Do you pull over for MVAs?

[banana5]

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[crewmaster1]

As and EMT/Med student I only pull over if it looks like someone is seriously injured and there is no other agency/EMS there. This seems to be a rare event. I'm not stopping for lame fender benders to talk to someone having a panic attack!

 

[Chronic Student]

I used to try and find a reason to stop, any reason would do.

Now I try and find a reason not to stop. I actually can't remember the last time I came across an injury accident where EMS wasn't already on the scene.

I'm sure I would if it seemed bad and no one had responded yet.

-Mike

 

[deleted109597]

Only if nobody else is there. Then I look at the mechanism, and decide yes or no. Since I am not an MD yet, and never took EMT courses, all I am going to be able to do is BLS, so that cuts down how often I stop.

I've only stopped twice. The concept of transferring to lower care is interesting, but since we do it all the time for transfers to other medical centers, I don't think there is a liability aspect to it.

 

[J.J.]

I recently stopped at a head-on MVA involving a father and his young son. There was no EMS or Police on scene and when I went by the boy was laying in the grass surrounded by other pedestrians. Everyone was stable at the scene. Paramedics soon arrived and I left.

As I was asking questions though, I learned both the father and son had cancer. Both had ports. Freaked me out at first because I noticed something poking out of the little guys chest. I felt bad for the two of them.

Like the above, I stop only when there is no one on scene and my assistance could be life saving (BLS).

JJ

 

[FoughtFyr]

As an EMT I usually pull over when I see something serious and no agency has responded (cops, fire, etc.). Do you? Is it considered neglect if say, a physician pulls over for an MVA and then EMTs/medics take over care, since you'd be transferring treatment to someone less qualified?

Just curious.

No, it is not neglect. All states have EMS acts which clearly delineate that EMS personnel within that role act with the authority of physicians in terms of transferring care. Otherwise no inter-facility would be possible either. But, on one occasion I did ride in with a "part-time" ALS squad so that a line could be started on a trauma patient who was in bad shape. Ahh, the joy of rural EMS.

- H

 

[The White Coat Investor]

I have stopped for a few. I have been thoroughly impressed by how well the paramedic takes charge of the scene upon his arrival and I usually slink off to my car and take off without revealing my level of training. You know what I've learned? The paramedic is better than I am at almost everything that happens on the side of that roadway. I may be a helluva lot more skilled in the trauma bay, but I don't recall getting any training in residency in crowd control, extrication, scene assessment, backboarding patients, starting IVs in bouncing ambulances etc. I view my out of hospital care as INFERIOR to what the paramedic can provide. So when he shows up, I get the hell out of the way, (or at least let him run the show.)

That being said, I have successfully resuscitated cardiac arrest patients long before the paramedics arrived. Why do those guys walk in so slowly when they just got a call saying CPR in progress? I mean, defibrillating a guy even 30 seconds earlier would increase his chance of survival by 5% within the first 10 minutes. Nothing we do in the ED can increase survival rates like that.

 

[EctopicFetus]

I have stopped for a few. I have been thoroughly impressed by how well the paramedic takes charge of the scene upon his arrival and I usually slink off to my car and take off without revealing my level of training. You know what I've learned? The paramedic is better than I am at almost everything that happens on the side of that roadway. I may be a helluva lot more skilled in the trauma bay, but I don't recall getting any training in residency in crowd control, extrication, scene assessment, backboarding patients, starting IVs in bouncing ambulances etc. I view my out of hospital care as INFERIOR to what the paramedic can provide. So when he shows up, I get the hell out of the way, (or at least let him run the show.)

That being said, I have successfully resuscitated cardiac arrest patients long before the paramedics arrived. Why do those guys walk in so slowly when they just got a call saying CPR in progress? I mean, defibrillating a guy even 30 seconds earlier would increase his chance of survival by 5% within the first 10 minutes. Nothing we do in the ED can increase survival rates like that.

