Refusing To Assist With CPR Because of No Gloves?

[engine173351]

So we're working on a patient in the ED's "Trauma Room". The patient, a male in his mid-40's, was pulseless and nonbreathing when we arrived on scene. According to his family, they came home and found him on the floor, so it was an unwitnessed arrest. We hooked him up to our monitor, which advised "no shock" because he was in asystole. The paramedics get him intubated on scene and we deploy the AutoPulse, which eventually stops for whatever reason. So we begin manual compressions. When we get to the ED, there's an off-duty paramedic there who assists us with unloading the patient. We get him into the Trauma Room and the staff continues resuscitative efforts. The two paramedics who I was riding with are assisting the ED staff, so it's me and an EMT-I who perform chest compressions. After about six or seven minutes, the both of us are becoming exhausted, having switched out several times. So as the EMT-I continues compressions, I go out into the open area of the ED and ask for two people to come and assist. I get two people, the off-duty paramedic and another person (who has to leave when called out of the room). When the EMT-I signals for me to take over, I ask the off-duty paramedic to do compressions, as I feel like I'm too exhausted. But he says "Nah, I don't have any gloves," and proceeds to leave the room. So I go ahead and relieve the EMT-I before two nurses eventually assist with compressions. Unfortunately, our patient didn't make it, which was evident considering the fact that he could have went down four hours or four minutes before we got to him.

Here's my question. Was it in some way "wrong" for the off-duty paramedic to refuse to assist and leave? No gloves? I can guarantee you that there's at least eight, if not more, boxes of gloves mounted on the walls of the Trauma Room. I can understand if a person doesn't want to help, but it was clear that we needed assistance for compressions. To me, that was a cheap excuse. The real question is, should I mention it to someone at my service?

[TylerHastings]

I don't feel like the gloves excuse was a valid reason however the Paramedic was well within his right to refuse to assist seeing as he was "off-duty" he would not have been covered under any kind of malpractice insurance unless he maintained his own. With all due respect to you I would probably just drop it and say that you don't mention it to your service. You never stated if this medic even worked for your service so I am not sure what good if any that would do.

[Just Plain Ruff]

So we're working on a patient in the ED's "Trauma Room". The patient, a male in his mid-40's, was pulseless and nonbreathing when we arrived on scene. According to his family, they came home and found him on the floor, so it was an unwitnessed arrest. We hooked him up to our monitor, which advised "no shock" because he was in asystole. The paramedics get him intubated on scene and we deploy the AutoPulse, which eventually stops for whatever reason. So we begin manual compressions. When we get to the ED, there's an off-duty paramedic there who assists us with unloading the patient. We get him into the Trauma Room and the staff continues resuscitative efforts. The two paramedics who I was riding with are assisting the ED staff, so it's me and an EMT-I who perform chest compressions. After about six or seven minutes, the both of us are becoming exhausted, having switched out several times. So as the EMT-I continues compressions, I go out into the open area of the ED and ask for two people to come and assist. I get two people, the off-duty paramedic and another person (who has to leave when called out of the room). When the EMT-I signals for me to take over, I ask the off-duty paramedic to do compressions, as I feel like I'm too exhausted. But he says "Nah, I don't have any gloves," and proceeds to leave the room. So I go ahead and relieve the EMT-I before two nurses eventually assist with compressions. Unfortunately, our patient didn't make it, which was evident considering the fact that he could have went down four hours or four minutes before we got to him.

Here's my question. Was it in some way "wrong" for the off-duty paramedic to refuse to assist and leave? No gloves? I can guarantee you that there's at least eight, if not more, boxes of gloves mounted on the walls of the Trauma Room. I can understand if a person doesn't want to help, but it was clear that we needed assistance for compressions. To me, that was a cheap excuse. The real question is, should I mention it to someone at my service?

Not having gloves was a Crappy excuse what with the number of glove boxes in the room.

So if he doesn't have any gloves on him when he gets to the scene does he refuse to work the patient without the gloves.

He just didn't want to do CPR and that is a pussy of an excuse. I hate these types of lazy medics.

