Strange question

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equine_05

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Alright, I have an interesting question that a group of us were talking about yesterday. We were discussing incidents where we, as medical students, had to use whatever little training that we already have (from school or just first aid knowledge in general,) to help someone. For example, last summer I rushed this nine year old to an urgent care center after she had an anaphylactic reaction to a bee sting and her airway closed up, (thank God for epi.) It was at a picnic with some of my family's friends, and everyone thought "doctor" and looked to me. (That's right, the lowly med student.) Anyone else have experiences like this? If so, did it make you feel kind of helpless?
 
equine_05 said:
Alright, I have an interesting question that a group of us were talking about yesterday. We were discussing incidents where we, as medical students, had to use whatever little training that we already have (from school or just first aid knowledge in general,) to help someone. For example, last summer I rushed this nine year old to an urgent care center after she had an anaphylactic reaction to a bee sting and her airway closed up, (thank God for epi.) It was at a picnic with some of my family's friends, and everyone thought "doctor" and looked to me. (That's right, the lowly med student.) Anyone else have experiences like this? If so, did it make you feel kind of helpless?


I know there a law out there called good samaritan law. However, I would have done exactly what you did and that is get the girl to the ER. I know doctors who would not have done anything because of fear of lawsuit if things don't go so well. As a medical student, I still will not help someone in need just because of this situation. I know that may sound cruel. But that's life here where I live. People are lined up ready to cash in and if they think that they can do it with you, they sure will try.

Just last month, this guy was riding a motorcycle and crashed. No one stop and most just stood there looking. So I did what I always do when I happen upon an accident, dial 911. I think I would respond differently if it came down to me having to do CPR. Then again, I don't know how I would respond in a situation like that because I've been taught to pick up the phone and call 911. Perhaps when I graduate my thoughts may change. I sure do hope so. But, as it stand right now, I don't know enough to save a life other than CPR and knowing the signs of trauma and knowing how to stop severe bleeding.

Just my 2 cents
 
I wouldn't say I'm concerned but I am aware of this potential problem. As a rising MS-3 I realize that I'm in a dangerous situation. I don't know enough to help you, but I do know enough to hurt you more.

Personally, beyond CPR, my first reaction would be to dial 911.
 
Had I been in a similar situation as described by equine05, I'd have reacted exactly the same way (unless I had an adrenaline-injection in my side pocked 🙂)
Doctors worrying about lawsuits: It's sad that the world has come to this. I think it's up to the individual doctor/med. student how much he or she is willing to do, or more importantly NOT do in order to be on the safe side when it comes to law. My personal opinion is: Do what you can to save a life. If it's a cyanotic dying patient (f.ex. this girl with an anaphylatic shock), then I?wouldn't hesitate much performing a treachetomy. There is a very big chance that I will cut the carotid instead seeing how inexperienced I am, but the kid will die anyways. If there is a lawsuit, I will be able to justify why I did what I did and stand in for it. I am aware of the fact, that things are a little different in the States, so I can't speak for anyone living there.

Remembering the MOST important thing when being a doctor.
Best regards
Singh
 
I had a similar situation pop up on my plane filght back from London this past May.

We were mid way over the atlantic when they came down the hall looking for a doctor or a nurse to help with a manic depressive who had become violent.

I doubt any doctor would have been able to help. We ended up having to make an emergency landing in Iceland.

But I wonder if I was a full MD, would I still stay silent?
 
I was in church the other day, and they asked for a doctor/nurse when someone had a medical difficulty...I think he just fainted because it was too warm..and I have more than basic first aid training to assist..but then... they called for a 'doctor/nurse', not someone with first aid knowledge/medical student..so, I sat in my seat..
I guess I wanted to protect myself..and of course...avoid gossiping when some people say that who the heck am I since I am not yet a doctor rite?

But there was an instance once where I kinda helped my friend get her gramps to walk, he had edema since he was immobile for a long time and he just didn't want to walk because he was depressed but gave the reason his legs were painful..I managed to convince him to walk (BS knowledge) 😀
 
Jasminegab said:
I know there a law out there called good samaritan law. However, I would have done exactly what you did and that is get the girl to the ER. I know doctors who would not have done anything because of fear of lawsuit if things don't go so well.

Actually, while studying for boards, I found out that a doctor CANNOT be sued if he/she stops to help someone, as long as they practice within the scope of their knowledge. It's to encourage doctors to stop and help if there is an accident.
 
the good samaritan law protects anyone who comes to the help of someone who is injured and in need of help. jasmine obviously doesnt understand how it would protect her.

so long as the samaritan is not acting recklessly (and btw, i think trying a tracheotomy with no training would count as reckless) you will not be sued.
 
It is stories like these that make me happy that I have 9 years EMS experience with 7 as an EMT before starting medical school. That being said the smartest thing you can do is to call 911. All of these patients need to be seen and monitored in the hospital. However, if you know how to do more (due to formal training) I think you could do it and be covered by good samaritan law in most states (the statutes are different from state to state). However, from what I have heard most 1st and 2nd year medical students only really know CPR and basic first aid which would limit what you can legally do (this is also why I am glad that I will still be certified as an EMT through the 1st two and a half years of medical school).
 
When I was in med school a group of us (about 10-15 med students) went to see M.Butterfly on Broadway. In the middle of a very intense scene in the show some guy sitting a few rows in front of us had what in retrospect I think was a vTach arrest. His wife started screaming, Tony Randall stopped the play, asked for the house lights, and actually said, "is there a doctor in the house" Fortunately for the row full of terrified med students it was a typical New York crowd and there must have been 20 docs who came to his aid. After EMS took the patient away Tony Randall and BD Wong launched right back into the play.

Since then I've responsed a number of times to requests for a doctor on a plane flight including one case where a dentist was giving CPR to a conscious young women who had briefly passed out. My rule for car crashes is if everyone is up walking around I just call 911. Most of the time if you have no equipment with you there isn't much you can do in the field other than CPR and call 911
 
So according to the "Good Sam" laws, med students who have no prior EMS training are to be treated legally as everyday citizens even if they are in their last few years of med school? What if a procedure/treatment was attempted on the scene that the student had already been introduced to or taught in class that produced a negative effect on the patient? Wouldn't the legal outcome have to depend on the specific situation/the student's level of training or does the Good Sam law still apply?
 
Good Samaritan laws vary by state, but basically provide protection to people who stop and provide emergency assistance up to their level of training and are not willfully negligent.

I have been in EMS for 18 years and always stop and help provided there is no obvious danger to myself. I have helped out people in stores, at accident scenes, in a National Park in Costa Rica - just about everywhere! Even a rollerblader that crashed into my car. I have never had anyone sue me or threaten to sue me. Most people never even know your name - often the police don't even record who your are.

So, if someone is hurt or sick and needs your help:

Call 911.

Give assistance to the best of your ability and do not go above the level of your training. Even if you don't know much just holding someone's hand and talking to them until EMS arrives is a wonderful thing to do.

Just don't go into a scene that isn't safe and don't move injured people unless they are unsafe where they are.

With regards to what you should do as a med student in terms of your level of training: I am an EMT-I and in CT that means I cannot intubate. If I am taught how to intubate as a med student, I am still not permitted to perform that task when not under the direction of a supervising physician.

Deirdre
 
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