NOw I dont have the link but i heard of a study done in israel where they had mds riding alond with ems and found that those people where the md was present fared worse. (again i dont know how well the study was done) The theory is that an md doesnt just scoop and run but is trying to do something definitive and as such means it is longer until the patient arrives in the ED where everything is available.

 

[FoughtFyr]

That being said, I have successfully resuscitated cardiac arrest patients long before the paramedics arrived. Why do those guys walk in so slowly when they just got a call saying CPR in progress? I mean, defibrillating a guy even 30 seconds earlier would increase his chance of survival by 5% within the first 10 minutes. Nothing we do in the ED can increase survival rates like that.

As a former medic, I think I can answer that. The number of times I have been called for "CPR in progress" only to rush in (at risk to myself and everyone else on the road) and find a conscious and alert patient who thought I'd move faster if they said they were doing CPR is roughly equal to the number of patients I've seen in the ED who've claimed "chest pain" in triage to "get to the back faster". I actually once got a call for "physician on scene, CPR in progress" (which usually got a bit more attention), to find a psychiatrist from Russia (unlicensed in the US) doing "compressions" on the back of a morbidly obese prone patient who was yelling at him to "get off". It seems the patient had "passed out" and this is what he thought to do...

Sorry, but the jaded reality sometimes interferes with the hypothetical best care.

- H

 

[southerndoc]

I walked to codes in the field, and I walk to codes in the hospital.

An out-of-breath rescuer only adds to the excitement, worsens the confusion, and makes it difficult for you to adequately perform your job.

There are very few situations in medicine that will make me run.

 

[deleted109597]

Also, running, be it in the hospital or in the field, increases the likelihood that there will be additional patients needing to be seen. I have seen many people run full bore into a nurse, tech, stretcher, wheelchair, or patient's family member in the hallway because they just went around that corner blindly. Not as bad as people who break ankles running up to the scene of the MVC, thus negating any positive benefit of being on the scene.

 

[The White Coat Investor]

I walked to codes in the field, and I walk to codes in the hospital.

An out-of-breath rescuer only adds to the excitement, worsens the confusion, and makes it difficult for you to adequately perform your job.

There are very few situations in medicine that will make me run.

Yea yea yea...how about walking quickly then? Would that be too much to ask? Literally, this guy was in v-fib and would have been dead if he had to wait for the paramedics to bring their defibrillator. (Luckily he collapsed near an AED.)

 

[Jeff698]

As a newbie paramedic, I'd stop at everything. Now, unless there are pieces of vehicle literally still in the air, I'll look for every reason I can not to stop.

The main reason is that there is almost never anything useful for me to do.

Having said this, the last time I stopped, there really were still chucks o' car in the air. I saw the collision right in front of me. Having barely avoided being a part of the collision, I didn't think there was much of a way to avoid stopping. And, as usual, my presence made no difference.

Take care,
Jeff

 

[pushinepi2]

What an entirely appropriate place for such an inquiry. We've got budding EMTs, veteran medics, doctors, and medics turned physicians. As one of the latter, here's my own half penny perspective on this issue.

It is vitally important to distinguish between legal and ethical obligations. This way, we can entirely skip over the issue of the dreaded Good Samaritan act. Doctors, nurses, and others should feel free to help out at the scene of an accident. However, EMTs and paramedics that respond to such an incident act under the authority and guidance of a medical director. Turning a scene over to paramedics IN NO WAY represents a transfer to a lower level of care. Especially in the case of ALS providers, the paramedic units are much more capable of transporting and handling a prehospital emergency event than most doctors. I've encountered neurologists, anesthesiologists, medical students, and nurses on innumberable scenes. In most cases, the offer of assistance comes from the best of intentions. It should be noted, however, that more people and more degrees at the scene of an event contributes to an already pre-existing sense of chaos.

We can argue about opinion here but a doctor to paramedic transfer (in the prehospital setting) is an absolutely appropriate strategy. The decision to stop at a scene is a personal one. We all have our own embedded ethical code, and I'm sure each circumstance will present a wide variety of challenges. Legally speaking, off duty nurses and physicians have no enforceable obligation to render assistance. This is not the case overseas where physicians are encouraged and in fact obliged to give first aid.

