Treating Patients While Off-duty

[ambodriver]

Quote you a law ? Read your Bible. If you are atheist I guess you have no obligations except to your selfish self. The fact that you say "you used to stop all the time" tells me that you know you are wrong now. In your early years you did the right thing, now that you are old, lazy, and burned out, you choose to do the wrong thing.

Who cares about your bible? Who are you to be preaching here? Give me a break super medic, push your own values on your kids, not to us.

Hmmmm, making me think. I know this is crazy but hear me out. In my hood we have toll roads and are about to have toll lanes on another interstate, where most people by a transponder for your windshield so you do not have to stop and pay. So lets say there is an accident, which is visible by one of the traffic cameras, lets say the person has been ejected and is not breathing, and I just drive on by. Five minutes later, I pass through the toll booth, and my transponder is registered as going through the toll booth. A smart lawyer subpeonas all camera footage from that toll road, and you can see me on camera, looking at the wreck as I creep by, but I do not stop. What do you think a jury would say ? True, I had no supplies, but I could open an airway, or do CPR.

Or an easier scenario, I pass and do not stop, but call 911 and give a fake name. The investigators want to interview all of the witnesses to find out what happened, I am called in and it is learned that I am a medic. What then ?

I know that there is no written law about this, but that does not mean you will not be found negligent. Most corporations have been found negligent for something incredibly stupid, but they lost just the same "thats why Preparation H has a warning label that says "do not eat".

really? I'm not sure why I'm responding to this.....probably just to point out this is one of the stupidest things I've ever heard on this forum.

[Bernhard]

If I'm alone, I could consider stopping but I'm rarely alone in my car, usually either my daughter or son are in the car with me. I won't leave them in a empty car so I can go and see what I can do.

I recall my father stopping at a vehicle accident scene and giving first-aid, leaving me alone in the car. I was around 8-10 years old. He never had more than an outdated basic first-aid course and no connection to EMS, but pulled an unconscious woman out of her car to lay down on her side. Damn, was I proud of my father!

But I understand you: having a small kid I'm responsible for is one of the reasons I may not give direct help, if I would have to leave him alone. But there would always be some other possibility, maybe just instructing others or something like that (once I even handed him to another person, but this was in a plane in some thousand meters above ground, so I was pretty sure that he doesn't get lost while I treated the cramping passenger).

At least anyone can call emergency services, especially since the availability of mobile phones.

In Germany every bystander is obliged to help, "as needed and as possible without harming himself or other duties" (rough translation of Germany's §323c criminal code). The good samaritan would be protected from any claims and is even covered by public insurance for injuries and damages on own clothes/equipment. This applies to off-duty emergency personel as well, even to tourists by the way.

And I would do, I already did and I would every trained EMS provider expect to give first aid in any situation, where on-duty care is not yet on scene.

This includes, that I'm able to see/expect someone beeing in need. I won't stop at every basic vehicle accident - that would be too much. Just when I see or expect someone laying on the ground, sitting in a wreck or I see a crowd standing around one spot looking down (most probably then there is someone laying there - once, it was a deer...).

I even stopped at some suspiciously looking cars beside the road, somewhere between the trees or bushes, damaged/unnaturally placed. Until now I never found someone in there, though. But it could be, I already had numerous EMS calls, where some random passer-by just found a victim by checking out a wreck.

Two exceptions: when it would put me in serious danger (this could be an accident on the other side of the Autobahn - I would never stop and cross this kind of high-speed road, it's simply too dangerous and next turn around mostly miles away). And when I'm responsible for others, who would be in danger if I leave them alone (i.e. my minor-aged son - but soon enough he will make a perfect assistant in such situations, he already treats his toy animals fairly good).

If on-duty providers are on scene and I see they're out-numbered by patients I even then would offer help. Well, in my own county I know almost all of them (and they may know my car) and in mass casualty situations I would be immedeately in charge anyway, but I would do it outside my area as well. I won't be offended if they don't need another hand.

This all is true without equipment as well. I usually always have at least my brain, my mouth and a pair of hands with me, good enough for first aid in most emergency situations. Every car in Germany is obligated to carry a small first-aid box (mostly band-aids and such) anyway. I personally have a blanket and an additional small jump bag in my car, no fancy things, just a little band-aid, good gloves, pharyngeal tubes and i.v./fluid (which is good for cooling burns and flushing eyes as well), but i can make it even without such stuff. A safety vest is obligatory in a neighbouring country where I'm occasionally drive through, so I can justify the 5 EUR for buying it.

