shack, with no advanced capabilities. There are no neurosurgeons, MRI's, or CT scanners. There is a world renowned Neuro Surgeon from the States on your cruise ship (a passenger like you, on vacation), but he refuses to even look at your child, because he is not covered by his malpractice insurance to treat people in foreign countries, and he lacks the tools that he is accustomed to (so he cant do any good). How do you feel then ?

Edited June 8, 2010 by crotchitymedic1986

[+medic]

Lets change the scenario just a bit, and see if anyone has a different attitude. You are on a cruise to some 3rd world country, you dock, and start enjoying the many amenities and activities that are available. You and your child decide to rent some jet skis, and are having the time of your life when another jetskier (drunk) collides with your jet ski and gives your child a serious head injury. The local hospital is a shack, with no advanced capabilities. There are no neurosurgeons, MRI's, or CT scanners. There is a world renowned Neuro Surgeon from the States on your cruise ship (a passenger like you, on vacation), but he refuses to even look at your child, because he is not covered by his malpractice insurance to treat people in foreign countries, and he lacks the tools that he is accustomed to (so he cant do any good). How do you feel then ?

Good scenario

What the best course of action would be to contact your countries consulate most including our own deal with issues like this all the time. Also depending on the country your cruse ship is in chances are you could not even bring a malpractice case against said doctor. But under Maritime law assuming your out in the open sea or under a foreign flagged vessel in port. Any doctor can treat you with out fear of prosecution to the best of his ability with the equipment at hand.

In a situation like this what would happen the nearest country with the capable means of evacing out the patient would be called. Our military does this a lot in third world countries when American citizens need urgent medical care. The Royal Navy and Royal Air Force do this as well in most of the ex colonel holdings and commonwealths of the British crown.

I have been on many temporary deployments for medical evacs as mechanical support while in the Air Force. We flew a lot of people out of the horn of Africa and other places I cant talk about. I also studied maritime law before I was in the Military.

But in reference to your last statement I would feel mad but do all I could to change to doctors mind. But with out the proper tools there is not much he could do. If it was me I would do my best to persuade him to just have a look since its better to try to do something then nothing at all if death was certain assuming that a medical evac was en route or being called.

Edited June 8, 2010 by +medic

[tskstorm]

Lets change the scenario just a bit, and see if anyone has a different attitude. You are on a cruise to some 3rd world country, you dock, and start enjoying the many amenities and activities that are available. You and your child decide to rent some jet skis, and are having the time of your life when another jetskier (drunk) collides with your jet ski and gives your child a serious head injury. The local hospital is a shack, with no advanced capabilities. There are no neurosurgeons, MRI's, or CT scanners. There is a world renowned Neuro Surgeon from the States on your cruise ship (a passenger like you, on vacation), but he refuses to even look at your child, because he is not covered by his malpractice insurance to treat people in foreign countries, and he lacks the tools that he is accustomed to (so he cant do any good). How do you feel then ?

How was he identified? Did I know him to be a surgeon or did he announce himself as one?

If he announced himself he pretty much volunteered to help, If I knew him to be a surgeon, where does his duty to act come into play?

This is an interesting twist but still doesn't have absolute answers.

[rat115]

Going back to the original question. I'm am mandated to stop within the county that I live in. I work on a volunteer service which is county run. If I see any accident, I am required to find a safe spot to pull over (this is important on our secondary highways), call for help, and render aid until an ambulance arrives. Here, it can be anywhere from 5 minutes to close to an hour depending where you are in the county and the weather for the ambulance to get on scene. Because of this, I do carry one of the two safety vests that the county provides in my vehicle at all times and one for the area Citizen's Emergency Response Team (CERT).

Would I stop outside my jurisdiction? That depends on the severity of the accident and if my kids were with me. I don't want my kids sitting in the car if it gets hit by some "lookey-loo" and injured. By myself, I don't have that much of a problem with it. I wouldn't use my county issue vest outside the county that I live in. That way, I'm just another Jane Doe whose's trained as a CERT volunteer and who's been taught how to hold c-spine, do basic first aid, or provide CPR. That keeps me under the Good Sam laws.

Outside the country, I have no real idea of what I'd do, to be totally honest. I'd definately try to find the best care possible. I'd be asking this doc if he could help me find a way to get the child transported somewhere else and, as was suggested, talking to the consolate. As a scenerio, I can totally understand how he'd feel 1) that he couldn't do what he was used to without the normal tools and 2) thinking about how he's on vacation. In real life, it'd probablly piss me off big time.

[JPINFV]

What if they ask? What if they say, how'd you know how to do all that?

Most providers I know can't resist saying "I'm a paramedic" it's what they are ingrained to do.

I took a first aid course.

I was in scouting growing up.