Please don't get your arm chopped off by the tail rotor on a BK 117.

Be safe,

Push

 

[tkim]

Only if nobody else is there. Then I look at the mechanism, and decide yes or no. Since I am not an MD yet, and never took EMT courses, all I am going to be able to do is BLS, so that cuts down how often I stop.

I've only stopped twice. The concept of transferring to lower care is interesting, but since we do it all the time for transfers to other medical centers, I don't think there is a liability aspect to it.

Not to put too fine a point, but while med school gives you a higher lever of training, since you don't possess a medical license, much less EMT certification, you aren't transfering to a lower level of care.

Besides, there would be very rare circumstances that anyone without the right equipment, would do anything more than CPR and BLS. Forget invasive unless you have the training *and* the license to do so.

I don't stop anymore unless it looks bad and there's no EMS/fire in sight. I'm not desperate to liplock anyone on the highway.

 

[deleted109597]

Not to put too fine a point, but while med school gives you a higher lever of training, since you don't possess a medical license, much less EMT certification, you aren't transfering to a lower level of care.

I meant after finishing school (in 5 months) and to EM docs in general. Right now I am nothing, or actually below nothing if that is possible. So I was talking in hypotheticals.

 

[In da know]

One thing to take into account, in our area due to the proximity of a teaching hospital with a wide variety of physicians and nurses with very little clue as to what to do in the field, they require proof of licensure before you may take any role in patient care. As a nurse you can't do anything other than BLS care on a scene, don't kid yourself. As a EMT/Paramedic not on duty/at work you can't do anything other than BLS unless you have someone to sign off on you for everything you do, not a lot of doctors going to provide carte blanche coverage. As a physician you are entitled to do whatever you have been trained to do as long as you; 1. can prove licensure, 2. understand that any direction you make outside the standard practice guidelines for the EMS providers makes you responsibile for all management of the patient to include doing your own procedures(IV's, med's) and transporting with the patient to the hospital. That's why if it looks bad, no one else is there and we are in BFE my wife and I will stop, if not you're just in the way.

 

[Paws]

I actually once got a call for "physician on scene, CPR in progress" (which usually got a bit more attention), to find a psychiatrist from Russia (unlicensed in the US) doing "compressions" on the back of a morbidly obese prone patient who was yelling at him to "get off". It seems the patient had "passed out" and this is what he thought to do...

Sorry, but the jaded reality sometimes interferes with the hypothetical best care.

- H

I am totally prepared to let emt's, etc take over care since I would be absolutely no help in a roadside emergency. At least at this point, as a third year. If they wanted a good progress note and a printout from up to date, then maybe we could talk ...

 

[Hard24Get]

I just wanted to throw out there that my mom was spared death and a permanent spinal cord injury (rather than the temporary one she had) by an off-duty paramedic who was driving by.

BTW, I don't think anyone meant paramedics, etc represented inferior care, they were just asking medicolegally if it was considered as such, since we are told that we can't leave until someone equal or superior in training comes in. For instance, a doc I know said he helped someone on a plane and he wasn't allowed to leave until handoff at the hospital, rather than where the paramedics were waiting at the emergency landing. Delayed his vacation by hours...

 

[ERMudPhud]

I don't stop because I'm not carrying anything useful and there probably isn't anything I can add. One time on the way to work I saw a pickup truck that had just gone off the road and hit a light pole with minimal damage. It looked like the truck had exploded farm workers because there must have been a dozen of them running around the truck. I was only a few blocks from work, the mechanism was minor, and everyone was up roaming around. I figured I might as well go on into work because I was going to be seeing them all soon enough. Sure enough 10 minutes later they all came through the ambulance bay on backboards.