Even in private clothes I usually carry one pair of gloves. Already came in handy, when some bloody or disgusting situations arise. Or when my dog has a special problem on our walk out.

Even if someone already called 112 (european emergency number) I maybe call again, just to give a situation report update - or to be real sure, help is under way.

All in all I came across several occasions where I rendered aid beeing off-duty, from "nothing happened" (or just a dying deer) over occasional kid party injuries, passing out pedestrian, epileptic bycyclist, vehicle crashes up to multiple victims incidents and even one HAZMAT truck crash (just in front of me, boy were I scared!). I can't see a "hooray attitude" or sth. like this as long as I'm acting professional, calm and kind of effective until handing over the scene to the arriving regular EMS. To be not misunderstood: I surely don't strive around to get to scene first, it really just happens to me from time to time.

It's so cheap and easy to do at least something. And scenes calm down a lot if someone with experience takes care, sure at least this helps the people a bit. I don't really understand why someone wouldn't do it, especially with a professional emergency education, but I won't judge.

And it's some kind of fun seeing fellow on-duty EMS responders from the very beginning of them approaching a scene, makes me wondering how I do it when seen from another point of view (assuming this even helps me becoming a better provider!).

[Kiwiology]

There is a difference between doing CPR on somebody who has dropped dead in cardiac arrest at the supermarket or pulling somebody from a burning car and driving around being a whacker in your car kitted out with $10,000 worth of lights and medical equipment looking for jobs to go to on your scanner.

The only situation I'm going to do anything is for something like what I listed above - CPR or dragging somebody out a burning car or away from a bear who is about to eat him.

[BushyFromOz]

Quote you a law ? Read your Bible. If you are atheist I guess you have no obligations except to your selfish self. The fact that you say "you used to stop all the time" tells me that you know you are wrong now. In your early years you did the right thing, now that you are old, lazy, and burned out, you choose to do the wrong thing.

Either that or the vic was black and seeing as we are all racist white guys we turned the cheek and headed the other direction. that would suit your stupidity wouldn't mate?

While there is no law per se here that mandates i render assistance, there is some case law in civil proceedings where by medical professionals who "advertise" they are as such and who are close to an incident they are "obligated by their close proximity" to render assistance. The case this stems from involved a GP in his clinic working late after hours being asked to render assistance to a person on the street and refused advising them to call an ambulance, though seeing they are bound by a hypocaratic oath (thats hypocritic for you crotch) im not so sure i would be bound by the same obligation. The the "advertisement" of you position is one of the many reasons i dont have that retarded little ambulance sticker on my windscreen some of the guys have.

Point is, unless its something serious or the patient is a hot chick, im the guy standing in the background telling people to call 000

I'll Just admit it, you I are am lazy and/or burned out.

Just fixing your typo mate

[Bernhard]

There is a difference between doing CPR on somebody who has dropped dead in cardiac arrest at the supermarket or pulling somebody from a burning car and driving around being a whacker in your car kitted out with $10,000 worth of lights and medical equipment looking for jobs to go to on your scanner.

And there a lot of things between those extremes. If you're only going for "real life saving" than you're challenged very rarely.

Most things are minor injuries, some broken arms/legs/ankles and flesh wounds (well, you know what usually happens in vehicle accidents) or the occasional unconcious-for-some-reason pedestrian. A professional acting first-aider (with EMS background) can help a lot there, too. And if it's only by staying calm and assuring that help is on the way - other than all others just trying to stay away from the patient or some laymen doing strange things.

I personally know the other extreme, one EMT, part-timer in a private company of neighbour county who happens to live in my village: scans radio traffic and chases in his private car, almost fully equipped (including EMS jacket over driver's seat, big red emergency jumpkit "presented" on the back seat, star-of-life and blue reflective stripes all over the car). Was "dropped out" our local volunteer unit for similar strange behaviour even when ON-duty. Needless to say that his EMT-training he got in his company and his EMS-experience is the best of the world and we others all are just amateurs (almost citating correctly). And: he's no youngster, something over 50 y/o! I'm seriously willing to let him get shot forcefully removed by police next time, already said this to him and have rarely seen him since them.

