Treating Patients While Off-duty

[BushyFromOz]

Very astute observation richard, the fact we accept this kind of idea as something approaching normal does not bode well for the future.

[zmedic]

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.

Isn't there something about how FedEx/UPS can carry toxic/hazmat materials if they are under a certain weight/size? Scary.

[RaceMedic]

Z,

thats nothing. As a retailer, WalMart tractor trailers are rolling bombs. Think about all of the hairspray cans, next to BBQ lighter fluid, on top of 1lb propane cylinders, next to cases of matches ect ...ect in the same truck rolling down the highway everyday all day long. It isnt even only WalMart but every general carrier on the road with out placards because they are not carrying "enough" of any one thing to require a HazMat placard.

Placards are not required for a collection of materials like they carry, Only required for a certain amount of a single item. So long as they stay below the "set" limit of material they are free to load the truck and send it on its way.

For example:

For placarding you may need 20 cases of hairspray, or 20 cases of propane bottles, or 50 cases of lighter fluid.

so i could load that same truck with 19 cases of hairspray, 19 cases of propane bottles and 49 cases of lighter fluid and NOT need a placard.

That is scary !

I drove semi for 4 yrs while working my way through my paramedic degree prereqs

Edited October 12, 2011 by RaceMedic

[kevkei]

I think people tend to use terminology a little loosely. This is a battle between 'obligation' - something that you must do' vs 'discretion' - the ability to make a judgement or decision.

By saying you are obligated (morally, ethically, legally, spiritually, etc) you shall stop and render aid at all times and at all costs. It is black and white and never ceases. You stop at every and all MVC (I'd never get to work on time), every unwell looking individual you see (have fun in the inner city with that one.) Sounds completely impractical. Don't worry about life safety or hazards, go and render aid post haste.

By using your discretion, you take a multitude of factors into consideration, evaluate the risk vs benefit, and make a judgement call on the best information you can to come to a conclusion of act/don't act. To me, this does not sound like old, burnt out or not caring. It sounds reasonable and prudent.

Instead of saying we shall stop (shall is stronger than will) under all circumstances because it is our sworn duty and there are professional and/or legal ramifications, do the common man test. What would the average person in the same situation do under the given circumstances?

Sometimes I offer help, sometimes I don't. If that makes me a bad person, so be it.

[DFIB]

EMT dies off duty while stopping at an MVA.

http://www.jems.com/article/news/ohio-emt-struck-car-killed

[txladymedic]

I believe you are right Ruff, so long as you are off duty and especially if you are not in your jurisdiction then you do not have a duty to act. I too do a mental triage, and usually carry no more than PPE and maybe a very, very basic 1st aid kit...and unless it appears serious I do not stop or step in and help. And if I do offer help, I rarely volunteer that I am a paramedic, frankly I don't want the liability. I prefer to provide basic care give a quick report to the responding crew, ask if they need my help and if they don't, then I disappear.

But that is just me....

[Richard B the EMT]

I prefer to provide basic care give a quick report to the responding crew, ask if they need my help and if they don't, then I disappear.

But that is just me....

And me.

DFib, I know it happens, and not just to off duty personnel.

However, on a more personal note, I just looked into my house of Worship's monthly bullitin and services schedule, and found a donation had been made by the mother of a past president of the congregation, to the Temple Fund (of the West End Temple Saini Congregation, Neponsit, NY, "To Richard B..., for helping out at my car accident. From Cathy G".

A couple of weeks back, when looking up the temple's phone number to ask a question, I hear a loud "thud" from the nearby corner, looking out the window, I see a car stopped partly across the intersection, a pickup truck up on the sidewalk, and the mailbox laying down on the same sidewalk. Grabbing the wireless phone and Momma B's cell phone (Surprise! I still don't have a cell phone of my own!), I called it in to 9-1-1 while I walked up on the scene, only to find the 2 people in the occupied car were fellow congregants. Basically, they'd swerved, hit the parked and unoccupied pickup, which jumped the curb and knocked over the mailbox. One of the ladies had a nosebleed that had already stopped by the time I walked up, the other was later determined to have had an elevated BP from the excitement.

All I did was a bit of handholding of both the ladies, and the "Stare Of Life", but sometimes that's all that's needed, as was the case here, until a non-local FDNY EMS unit arrived. They looked at my departmental retiree ID quizzically, but accepted it as OK (I'm retired for being employed as an EMT, but my EMT is good through 2015).