Another time I was riding my bike to work while wearing scrubs when some softball players flagged me down with a teammate who had just broken his arm. It was already splinted so I just said, "Looks broke, I guess you better go to the hospital"

I've helped out on planes a few times and never had any problem turning the patient over to EMS when they arrive.

 

[ER-ER-Oh]

I've had exactly 2 experiences with this. The first was in rural upstate NY. An older gent got smacked by a car while I was getting a sandwich. I ran outside to find this poor guy lying in the road bleeding pretty well from a head lac. He had hit the windshield, made 2 big indentations, and then got thrown to the ground. I was the first person to get to him, with a rural EMS volunteer squad appearing within 10 minutes (pretty good I'd say, by the way). The guy had a history of A-fib, HTN, an old CABG, etc., was breathing about 30/min., and had some L chest tenderness. This big ole' paramedic lady was fumbling around with a c-collar for about 10 minutes while I was asking about the history and doing the ABC's. She was trying really hard to be in charge and I just let her go about her business, although the rest of the crew and the firefighters seemed happy I was there, as I had identified myself as an EM resident physician. When it came time to trasport the patient to the hospital about 20min. away I asked if they had a monitor for him. The paramedic rolled her eyes and said no. There was a state police EMS there by that time who said they had one they could use (why the first EMS didn't have one is beyond my understanding). They transported the guy, and I went behind them just to see how he did. The doc in the ED told me later that the paramedic was bitching about me asking for the monitor, which he giggled about. Everything turned out fine.

The other one was quite different. I stopped after seeing a car smashed into an overpass pillar. EMS was just pulling up when I got out my truck. I walked over and identified myself to the EMS guys and asked if there was anything I could do to help. They just started presenting the patient to me, like it was second nature. I looked in and saw the passenger trapped in the front, not speaking, about 2 feet of encroachment, an open R radial fracture that was bleeding at a good clip, and the smell of liquor. As EMS struggled with the c-collar I asked if they had any vitals. They said no, so I asked if I should get some, to which they replied to the affirmative. I got a pulse of 110, rr of 22, and just started to get the BP when I felt someone tugging at my foot (I was kneeling in the L rear passenger seat as firefighters were working on the extracation from the rear of the car) and yelling to get out of the car. I turned to find the Fire Chief pulling me out of the car. I got out, identified myself ( I had my hosp. badge with me) and asked what the problem was. He gruffly told me he was in charge of the scene and didn't want me there. I responded politely that I had asked the paramedics if they needed help and they said they did. He again, gruffly, told me to move away from the vehicle. I complied. He continued to lecture me on involving myself as I watched, kind of in a trance of disbelief at his aggressive behavior. He then asked the paramedics if he should call in the helicopter. The paramedics were not sure. The BP was like 90's/40's I think and they were waffling a bit. They had not splinted her fracture and were moving towards the bus. The paramedic asked me what I thought. I asked if they had checked her pelvis for stabiltiy, which they had not. They responded that it was hard to tell. At that point I just walked over and felt it myself. It seemed ok, and they went on their way. I walked over to the chief and basically let him have it. I said I was only helping after asking the paramedics, and that they seemed eager to have another set of hands. I told him his method was out of line and unprofessional, not to mention totally about his ego and not in the patient's best interest. I told him I had no intention of usurping his authority on the scene, and simply left.

 

[Wackie]

I'm not stopping for a fender bender, but if it's something bad then yes I'll stop.
I carry next to no equipment, but in Texas I'm protected with acting within my scope of practice considering the availability of tools at the time.
Should someone need CPR, I'm not required to lip lock since it's a potential health hazard without a face mask.

The most important thing I can do is get EMS on the way and also to make sure nothing else is done that can cause more injury to the victim(s). People will go running in and try to rip a victim out of the car (that isn't on fire or posing any safety risk to the victim) with a potential neck injury when trying to help. Or the victim will start trying to get out or move around when they should remain still.
I'm also an eye witness for the police and EMS.


A few months ago, a doctor helped out at a car wreck. The victim of that car wreck (who was running from the police) friggin stole his Lexus and took off.
I bet that's the last time he ever stops to help.