But those extremes are not the topic here: that would be the stinking regular minor injury or uninteresting trauma call with just some blood or the orthostatic dysregulation or the 1000. epileptic seizure you see in your (EMS) life. Only, for those random passers-by and for this patient it may be the biggest disaster in their experience NOW. A trained professional as first-aider could make a difference even with no equipment. And as I expect that someone helps me if I'm laying down with some stupid broken ankle, I would do it for anybody else if possible.

And I really wonder, why someone would not do this.

[Richard B the EMT]

Bushy mentioned EMS folks "Advertizing" by having markings on their personal vehicles. I, for one, have EMT licence plates on my van, augmented prior to it becoming legal by adding reflective Stars of Life to them (State of NY Department of Motor Vehicles just started issuing EMT, EMT-P, and VAS plates [Volunteer Ambulance Service] with the SOL already on them).

I have to check the Vehicle and Traffic Laws book, but, if I recall correctly, nobody, say, a LEO, can complain, if a vehicle with such plate passes the scene of an incident, as the significant other, or another family member, might be driving without the EMT or Paramedic on board.

[Bernhard]

Bushy mentioned EMS folks "Advertizing" by having markings on their personal vehicles. I, for one, have EMT licence plates on my van,

I have the usual red cross plate of my volunteer membership in my car. It licenses nothing really much, since any active red cross member can carry this sign, no need to be special emergency medical trained. In our case here in our village, it's an additional indicator to allow parking directly at the station. But the different meter maids don't seem to care much, I got written up several times now (costs 15 EUR if I want to pay, a phone call if not).

[captainstandup]

Nope don't stop, simple as that. Where I'm from the ambulance is little more than 5 minutes away. The backup ambulance is little more than 10 minutes away and I have no equipment on me, including gloves so I don't stop. What am I going to be able to do without any equipment. I can look pretty on scene though.

Of course, there are those on this site who have better equipped personal vehicles than many ambulance services.

Perhaps you would consider getting a few pairs of gloves and throw them in your "glovebox" I personally stopped at an MVA on I-40 one morning. A man driving a small pickup truck had been rear-ended at high speed and when I approached the vehicle he was unresponsive and gasping to breathe. All I had was a pair of gloves, but i was able to stabilize his c-spine and remove most of a McDonalds biscuit that had his airway occluded. He began to breathe easier, then normally and regained consciousness. This man did not have five minutes to wait for someone to clear his airway.

With this said, if I would have had my kids with me I likely would not have stopped due to the douchebags on the roadways these days. I cannot put my family at risk to go to the aid of others. I have had two trooper friends killed on this section of the interstate and realize there is nothing in the universe more stupid than a motorist.

[Just Plain Ruff]

Perhaps you would consider getting a few pairs of gloves and throw them in your "glovebox" I personally stopped at an MVA on I-40 one morning. A man driving a small pickup truck had been rear-ended at high speed and when I approached the vehicle he was unresponsive and gasping to breathe. All I had was a pair of gloves, but i was able to stabilize his c-spine and remove most of a McDonalds biscuit that had his airway occluded. He began to breathe easier, then normally and regained consciousness. This man did not have five minutes to wait for someone to clear his airway.

With this said, if I would have had my kids with me I likely would not have stopped due to the douchebags on the roadways these days. I cannot put my family at risk to go to the aid of others. I have had two trooper friends killed on this section of the interstate and realize there is nothing in the universe more stupid than a motorist.

Fair enough, I really actually need to get some because if i'm going to be mandated by Crotchity to stop because it's in the bible, then I better get some. I do have some pretty significant psoriasis that causes splits in my fingertips and other areas on my hands so gloves would be a good idea.

If I'm alone in my car then I'll stop (all dependent on the situation) but if my child is with me, and now with my newborn coming today, then I'll call 911 or pull to the side and give advice to bystanders.

But remember in my area where I live, an ambulance is less than 10 minutes away from any direction in my area. If I'm rural then that's a different story.

And you are completely correct, the end of civilization will be when a distracted driver causes a wreck with a Fed Ex truck that is carrying a dirty bomb laced with some biological weapon.

Edited October 10, 2011 by Ruffems

[Richard B the EMT]

And you are completely correct, the end of civilization will be when a distracted driver causes a wreck with a Fed Ex truck that is carrying a dirty bomb laced with some biological weapon.

The fact that we, as medical or public safety personnel (subject for another venue within EMT City) are making jokes about such devices being innocently carried by a package delivery service truck, shows we have already passed the end of civilization, or are on the brink, but most of us don't realize it.