Accident Scenes: Do You Always Offer Assistance? - page 4

Had an interesting experience when I took my sister and BIL to Portland International this morning: as I was pulling into the terminal, we saw a woman lying on the ground with several people standing... Read More

  1. by   kids
    Three times, all by virtue of being the first one there who had a clue:

    1) 1995, riding in the back seat of a car with a trach/vent kid who lived in the mountains far from anything. We witnessed a motorcycle -vs-deer and stopped. While mom drove for help I maintained C-spine with my knees and administered 02 for 1 hour while waiting on EMS. Person ended up having road rash and a fx femur.
    2) 1997, Labor Day weekend at Long Beach WA. Watched a Jeep load of drunks roll on the beach about a mile from town, only one person thrown, a 60 yo grandmother. I held C-spine with my knees as the tide edged in, luckily 4 wheelers tend to run prepared, we had plenty of blankets. Took EMS 30 minutes and they left me with her head another 20 minutes until they got a collar on her to loaded her up. Person ended up having a fx clavicle and dislocated shoulder.
    3) June 30, 1997, 10:30 pm. I had come home from grocery shopping with my 12yo son, he asked if he could go to the end of the block to where his older brother and sister were (along with the rest of the neighborhood). I said yes. I was slicing pound cake for straberry shortcake when the phone rang, it was a neighbor girl. She said "Justin hit his head and his lips are turning blue". I told her to call 911 and took off running. I found my youngest son lyng in the street with his older brother screaming and trying to pick him up and his older sister (and others) stopping him. He was seizuring, I knelt to protect his head, when it stopped he wasn't breathing. I held C-spine with my knees and performed rescue breathing on him on in the street until EMS arrived. He spent a week in PICU, another week on the floor then a month at inpatient therapy learning to walk and feed himself (and another year of in-home and outpatient therapy). He is for the most part OK now, but he has almost no affect and will probably never "outgrow" the ADHA he had before the injury.

    "Hitting his head" occured when he fell off the hood of a car going around a corner at an estimated (by the driver) 30 miles an hour. The car was driven by the 25y sister of a neighbor kid. Her own 3yo was in the back seat. Yes, she went to jail for a long time, we accepted 25% fault and settled out of court with her insurance company.
    Last edit by kids on Jun 25, '04
  2. by   SC RN
    Quote from kids-r-fun
    3) June 30, 1997, 10:30 pm. I had come home from grocery shopping with my 12yo son, he asked if he could go to the end of the block to where his older brother and sister were (along with the rest of the neighborhood). I said yes. I was slicing pound cake for straberry shortcake when the phone rang, it was a neighbor girl. She said "Justin hit his head and his lips are turning blue". I told her to call 911 and took off running. I found my youngest son lyng in the street with his older brother screaming and trying to pick him up and his older sister (and others) stopping him. He was seizuring, I knelt to protect his head, when it stopped he wasn't breathing. I held C-spine with my knees and performed rescue breathing on him on in the street until EMS arrived. He spent a week in PICU, another week on the floor then a month at inpatient therapy learning to walk and feed himself (and another year of in-home and outpatient therapy). He is for the most part OK now, but he has almost no affect and will probably never "outgrow" the ADHA he had before the injury.

    "Hitting his head" occured when he fell off the hood of a car going around a corner at an estimated (by the driver) 30 miles an hour. The car was driven by the 25y sister of a neighbor kid. Her own 3yo was in the back seat. Yes, she went to jail for a long time, we accepted 25% fault and settled out of court with her insurance company.
    Boy, reading that brought tears to my eyes. My son is twelve years old. You just never know what stupid things they'll do ... even when there is an "adult" around. Thank God he is okay.
  3. by   Scififan
    In my part of the universe we can lose our Nursing Registration if it is found that we haven't stopped and helped, but then we aren't in such a sue happy part of the world, thank goodness. Personally I don't think I could live with myself very easily if I didn't stop, there's been occasions when I've passed an accident scene and its obviously being dealt with I'm hugely relieved!!
  4. by   VivaLasViejas
    I'm with you on that one........I MUCH prefer to leave the emergencies to the people who are best equipped to deal with them. I'm a med/surg nurse, not an EMT or an ER nurse, and I'm always happy to let the paramedics take over at a scene. I know my limits as a health care practitioner, and since I hold no illusions about being some kind of hero, I also have no problem giving up control of the situation and getting the heck out of the way so the real heroes can get to work.
  5. by   LadyBugLass
    Funny story about a nurse bystander...