 

[12R34Y]

I walked to codes in the field, and I walk to codes in the hospital.

An out-of-breath rescuer only adds to the excitement, worsens the confusion, and makes it difficult for you to adequately perform your job.

There are very few situations in medicine that will make me run.

Amen!!!!

Responded to 2 codes on call the other night....nice and leisure like. A fast walk is all it takes. Usually the only one in the room who's pulse isn't 140 BEFORE they get in the room and out of breath.

I also rarely hurried other than a brisk walk for codes in the field back in my paramedic days.

Desperado makes great points and I couldn't have said it better. Paramedics are PRE-hospital experts and do their jobs well. We should all just let them do it with minimal interference.

I always hated the know-it-all m.d. on scene of my calls......Now I've promised to never be that know-it-all physician even as a future medical director.

later

 

[roberts36]

As a current career EMT and hopeful EM resident in 4-5 years, I have to thank all of you that respect prehospital providers for their education. I have actually had a physician (anesthesiologist) restrained by the police on scene of a head-on collision with 2 entrapt, submarined pts both w/ bilat open mid-shaft femurs. He was apparently first on scene, called 911, then proceeded to yell at each of the incoming 4 medic units and rescue company for not appropriately extricating these patients (down to the size of collar and type of backboard). Last I checked, anesthesia residencies didn't include any extensive vehicle extrication training.

Long story short, the police departments tend to side with EMS in this situation and ended up physically restraining this guy 20 yards away. PLEASE - don't be that guy.

And for what it's worth...I don't stop either.

 

[PluckyDuk8]

During my first year of medical school, walking around my parent's neighborhood with my boyfriend (both of us were also EMT-Bs), we literally watched as a tree cutter fell two stories from a tree. His fellow tree cutter (Spanish speaking only, so we couldn't tell him not to touch him) before we got to him cradled him in his arms (aak! the neck!). We held c-spine and and took vitals until EMS got there a few minutes later. We gave them a standard EMT-B report, so it was obvious we weren't random people, and even though there was definitely enough staff (fire reports to all calls) they didn't even give us a measly verbal thank you. Just ignored us entirely. According to the homeowner of the tree, the poor guy ended up with some kind of paraplegia.

Another thing that was horrible was not being able to stop at a scene of a new car accident when I was driving the private ambulance when you have a patient inside and several people at the scene are trying to desperately wave you over. Luckily though, it was in Chicago where EMS would have gotten there a minute later anyway.

 

[12R34Y]

During my first year of medical school, walking around my parent's neighborhood with my boyfriend (both of us were also EMT-Bs), we literally watched as a tree cutter fell two stories from a tree. His fellow tree cutter (Spanish speaking only, so we couldn't tell him not to touch him) before we got to him cradled him in his arms (aak! the neck!). We held c-spine and and took vitals until EMS got there a few minutes later. We gave them a standard EMT-B report, so it was obvious we weren't random people, and even though there was definitely enough staff (fire reports to all calls) they didn't even give us a measly verbal thank you. Just ignored us entirely. According to the homeowner of the tree, the poor guy ended up with some kind of paraplegia.

Another thing that was horrible was not being able to stop at a scene of a new car accident when I was driving the private ambulance when you have a patient inside and several people at the scene are trying to desperately wave you over. Luckily though, it was in Chicago where EMS would have gotten there a minute later anyway.

I ALWAYS stopped when I was driving the ambulance with a patient in back. your partner stays with the patient in the back and you check it out/call it in and make sure nobody needs there airway opened.

You should have stopped. It takes about 2 minutes and the transfer/call you were doing is probably not going to affect the patient in your unit at all.

It was actually our company policy to stop.

luck you didn't get into trouble over it.

later

 

[PluckyDuk8]

If I remember correctly it was our company policy not to stop when you have a patient in the back. I think I asked about it on the radio at the time. My memory could be wrong, though.