Would you like to take over caring for the patient? (Seriously, I bet most people who want to quarterback wouldn't take you up on this offer).

[jonas salk]

I'm not going to say i'd never stop to help, but it would have to be a very specific situation, and the circumstances would have to be 'perfect' in order for me to willing put myself into a potentially dangerous situation.

A short while ago i arrived about 40 minutes early for an afternoon shift so i decided to go drive around the block to go to a Tim Horton's for a coffee and a sandwich to eat at base. Right at the intersection where the TH was, i saw a couple of cops in the intersection and a woman lying on the road a couple metres from a stopped car. She probably got hit. But I didn't know for certain, it was raining heavily so there was a good chance that she was hit. I weighed the options in my head and ultimately decided to drive by and forgo the coffee. Was it the right choice? For me yeah. Would it have looked bad if someone saw me drive by while in uniform? Probably, but i don't care about optics and luckily my car has a good tint job . I could also see one of our trucks coming up the road behind me, literally only about 60 seconds away from patient contact. My presence wouldn't have really done anything other than get me soaking wet and potentially late for work. It did cost me my coffee and sandwich though.

A couple weeks ago I was Niagara Falls NY doing some crossborder shopping and we stumbled upon a fresh MVC, only ones on scene were PD. It looked relatively minor, but either way I didn't want to put myself into that particularly situation. So i drove on.

[BlissEMT]

I'll probably get in some kind of hot water for saying some of the things I'm about to say, but I just gotta...

I'm fully with +medic on this one. If I see an accident, either happen right in front of me or on the side of the road with no EMS/response vehicles present, and it is safe for me to do so, I will stop. I always have a first aid kit, with several pairs of gloves, bandaging for open wounds, face mask for CPR, etc... in my car. I also have a road safety kit in my trunk (has flares, blankets, water bottles, etc. in it).

Here at least, if you are certified in any form of EMS, you immediately have a duty to act if someone else has not yet done so. This duty can be taken care of by calling 911, or stopping to help, but I always stop to help. I've had one-too-many stops that ended up being a positive outcome to not continue stopping.

Good Sam laws protect caregivers as long as their care was given within their scope-of-practice. So, as an EMT-B, if I have O2 in my car, I can administer it. If the person has been stung by bees and has a current Rx Epi-pen, I can administer it. I have to have already called for on-duty EMS, but I am covered as long as I am not providing care outside my training level.

I'm hearing a lot of the "well, without my ambulance, I can't do anything...." mentality, but I think that's baloney. If you were only trained to provide care within the safe, controlled realm of an ambulance, what good are you to EMS? (This is the part that I figured would get me in some trouble...) I'm not pointing fingers, but if your skills are no good without an ambulance to perform them in, are your skills any good at all? I'm thinking no.

I got into EMS because all my life -- literally since I was 13 -- accidents and trauma incidents have found their way to me, and I figured if this is going to continue happening, a little more training will at least prepare me for the inevitable.

My boyfriend calls me the "PVR" (personal vacation ruiner) but I stop because if I don't, I will think about what would have happened. And when I apply it to the past incidents when I did stop, and reverse the outcome, I can't just drive by.

[+medic]

I'll probably get in some kind of hot water for saying some of the things I'm about to say, but I just gotta...

I'm fully with +medic on this one. If I see an accident, either happen right in front of me or on the side of the road with no EMS/response vehicles present, and it is safe for me to do so, I will stop. I always have a first aid kit, with several pairs of gloves, bandaging for open wounds, face mask for CPR, etc... in my car. I also have a road safety kit in my trunk (has flares, blankets, water bottles, etc. in it).

I agree with BlissEMT this whole issue is assuming that there is NO other responders are present not even the police and its safe to pull over. Also it helps to have the basic gear to do some good.

Edited June 9, 2010 by +medic

[JakeEMTP]

I'm hearing a lot of the "well, without my ambulance, I can't do anything...." mentality, but I think that's baloney. If you were only trained to provide care within the safe, controlled realm of an ambulance, what good are you to EMS? (This is the part that I figured would get me in some trouble...) I'm not pointing fingers, but if your skills are no good without an ambulance to perform them in, are your skills any good at all? I'm thinking no.

It's not that I need an ambulance to work in, it's what the ambulance has on it that I need. Seriously, I don't have anything in my personal truck that would be any good on a call. I have no identifying wacker stickers on it. Fortunately, in NC we are not obligated to stop and I don't. As you progress in your career, the "I got into EMS to help people and save lives" mentality will fade along with the adrenaline rush. It's true, that's why we're here, but it is a job, and it's not 24/365. What are you going to do anyway as a EMT-B which would fall under your scope and be a life saving intervention?

Do you honestly carry O2 in your car?