MVC's on the interstate

[tskstorm]

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.

good Sam laws only go so far don't depends on them to keep yourself out of trouble

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.

One of if not my greatest lifesaving tool is the Ambulance. We are trained in Emergency care not definitive care. Further with no equipment, what skills am I performing? C-spine stabilization? Although without gloves I wouldn't even do that.

[BlissEMT]

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?

I don't carry O2 in my car, but I have friends that do. They work rural EMS and the chances are high that they get a call and are closer to the scene in their POV, then driving to the ambulance bay and back.

What am I going to do when I stop? CPR, assisted ventilations (mouth-to-mask), C-spine stabilization, bleeding control, treat for shock. All of those things fall under my scope and I have all the necessary equipment in my car all the time, in a kit no bigger than a tackle box, to do them. Are my interventions going to be life-saving? Possibly, but probably not. But I sleep better at night knowing that I stopped and did what I could.

As far as it not being a 24/365 profession... well, when you have 27 first cousins that live locally and call you with any and all the medical questions they can find, and have 10 nieces and nephews that won't even let mom and dad put a bandaid on their scrapes without calling me first, I guess I'm just used to it being a part of my life 24/365. I have heart strings that are easily tugged upon, and a sore spot for kids especially, but I don't think that "mentality" is ever going fade. And I can't say that I want it to.

One of if not my greatest lifesaving tool is the Ambulance. We are trained in Emergency care not definitive care. Further with no equipment, what skills am I performing? C-spine stabilization? Although without gloves I wouldn't even do that.

But all it would take is a pair of gloves to have the equipment to do that, which can potentially be a life-saving skill. And while you're doing it, you can reassure the patients until on-duty EMS gets there.

And I wouldn't ever recommend doing it without gloves. But, how much space do gloves really take? Besides my first aid kit, I keep a pair with my CPR mask in the cubby on my door, and a pair in my glove box (per my nephews insistence, because "why would you call it a glove box, if you're not actually going to keep gloves in it").

I'm not trying to argue or say that I'm right and you're wrong, everyone's entitled to their own methods, but if that's the only reason you wouldn't stop and help, it's an easy fix.

[tskstorm]

But all it would take is a pair of gloves to have the equipment to do that, which can potentially be a life-saving skill. And while you're doing it, you can reassure the patients until on-duty EMS gets there.

Now all the OP said was MVC on interstate, what happens when you walk up to the vehicle to reassure the patient everything will be okay and you get shot? Because the reason they crashed was they were running away from local LEO. Also the extent and damage of the MVC is not really defined here, you might want to define it for your posts. Right now I see you stopping at every little ding and dent possible.

And I wouldn't ever recommend doing it without gloves. But, how much space do gloves really take? Besides my first aid kit, I keep a pair with my CPR mask in the cubby on my door, and a pair in my glove box (per my nephews insistence, because "why would you call it a glove box, if you're not actually going to keep gloves in it").

You assume the reason I don't carry gloves is space? Absolutely not, it is liability. I have learned through many other peoples mistakes that in this wonderful country once you identify yourself as a professional in any field, people expect that level of professionalism and care. They will sue you if they don't get it, they don't care about good Sam laws, and whether or not the case holds water, I don't want to go through the entire process. Further being a paramedic and long time person in the 911 system here, I know for a fact an MVC is dispatched as a BLS call. Now I am acting as a good Samaritan, but identified myself as a Medic, how do I transfer care to BLS without needing to worry about abandonment ? Sure they have more equipment but regardless I still maintain the higher medical authority and better assessment skills.

but if that's the only reason you wouldn't stop and help, it's an easy fix.

It is an easy fix if you find it to be a problem. I don't see a problem with not stopping, so there is nothing to fix.

Food for thought

You have gloves, you stop and something unpredictable happens and now you're expose (blood in your eyes or in an open cut whatever the case may be) What happens ? Who covers you? Who pays for your care?

[BlissEMT]

Now all the OP said was MVC on interstate, what happens when you walk up to the vehicle to reassure the patient everything will be okay and you get shot? Because the reason they crashed was they were running away from local LEO. Also the extent and damage of the MVC is not really defined here, you might want to define it for your posts. Right now I see you stopping at every little ding and dent possible.

The OP described the accident he saw and stopped for, so I've been posting with similar MVC severity in mind, I'll make sure to clarify that in the future. I'm not saying I stop for every little thing, but if there is a possibility that injuries have occured, I stop. Similar to appraising the damage to your vehicle before calling the cops for a fender bender. Here, they say not to call for a squad for less than $1000 damage unless there is a disagreement between parties (uninsured driver, etc). If I feel there was enough force behind the colliding vehicles to cause injury, I stop. If there is significant damage related to the method of collision, I stop.