[Bernhard]

Was it in some way "wrong" for the off-duty paramedic to refuse to assist and leave? No gloves? I can guarantee you that there's at least eight, if not more, boxes of gloves mounted on the walls of the Trauma Room. I can understand if a person doesn't want to help, but it was clear that we needed assistance for compressions. To me, that was a cheap excuse.

Not exactly good style to not helping you if specifically asked, but more or less OK since he was 1. off-duty and 2. not really needed, numerically. There obviously were enough on-duty folks there (you won't tell me that a bunch of emergency room staff, two medics and two first responders aren't enough for a code in a trauma room environment?).

The "no gloves" argument may just be a fast excuse despite finding some other quick reason, given the glove boxes around. Maybe he had some of the questions in mind I have below...

The real question is, should I mention it to someone at my service?

I wouldn't. The obvious counter questions would be like: "Why exactly weren't you enough to work the patient, given the staff already there? Why did you randomly pick people from outside to help in a staffed regular emergency room? Who was in charge in that situation and why didn't you notify this person and/or why was this person not able or willing to get the problem solved? If you were in charge, how comes this, considering you are one of the least qualified people there and obviusly didn't belong to the hierarchy?".

Maybe I misunderstood a lot, then please correct me.

[paramedicmike]

Off duty is off duty. Using the lack of gloves as an excuse was a bit lame. But if he was truly off duty then you don't have any complaint.

[engine173351]

Thanks everyone for your advice. I guess I saw things differently, being one who would drop everything in a heartbeat (no pun intended) to assist with CPR, duty status aside. I think I made a bigger deal out of it that it was, and I appreciate everyone's input.

[Just Plain Ruff]

Off duty is off duty. Using the lack of gloves as an excuse was a bit lame. But if he was truly off duty then you don't have any complaint.

Mike, I realized after posting the I meant to add the off duty part.

If the guy was indeed off-duty then the excuse is still not a good one but the better excuse would have been "I'm off duty and heading home"

The guy was dead, would having a couple of fresh hands have made any difference? NOPE - a dead guy was transported to the ED and they worked him forever it seems if the OP was getting exhausted. Sounds like someone should have said "no transport" to begin with, unless they are required to work in the dark ages and transport all arrests that are started(behind the times if you ask me)

Thanks everyone for your advice. I guess I saw things differently, being one who would drop everything in a heartbeat (no pun intended) to assist with CPR, duty status aside. I think I made a bigger deal out of it that it was, and I appreciate everyone's input.

No worries Grasshopper, I'll bet that you will get over the drop everything attitude eventually.

[paramedicmike]

If the guy was indeed off-duty then the excuse is still not a good one but the better excuse would have been "I'm off duty and heading home"

Agreed. Saying, "No, I don't have gloves" doesn't make him wrong. It might make him a jerk... but not wrong.

No worries Grasshopper, I'll bet that you will get over the drop everything attitude eventually.

Ruff is right.

The sooner you learn to get over this drop everything attitude the better off you'll be. There are limits to everything. You can't help everyone every time someone needs it. While at work and on the clock? Absolutely. Jump in. Be available. Go above and beyond. But off duty time is off duty. And sometimes you just gotta walk away from it.

[Bernhard]

By the way...

we deploy the AutoPulse, which eventually stops for whatever reason.

Did you meanwhile find out, why?

I'm vaguely considering to get hands on one of those for our volly squad. I know the "Lucas 2" from a test phase here in our district, already used it in one case and found it quite good (positive outcome!). From advertising information, the Autopulse makes a better impression, but I don't have seen one in real life yet. So I'm interested in some first hand experience. Maybe in another thread?

[hatelilpeepees]

I am all for being a team player, but it is not my responsibility to run codes for an ER. All hospitals should have a "code team" that responds 24/7. I am guessing you gave them a radio or phone report that you were transporting a "code", so if the ER was not ready for your patient that is their problem. If I was the ER manager I would be quite upset if someone was recruiting people from the lobby to give patient care.