 

[crewmaster1]

I always stop in the ambulance with a patient, unless my patient is super sick. A couple of minute response from normal EMS can make a big difference when it's an airway issue. Also to check out what resources are needed. It is nice to get two medic rigs rolling if there are multiple sick patients rather than wait for EMS to show up then call another unit. Same for MCI, you can at least say how many patients/potential transports. Single vehicle crashes can have lots of peeps if you're rollin' a mini van!

 

[crewmaster1]

One nerd at my ambulance company, who is an EMT B, carries a back board in the back of his truck. I always make fun of him and ask him how the hell is he going to back board a person by himself. He'll be stuck waiting for EMS anyways, and once they get there they will have their own BB. He's the same guy that has giant EMS stickers all over his truck and a CB with a ghetto siren thing hooked up. Yeah, he also has the neat yellow light bar too. Cool guy. OK I admit it, I've always wanted to hang out with him and go driving around looking for fender-benders. I'm really jealous on the inside.

 

[Wackie]

I ALWAYS stopped when I was driving the ambulance with a patient in back. your partner stays with the patient in the back and you check it out/call it in and make sure nobody needs there airway opened.

You should have stopped. It takes about 2 minutes and the transfer/call you were doing is probably not going to affect the patient in your unit at all.

It was actually our company policy to stop.

luck you didn't get into trouble over it.

later

Here, we're supposed to radio it in. We're not allowed to stop if we have a patient. It's considered neglect/abandonment, even if only one member checks things out. Here it's one crew per patient, not one medic/EMT per patient.

One nerd at my ambulance company, who is an EMT B, carries a back board in the back of his truck. I always make fun of him and ask him how the hell is he going to back board a person by himself. He'll be stuck waiting for EMS anyways, and once they get there they will have their own BB. He's the same guy that has giant EMS stickers all over his truck and a CB with a ghetto siren thing hooked up. Yeah, he also has the neat yellow light bar too. Cool guy. OK I admit it, I've always wanted to hang out with him and go driving around looking for fender-benders. I'm really jealous on the inside.

There was a guy similar in my class. Even before he's certified, he's got lights and sirens, has a belt full of crap that he carried with him all the time, rescue equipment in the back, and thousands of dollars worth of radio equipment and 50 antenna on his POS car.
He was a STAN (****, That Ain't Nothin') when it came to story time. We nick named him "Radio".

 

[Chronic Student]

We had one of those too. Had the 'batman' toolbelt with everything from a spyderco knife to the pocket face mask.

Just to be a little bit more nerdy he had the 'Volunteer Traffic Assistance' stickers on each of the doors of his truck. He had EMT stickers everywhere and lapel pins and always seemed to be at the station.

Did I mention this was the same guy who failed his EMT-I exam three times and his ambulance confidence course twice.

Oh God, did he love to drive contra-flow. Even when he didn't really need to, I still shudder when I think about it.

-Mike

 

[streetdoc]

I ALWAYS stopped when I was driving the ambulance with a patient in back. your partner stays with the patient in the back and you check it out/call it in and make sure nobody needs there airway opened.

You should have stopped. It takes about 2 minutes and the transfer/call you were doing is probably not going to affect the patient in your unit at all.

It was actually our company policy to stop.

luck you didn't get into trouble over it.

later

I see where BAD things could happen if you pull over. BAD BAD things-the types that lawyers love. Especially if you are a PRIVATE TRANSPORT service suddenly in the midst of a chaotic scene call. Radio it in, give as much info as possible and KEEP GOING!
I hope that company had some kind of legal insight into the repercussions of stopping on the side of road and then having (god forbid) an 18 wheeler plow into the back of the amublance with patient and crew inside. oh bad things i tell ya. I've seen it happen (empty ambulance though-luckily!).
streetdoc

 

[12R34Y]

I see where BAD things could happen if you pull over. BAD BAD things-the types that lawyers love. Especially if you are a PRIVATE TRANSPORT service suddenly in the midst of a chaotic scene call. Radio it in, give as much info as possible and KEEP GOING!
I hope that company had some kind of legal insight into the repercussions of stopping on the side of road and then having (god forbid) an 18 wheeler plow into the back of the amublance with patient and crew inside. oh bad things i tell ya. I've seen it happen (empty ambulance though-luckily!).
streetdoc

Everytime any ambulance/fire truck/police pull over on the side of the road they run the risk of getting rear-ended. No more likely, no less likely.