Wow, a public acknowledgement, and by name, too!

[DFIB]

And me.

DFib, I know it happens, and not just to off duty personnel.

However, on a more personal note, I just looked into my house of Worship's monthly bullitin and services schedule, and found a donation had been made by the mother of a past president of the congregation, to the Temple Fund (of the West End Temple Saini Congregation, Neponsit, NY, "To Richard B..., for helping out at my car accident. From Cathy G".

A couple of weeks back, when looking up the temple's phone number to ask a question, I hear a loud "thud" from the nearby corner, looking out the window, I see a car stopped partly across the intersection, a pickup truck up on the sidewalk, and the mailbox laying down on the same sidewalk. Grabbing the wireless phone and Momma B's cell phone (Surprise! I still don't have a cell phone of my own!), I called it in to 9-1-1 while I walked up on the scene, only to find the 2 people in the occupied car were fellow congregants. Basically, they'd swerved, hit the parked and unoccupied pickup, which jumped the curb and knocked over the mailbox. One of the ladies had a nosebleed that had already stopped by the time I walked up, the other was later determined to have had an elevated BP from the excitement.

All I did was a bit of handholding of both the ladies, and the "Stare Of Life", but sometimes that's all that's needed, as was the case here, until a non-local FDNY EMS unit arrived. They looked at my departmental retiree ID quizzically, but accepted it as OK (I'm retired for being employed as an EMT, but my EMT is good through 2015).

Wow, a public acknowledgement, and by name, too!

That is very rare but way cool. I stop for just about everything. Posted the article to help the guys that were saying it is our "duty' or "obligation" to stop and render aid when it is obviously a personal descision.

[Bernhard]

By saying you are obligated (morally, ethically, legally, spiritually, etc) you shall stop and render aid at all times and at all costs. It is black and white and never ceases. You stop at every and all MVC (I'd never get to work on time), every unwell looking individual you see (have fun in the inner city with that one.) Sounds completely impractical. Don't worry about life safety or hazards, go and render aid post haste.

I don't agree! "Obligated to help if someone is in need [for emergency medicine]" includes detecting the need first. With a certain education and EMS experience you simply don't hop on any homeless or drunk or car accident where you see everyone standing around discussing.

But if you see a homeless drunk on the main railway station laying within the baggage cart stock or a car sideways in the middle of a dark meadow with lights still on, THEN you stop. Even if in an MVA a person clearly still sits in their car and some people standing around obviously helpless. Maybe the car in the meadow is abandoned or the drunk homeles really is drunk and homeless from free will with no medical condition - that is a risk I take. All of the above scenarios I was in - the homeless was suffering from low blood glucose level (even not drunk), the car driver was heavily injured and it took a while to extricate him and the sitting patient just was a little old lady totally shaken up by the accident she made but without any medical condition. I already stood (in my best business suit) in the driver's compartment of a totaled truck full of HAZMAT, just because you couldn't read the markings (I have a photo). Yes, this includes getting late to work - but who am I to decide without a closer look that "someone is not in need" or "that's not the time to find someone in need today"? Again, having EMS experience helps a lot clearing a situation, so that I can do my business again faster than a lay person.

Sometimes I offer help, sometimes I don't. If that makes me a bad person, so be it.

Even if this implies you see someone in desperate need and you simply decided this morning not helping today, I won't judge it, it's totally your decision. But not mine.

EDIT: typo and making a statement clearer.

Edited October 30, 2011 by Bernhard

[Asysin2leads]

Personally I think the difference between a hero wannabe and a professional is that a professional calculates the risk before taking action. The first thing we learn is scene safety, and an MVC, especially at the side of a highway, especially when you are off duty without any way to put up appropriate warning signals, is a very unsafe scene. JEMS today had an article about an EMT killed in such a fashion.

The fact of the matter is that an off duty prehospital care provider, even if they had a full jump kit, can do very little that will improve patient outcome. The chances of them facing death or catastrophic injury versus the chance of them providing any sort of meaningful assistance is very slim. There is a big difference between saying I am not going to render aid off duty under any circumstances and saying I have to stop at every single fender bender that occurs. You can find a medium someplace in there.