    The year was 1993; I was a very young and very new EMT. I worked at an amusement park of pretty good size. I worked in First Aid, and we only worked ONE person at a time; it was AWFUL!! It was the most demanding job I ever had. It would get up to 100-110 degrees and folks would just flock to this park like it was leaving tomorrow. Of course, the drinks were like $4 each, and the food was expensive, and it cost a lot to get in, so no one would eat or drink fluids all day, and then stand in line for an hour for some stupid ride that lasted 3 minutes. Needless to say, whole families dropped like flies. One day, I had FIFTEEN very sick people in the first aid station getting air conditioning and ice water (no IV's, park would not pay for them). In addition, the ones that couldn't walk had to be dragged back the station in a wheelchair by yours truly. We were discouraged from calling the ambulance because "their presence reflected poorly" on the amusement park.:uhoh21:

    So, one fine hot day, a patron goes down in the ravine where the line for the Ragin' River ride is. I show up with my little wheelchair and an ice pack. I see a man lying on the ground (about 300 lbs and COMPLETELY unconscious), a small group of stunned looking people standing nearby, and a women LYING ON TOP of the man, screaming and sobbing....

    "PLEASE WAKE UP!!!! IT WILL BE OKAY!!! I LOVE YOU!!!"

    Obviously, the wife.

    She has a big ole lollipop in her hand (the rainbow colored ones that spiral around the stick) and she keeps shoving it in his mouth. I keep trying to take it away and peel her off of the inert human being below her.

    "HE NEEDS THIS!! HIS BLOOD SUGAR IS LOW!!!" More sobbing and pleas to wake up, in addition to declarations of affection.

    So, I assume he is a diabetic, and that he is hypoglycemic, in addition to signs of major heatstroke.

    I told the supervisor (non-medical person) that an ambulance WAS going to be called, period.

    The ambulance shows up, and I have accomplished nothing. So, I attempt to soothe the crazy woman. When the crew loads him up, I tell her that she can ride up front, and she wipes her eyes and says "Oh, you might tell his family that."

    HUH?!?!

    "I'm just a nurse who REALLY CARES ABOUT OTHER PEOPLE."

    "So is he a diabetic?"

    "Oh I don't know, honey, I just thought he was because he was passed out and all." Sigh. "It feels so good to take care of people."

    The folks standing off to the side were the family; they were too shocked by this freaky, bawling woman assaulting their husband and father with a large sucker in her "first aid" attempt to say a word to me.

    It was a LONG time before I trusted another nurse bystander. That woman was NUTS.
  6. by   VivaLasViejas
    So, how did you KNOW she was a nurse?? Because she said so? No professional nurse I know would behave in such a manner, let alone try to shove a lollipop in the mouth of an unconscious person. This lady sounds like a nutcase, all right, but please don't assume someone is a nurse (and mistrust them automatically) just because they say they are.......lots of nurse impostors and wannabes out there.
  7. by   LadyBugLass
    :chuckle Oh, I know that NOW! But at the time, it like, scarred my fragile young mind! I can still see that sucker in my minds' eye.

    Now, with some experience under my belt, I would have had the sense to ask more questions and have the Wacko Woman escorted out by security.

    Let's just use the phrase "nurse"!
    Last edit by LadyBugLass on Jun 26, '04
  8. by   scobylover
    I don't think I explained myself about the "getting in trouble" part. I meant by the nursing board for our state. I was told this about 12 years ago by a friend who had just finished nursing school. It could have changed since then. I will be sure and ask when I start school in the fall!
    As for stopping, I will always stop if EMS is not around. I may not be able to do much in terms of healthcare right now or depending on what type of nursing I go into, but I cam be the calm voice for a scared person who is concious and hurt till EMS arrives.
  9. by   Dixiedi
    Quote from RN4NICU
    Honestly, it would depend on circumstance. I tend to not carry personal protective equipment around with me. You never know who you are dealing with or what you are exposing yourself to. I would not expose myself to another person's blood (I get cracked skin on my hands from the hospital's soap - this is a means of entry for pathogens) or provide artificial respirations without a barrier (what if they vomit?) To risk contracting something is to risk no longer being able to care for my ACTUAL patients, plus to risk my own health which I try to be very protective of (I know how hospitals work - I DO NOT want to be a patient in one). So, no I do not believe that there is an unwritten guideline that nurses should stop and help. In fact, in my state, the law is even interpreted this way - there is no "duty to care" in these circumstances, so action cannot be taken against you if you do not assist.