You assume the reason I don't carry gloves is space? Absolutely not, it is liability. I have learned through many other peoples mistakes that in this wonderful country once you identify yourself as a professional in any field, people expect that level of professionalism and care. They will sue you if they don't get it, they don't care about good Sam laws, and whether or not the case holds water, I don't want to go through the entire process. Further being a paramedic and long time person in the 911 system here, I know for a fact an MVC is dispatched as a BLS call. Now I am acting as a good Samaritan, but identified myself as a Medic, how do I transfer care to BLS without needing to worry about abandonment ? Sure they have more equipment but regardless I still maintain the higher medical authority and better assessment skills.

I didn't assume the reason you didn't carry gloves was space, but you said in an earlier post, " Further with no equipment, what skills am I performing?" I was just trying to point out that lack of equipment is not a reason to not stop. If you were one that would stop, but doesn't because you have no equipment in your car, all you need is a pair of gloves to perform some more basic skills.

Also, I don't identify myself as an EMT, I usually say something along the lines of "I'm trained in advanced first aid, may I help (you/your child/whomever)?" If the BLS unit arrives there and wants to know more, I identify myself and my training level to them.

As far as abandonment goes, you're putting this person in the hands of on-duty trained professionals that have the means to treat and transport the patient, and you're following the continuum of care, not just stabilizing c-spine, then walking away when they arrive on-scene. I don't see anyone finding that as abandonment.

It is an easy fix if you find it to be a problem. I don't see a problem with not stopping, so there is nothing to fix.

I may be misinformed, but I believe that in MN, I am required to stop. Some of the other people I personally know also say that if you are trained in skills that could be useful and can safely do so, you are required to stop or administer aid if the victim gives you permission, and you act within your scope. Driving by would be considered neglect, which is a breach of duty and can lead to liability. I may be wrong, but that was my understanding from the conversations we had in class and some of the conversations I have had with friends that are also in a medical profession. MN is weird about other things, so it would not surprise me.

Food for thought

You have gloves, you stop and something unpredictable happens and now you're expose (blood in your eyes or in an open cut whatever the case may be) What happens ? Who covers you? Who pays for your care?

Again, with state-to-state laws varying so much, this may not apply to the majority of people here. If I am injured (say another vehicle hits me) while getting in or out of my vehicle, or approaching my vehicle, my auto insurance has to cover any medical costs I incur - ER, Chiropractic, Physical Therapy, etc. As for accidental exposure, my health insurance would cover my testing and care, as deemed "medically necessary" by my physician.

So, I give you this for thought: You're driving home from work, and see a vehicle change lanes into another vehicle, causing that second vehicle to hit the gravel on the side of the shoulder, and skid into the ditch. You call 911 and report the accident, but drive on. The following day, you find out from your neighbor that her husband was the one in that accident, and has a broken leg, a couple fractured ribs, and is in critical condition because of the lack of oxygen from respiratory failure, secondary to the chest trauma, during the 20 minutes it took the BLS unit to get there. Knowing you could have assisted his respirations with just a pair of gloves and a face shield, do you think you might have stopped?

[tskstorm]

The OP described the accident he saw and stopped for, so I've been posting with similar MVC severity in mind, I'll make sure to clarify that in the future. I'm not saying I stop for every little thing, but if there is a possibility that injuries have occured, I stop. Similar to appraising the damage to your vehicle before calling the cops for a fender bender. Here, they say not to call for a squad for less than $1000 damage unless there is a disagreement between parties (uninsured driver, etc). If I feel there was enough force behind the colliding vehicles to cause injury, I stop. If there is significant damage related to the method of collision, I stop.

He states a car got pushed into a guardrail, never an estimated speed or an amount of damage. He did identify the rest of the scene a 'wreck' but that's subjective. A wreck to me wouldn't have patients, just dead bodies.

I didn't assume the reason you didn't carry gloves was space, but you said in an earlier post, " Further with no equipment, what skills am I performing?" I was just trying to point out that lack of equipment is not a reason to not stop. If you were one that would stop, but doesn't because you have no equipment in your car, all you need is a pair of gloves to perform some more basic skills.

I don't stop because of everything I've stated previously. Not having equipment further compounds how I feel.

Also, I don't identify myself as an EMT, I usually say something along the lines of "I'm trained in advanced first aid, may I help (you/your child/whomever)?" If the BLS unit arrives there and wants to know more, I identify myself and my training level to them.

There's a difference between advanced first aid and being an EMT? Irrelevant, you are identifying yourself as a trained person. Once you divulge your profession or credentials to the crew responding you are still responsible.

As far as abandonment goes, you're putting this person in the hands of on-duty trained professionals that have the means to treat and transport the patient, and you're following the continuum of care, not just stabilizing c-spine, then walking away when they arrive on-scene. I don't see anyone finding that as abandonment.

Continuum of care here would require me to go with them. As per local protocol as a certified medic, riding as an EMT (happens everyday here) I'm still required to perform life saving treatments. When this patient needs any sort of ALS intervention the on duty BLS crew could not render I'm still responsible. I can not hand care off to an EMT crew.

