Abandonment

[athiker]

First, some background and then a question. We are working on a highway response policy in a snowy Vermont town that covers 15 miles of interstate. In the plan we are to stage at a parking lot next to the highway on ramp unless we are notified by police or fire that we are needed. This all comes from the fact that we tend to transport around 15% of people that we respond to on the highway and it is often difficult to locate the accident in the first place.

The question: We respond to a confirmed injury on the interstate. While we are responding we see another accident on the interstate. Are we required to stop at that accident or just call for another ambulance for evaluation? If we find that there are injured patients do we stay and treat them (and dispatch another ambulance to the original call) or continue to the original accident? Do we have a duty to act when we see the second accident? Would we be abandoning our first accident if we render care at the second accident?

Does anyone have any first hand experience with this? Which argument holds up in court? Thanks for any input.

Mike

[medic001918]

The appropriate thing to do in this case is to notify dispatch of the second accident that you found and ask them what they would prefer you to do. They know where they have units assigned. As soon as someone calls 911 and you are dispatched to a call, you have a duty to act to that call. Anything less is abandonment. If dispatch reassigns you to the new crash and reassigns someone else, you have fulfilled your obligation and a new one is set forth (at the scene you're passing by). To stop at a scene while you're on the way to another call is not how the situation should be handled.

Shane

NREMT-P

[Asysin2leads]

I believe it varies from location to location. Check in with your local EMS Gods and see what they say. I believe the Vermont Fire Safety council is a good place to start.

[CaptBP]

I agree. You should let the dispatcher know of the 2nd accident. There is a confirmed injury at the 1st accident and your skills ARE needed. The accident you pass may or may not need your skills. Either was you are obligated to respond to the call/incident that you are dispatched to. You are also obligated to report the other accident to dispatch. Dispatch will decide which accident to send you to and the decision will be out of your hands.

[NREMT-Basic]

My two cents on abandonment-

legally its once you have made patient contact and you just walk away or leave without the patient and without a refusal. The other way is if you get them to the ED and wheel them into a bay, and just leave them there with no one signing for them, of equal or greater "rank" than yourself."

[mediccjh]

The search feature is your friend. This topic has been beaten more than dead horses.

[Asysin2leads]

I agree. You should let the dispatcher know of the 2nd accident. There is a confirmed injury at the 1st accident and your skills ARE needed. The accident you pass may or may not need your skills. Either was you are obligated to respond to the call/incident that you are dispatched to. You are also obligated to report the other accident to dispatch. Dispatch will decide which accident to send you to and the decision will be out of your hands.

Capt, I have got to start working in your area where all MVA's are confirmed with injuries.

[jedifire11]

If my suspicions are correct, I run in the same area as CaptBP. Last time I checked, there are very few MVC's that are dispatched as confirmed injuries. Most times, they are refusals, or if they are transported, they are transported to the local hospital, which is not a trauma center.

On the original point, in our area, we usually advise dispatch of the second accident and check to see if there are any injuries. If there are, we stay and the rest of the MVA assignment is dispatched and another ambulance is dispatched for the first call.

[CaptBP]

You are right that most accidents don't come out with confirmed injuries. I used poor wording there. The point I was trying to make was that you have been called to the initial accident for a reason and I would not stop to triage the second accident without consulting dispatch first. Basically you have the responsibility to report the incident but the decision to stop and respond to the second accident over the first one is not yours to make.

They know where they have units assigned.

You hit the nail on the head. Dispatch can determine if you stopping is for the best. There may be another available unit just around the corner, but then maybe there isn't. The point is that you don't know.

[Dustdevil]

Dispatch can determine if you stopping is for the best.

Disagreed.

Unless dispatch is monitoring CCTV cameras of each accident scene and biotelemetric transmissions from the victims.

Don't give dispatchers too much credit. It goes to their heads way too easily.