    There might, however, be a potential for a civil suit if you do assist. It is my understanding that the "good samaritan law" is meant to protect well-meaning bystanders without medical knowledge. In our lawsuit happy society, coupled with a tendency of jury members to side with the "victim" against a medical professional, I have NO faith that I would be protected by that law in an actual lawsuit. The law does not have a history of standing up for nurses - but it does have a history of standing up against them.

    Its sad that these things even have to enter into consideration, but that is the world we live in.
    The Good Samaritan law WILL protect nurses and Doctors too as long as you are providing first aid at the scene of an accident.
    (I have stopped at several accidents over the years. It's maybe wrog of me but I make a quick guess and decide if I will subject myself to possible contamination. There was one accident where I did nothing more than talk to the lady and call 911 on my cell. I would not have touched her with a 100 ft pole. Have to protect myself firsts. I know, sounds bad but who would take care of my family if I have picked somehting up from her? She was drunk as a skunk (not the reason I decided to withhold care) but she drank and then drove. She made the choice to get into a wrestling match with a tree, nobody forced her into it. I feel no regret for having protected myself.
  10. by   Gompers
    Since becoming a nurse, I've only passed one accident where EMS was not yet on the scene. I didn't stop. There was nothing I could do - an SUV rolled over going down an exit ramp and was still upside-down with the occupants inside. What was I supposed to do? Crawl inside and risk my own life? There were already at least 5 or 6 people on the scene to help. Had no one been on the scene or had someone been thrown out of the vehicle I might have stopped, but I didn't feel safe offering assistance if I couldn't even reach the victims. I did call 911 from my cell phone and reported the accident immediately - good thing, since the dispatcher said no one had alerted the EMS about it yet.

    I'm still unsure of the laws - some say you have to stop if you're a medical professional, others say you don't.

    I agree with the other poster who mentioned being careful stopping for minor "accidents" as I too have heard of people getting mugged or worse this way. Sick, but true.
  11. by   LadyBugLass
    I cannot emphasize this enough...PLEASE don't do anything that will:

    1. Get you hurt.
    2. Make you uncomfortable.
    3. Is outside of your scope of practice.

    I myself always had to wait for the fire department to deal with people in an unstable car, even on duty! Those guys had the equipment and the training to take care of that; I am not a firefighter and my expertise in that area is minimal. I would not expect one of them to intubate! If I did something that I was not adequately prepared for, and then got hurt or injured a pt., workers comp. or the city's insurance would not even touch me.

    Also, I noticed that someone mentioned something about helping out on a scene AFTER EMS arrived, which is perfectly acceptable if you are asked to help and don't mind doing so (nurses have saved my bacon on more than one occasion!)

    But DO AVOID doing something invasive (like start an IV) or any heavy lifting (like the patient.) I myself would have never asked someone that I was not 200% familiar with to do something that might hurt a pt., or ask someone that was not a fellow crew member to lift anything heavier than a jump kit. It is a huge responsibility to guard the safety of everyone on the scene, including bystanders.

    If you offer to do something and the EMS folks decline, please don't be offended...if you were hurt and defenseless, you would not want the people that are supposed to protect you to allow "just anyone" to start their IV or give you medications or defibrillate you. Nurses at the scene tend to do really well at taking a history, gathering up meds, cards,and information, talking to family members, reassurance, and a whole lot of other things that are so important!!

    Once, I had a doctor pull over to "help" and basically take over the whole scene, even though he had NO training in this particular area. After he started yelling at me because I would not let him intubate, I just handed him a cell phone with my medical directors home number typed in and told him to ask my boss. After a few minutes of heated conversation, he threw the phone at my partner and drove off at a high rate of speed...what a nuisance.
  12. by   VivaLasViejas
    See, that's what I mean........you have to stay within your scope of practice and expertise, recognize your limitations, and let the people who do this sort of work everyday get in there and do their job. Personally, I'm as good as anyone when it comes to starting IVs, but out in the field? Huh-uh. I would no more initiate an IV on a patient lying in the road than I would let a paramedic give meds to a post-op patient on my floor.....we are both trained to perform these tasks, but it's when we stray off our "home turf" and take our practice into unfamiliar territory that we risk getting into trouble. :uhoh21:
  13. by   StrbryJelo
    There are a lot of strange people out there that profess to being what/who they are not, but in 27 years and several states I've known a few nurses like this. Actually, one works in my hospital right now. And FYI, Cake Mate gel is terrific for an unconcious hypoglycemic. Just give it sublingually and it will absorb. Also, this product comes in a tube that is handy to carry as it won't leak or break and also lasts for months without spoiling.

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