We put patients in the back of the rig on the highway and sit for a few minutes prior to leaving.....what's the difference.

I actually worked in a community (county ambulance) that served approximately 12 different fire services (each with their own first response ambulance......that didn't transport).

It waas the policy of EACH of these 12 services to stop at all accidents. As that would be unethical and radio it in and do a quick scene size up and make sure nobody needed the ABC's corrected for a few minutes until another rescuer got there.

Saying that lawyers will sweep down and get you is just practicing CYA medicine and that's always in my mind bogus.

Bottom line. it's the right thing to do.

And since when is it abandonment to NEVER leave the patient unattended.

That must be YOUR company policy because that is NOT abandonment (unless you both left the ambulance.....which I'm not advocating)

later

 

[streetdoc]

Everytime any ambulance/fire truck/police pull over on the side of the road they run the risk of getting rear-ended. No more likely, no less likely.

We put patients in the back of the rig on the highway and sit for a few minutes prior to leaving.....what's the difference.

I actually worked in a community (county ambulance) that served approximately 12 different fire services (each with their own first response ambulance......that didn't transport).

It waas the policy of EACH of these 12 services to stop at all accidents. As that would be unethical and radio it in and do a quick scene size up and make sure nobody needed the ABC's corrected for a few minutes until another rescuer got there.


Saying that lawyers will sweep down and get you is just practicing CYA medicine and that's always in my mind bogus.

Bottom line. it's the right thing to do.

And since when is it abandonment to NEVER leave the patient unattended.

That must be YOUR company policy because that is NOT abandonment (unless you both left the ambulance.....which I'm not advocating)

later

True bad things can happen anytime and anywhere, but i'm assuming this is a hypothetical transport (interfacility) where the crew is not necessarily used to working on the side of the road. If I am the pt in the back of that truck headed to hospital B I do not want to stop for a recent accident.
One-the crew may not be "up to speed" on scene safety.
2-even if they are, we are putting our selves into increased jeopardy (and they are then making me do something I don't want-can't a pt refuse?). Accidents happen enough without going looking for them! In this day of cell phones, it is likely that another crew is already on the way and therefore you are not doing anything that is delaying the treatment that they are going to get and are entilted to.
3-If that is my dime paying for my ride to hospital B, then it is my ride.

I worked for a small rural county where, at times, we had NO trucks available. We never trumped one call for another or loaded 2 that were close by due to the "you never know" nature of the job. You could end up having someone agonal on that scene and then what? You are tied up with that...all the while your "stable" transport pt hits vfib. ah, you never know.

It is best to follow policy, but that policy just kinda worries me. slippery slope...
streetdoc

 

[Wackie]

And since when is it abandonment to NEVER leave the patient unattended.

That must be YOUR company policy because that is NOT abandonment (unless you both left the ambulance.....which I'm not advocating)

later

Say you leave the truck to check on an accident. You make contact with a victim who needs care. You're entitled to stay with that victim until you can transfer care to appropriate professionals.
While you're tied up with that, the patient you were transporting starts to crash.
Now the patient in the box can't be transported because you're tied up with another patient and your partner can't drive and take care of the patient at the same time.

What do you do?


I'm sorry, but when I'm on duty and have a patient, that patient deserves all of my attention. I'm calling in the accident and continuing on, "right or wrong" as it may be.

 

[12R34Y]

Say you leave the truck to check on an accident. You make contact with a victim who needs care. You're entitled to stay with that victim until you can transfer care to appropriate professionals.
While you're tied up with that, the patient you were transporting starts to crash.
Now the patient in the box can't be transported because you're tied up with another patient and your partner can't drive and take care of the patient at the same time.