I may be misinformed, but I believe that in MN, I am required to stop. Some of the other people I personally know also say that if you are trained in skills that could be useful and can safely do so, you are required to stop or administer aid if the victim gives you permission, and you act within your scope. Driving by would be considered neglect, which is a breach of duty and can lead to liability. I may be wrong, but that was my understanding from the conversations we had in class and some of the conversations I have had with friends that are also in a medical profession. MN is weird about other things, so it would not surprise me.

MN and VT are the states I am aware of that require you to stop regardless of the state you have your certification/license from. While you may be required to stop, which is fine, I wouldn't want the liability of stopping when I'm in a place that doesn't require it.

Again, with state-to-state laws varying so much, this may not apply to the majority of people here. If I am injured (say another vehicle hits me) while getting in or out of my vehicle, or approaching my vehicle, my auto insurance has to cover any medical costs I incur - ER, Chiropractic, Physical Therapy, etc. As for accidental exposure, my health insurance would cover my testing and care, as deemed "medically necessary" by my physician.

This isn't about the money to cover the immediate injury, its about long term care, If you get hit and are permanently disabled, think about all the other patients you could have impacted? Are you okay with living on disability? Just because I can get medications from my health insurance, does not mean I want to be on the cocktail the rest of my life, further when the disease I could have caught prevents me from working, who will feed my kids? Pay my mortgage? etc...

So, I give you this for thought: You're driving home from work, and see a vehicle change lanes into another vehicle, causing that second vehicle to hit the gravel on the side of the shoulder, and skid into the ditch. You call 911 and report the accident, but drive on. The following day, you find out from your neighbor that her husband was the one in that accident, and has a broken leg, a couple fractured ribs, and is in critical condition because of the lack of oxygen from respiratory failure, secondary to the chest trauma, during the 20 minutes it took the BLS unit to get there. Knowing you could have assisted his respirations with just a pair of gloves and a face shield, do you think you might have stopped?

1. I don't have gloves. 2. Mouth to mouth is not allowed in my protocols with or without face shield. It is expected as a professional you will have the proper tools, meaning a BVM with high concentration oxygen. 3. If I was hurt or contracted a disease during all this my neighbor wouldn't be paying my bills. Feeling empathetic for people is one thing, feeling guilty for not stopping at the scene of an accident, not so much. Actually, not at all. Scene safety comes first, until an ENG company comes and blocks off the appropriate lanes of traffic again as per local protocol. Its simply not safe.

[BlissEMT]

Thank you tskstorm. I can now see exactly the thought you've put into your reason to not stop. And, I respect it.

Usually, I try to keep my thoughts away from the negative, and focus on the positive things my presence could mean. I never would perform skills without PPE, but I'm not ignorant enough to think that if I'm wearing them, nothing bad can happen. I know it is always a possibility, but it's a hazard of the job.

The scenario I posed to you was not in any way to make you feel guilty for not stopping, just to make you wonder if you would feel differently if you personally knew the person.

Being in MN, I have to stop, so I will, but I feel better knowing I did what I could, so you will not hear me complain!

[tskstorm]

Thank you tskstorm. I can now see exactly the thought you've put into your reason to not stop. And, I respect it.

Usually, I try to keep my thoughts away from the negative, and focus on the positive things my presence could mean. I never would perform skills without PPE, but I'm not ignorant enough to think that if I'm wearing them, nothing bad can happen. I know it is always a possibility, but it's a hazard of the job.

The scenario I posed to you was not in any way to make you feel guilty for not stopping, just to make you wonder if you would feel differently if you personally knew the person.

Being in MN, I have to stop, so I will, but I feel better knowing I did what I could, so you will not hear me complain!

Now if only we could get some others to chime in with their opinions.

[JTpaintball70]

I drove by 7 MVCs on the way home from CO Springs today. 3 of them happened right in front of me. The reason I didn't stop? It was pouring and visibility was nil. I was not about to get out of my truck with no jacket, no reflective vest, and no big red house marker blocking off lanes of traffic.

[BlissEMT]

I drove by 7 MVCs on the way home from CO Springs today. 3 of them happened right in front of me. The reason I didn't stop? It was pouring and visibility was nil. I was not about to get out of my truck with no jacket, no reflective vest, and no big red house marker blocking off lanes of traffic.

I think that would count as an 'unsafe situation'. Would you stop otherwise?

[JTpaintball70]

I think that would count as an 'unsafe situation'. Would you stop otherwise?

Unless the accident physically stopped me from proceding past it, nope wouldn't stop

I don't carry anything that would make it safe for me to stop to help at an accident, and usually when I'm going somewhere I don't want to be late for whatever I'm doing.

I've never lived in a state where I've been reqiured to stop for anything, and I kinda like it that way.

Edited June 12, 2010 by JTpaintball70