What do you do?


I'm sorry, but when I'm on duty and have a patient, that patient deserves all of my attention. I'm calling in the accident and continuing on, "right or wrong" as it may be.

I don't know where you guys worked, but where I worked...... a busy 30,000 call/year service. about 99% of my calls were all never transported hot from the scene and are all usually super stable.

these scenarios are kind of ridiculous and very very very hypothetical. 99.99999% of the time the accident you are stopping at does NOT having anything wrong with the ABC's AND 99.999999% on that same call your patient isn't going to suffer for stopping for a few minutes.

These people you bring to the ER will sit in the room for hours waiting for results of tests etc.....a few minutes is hardly important.

I had to unlearn this after becoming a doc and all thru medschool.

I remember hauling some SICK people to the ER (or at least what I thought was sick) and then you get all excited and give report to a nurse (who doesn't really share your excitement).

They then take your NRB face mask off. The patient moves the cot and then registration comes.........the nurse does her assessment. 20 minutes later the doc might stroll in then they get CXR/12-leads/labs etc....4 hours later they ...............you get my drift.

My point is your hypotethical scenario would take an act of Congress to have all of those events happen simultaneously.

You should stop at MVA's when you are on duty. I know if I was stuck upside down in a vehicle and my family was also in the car and I saw an ambulance drive by I'd probably hunt them down and kill them.

later

 

[FoughtFyr]

You should stop at MVA's when you are on duty. I know if I was stuck upside down in a vehicle and my family was also in the car and I saw an ambulance drive by I'd probably hunt them down and kill them.

later

Absolutely against the EMS act in the State of Illinois. If you did it, you would expect to be in the EMS Director's office learning the terms of your suspension.

- H

 

[Chronic Student]

I would have to agree with FF here. It was against SOP for us to stop with a patient already on board.

-Mike

 

[Wackie]

My point is your hypotethical scenario would take an act of Congress to have all of those events happen simultaneously.

You should stop at MVA's when you are on duty. I know if I was stuck upside down in a vehicle and my family was also in the car and I saw an ambulance drive by I'd probably hunt them down and kill them.

later

It's illegal where I am to stop with a patient in the back, so the situation happened enough to warrant it being in writing.
Especially while on duty, it all depends on your local laws and then company/city's policy.

 

[12R34Y]

I guess you all have differing policies than where I worked (obviously).

We were OBLIGATED to stop and determine need for resources etc....There wasn't an option of NOT stopping. I figured everybody stopped. Oh, well.

Do what you company tells you to do.

I'd still be raving made if an ambulance drove by me and I was actually hurt.

that's just me though.

later

 

[totalbodypain]

I pretend like I am busy changing the channel on the radio station and clueless to the accident at hand and drive on. I don't have MD plates (which for reasons that I can't explain people actually get in NY), and therefore will never get called on it....There are way too many yahooos on the scene allready and the last thing they need is a grouchy em resident.

 

[shaggybill]

While I was doing an ambulance clinical for my EMT-B, we ran a stoplight on a way to a call and caused a wreck. I guess the guy was watching our ambulance and not the road and rear-ended the car in front of him pretty hard. The paramedic just called it in and we continued.

 

[sphincter tone]

Our policy is to stop and assess the scene ONLY if the patient we are transporting is stable. If we are transporting an urgent/ critical patient we radio it in and keep on trucking (however it does suck when you have to dodge bystanders practically throwing themselves in front of the truck trying to get you to pull over).

If we are enroute to an emergency call and get flagged down, we call it in and it's up to dispatch whether we stop (usually) or keep going to the original call (if that one is CPR in progress or if we're being flagged down for a minor MVA with everyone out of the vehicle and ambulatory).

I only stop at MVAs if I'm in the county I work for (and since I don't live there, time spent driving through it is pretty much limited to driving to and from work). The rest of the time there is either no place to stop safely or an off duty dermatologist already on scene directing the festivities.