Accident Scenes: Do You Always Offer Assistance?

Nurses General Nursing

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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 around, looking frantic. Of course, I'd rather NOT have to be a nurse on my days off, but there were no EMS around, and these people looked like they had no clue as to what to do, so I jumped out of the car and ran to the scene. The poor lady, who was of indeterminate late middle age, had just been pinned between two cars and had sustained probable crush injuries from the hip to the knees....it didn't appear that she'd lost much blood, but as I assessed her she started to shiver violently and I knew right away she was going into shock---her pulse was rapid and thready, and she was beginning to fade out. There was a bystander who volunteered his recently-acquired CPR skills if needed, so I knew we could keep her going if we had to, but at the same time I was hoping we wouldn't have to!

So I yelled for someone to find me something to cover her with, and luckily another bystander had a couple of fleece blankets in his truck.....otherwise, there wasn't much I could do for her except hold her hand and keep her talking, and thank goodness someone had already called EMS, because they got to the scene about two minutes after I'd arrived and took over from there. Now I'm back home, hoping she's OK, because she was beginning to look pretty bad just before the paramedics got there..........and I'm wondering, does everybody here feel that being a nurse requires them to assist at accident scenes, or whenever they see someone in distress?

I don't mean when there's an ambulance on the scene and the REAL experts are available---I figure the EMTs are a whole lot better equipped and better trained in emergency situations than I am---but when it's obvious someone is in trouble medically and you can't tell whether anyone at the scene is trained to deal with it? I wanted nothing more than to get my people to the terminal---we were running late anyway---park my car, and get some lunch before they had to board, but I just couldn't NOT stop to see what was going on and try to help.

In these lawsuit-happy times (despite "Good Samaritan" laws that help protect first responders, nurses are still held to a higher standard than the average guy-on-the-street), I'm always nervous about treating strangers, even though I've rarely had occasion to do so. But again, I can't just walk away......and yes, I have to admit it made me feel pretty darn good to leave a scene knowing I've helped, if only a little. :)

Sorry that I didn't take the extra time to read all of the replies, but there IS a law about this. Not sure of the exact wording, but if you are the first to arrive and you don't stop, if your caught you can be charged with leaving the scene of an accident.

How could you NOT stop to help somebody in need?? Day off or not. You could possible be the saving link between life and death for someone!!!

How could someone drive/walk by an accident and not think about 'what if' for the rest of your life?? What if you heard on the news that the person died because nobody assisted them in time?? How could you stand to look at yourself in the mirror?? You would have guilt and then know that if you were ever found out.........a nurse that didn't stop to render aid?? OMG, I really think that there would be a possibility of losing your license or something??!!

I would stop.....regardless....and I have in the past. Made me feel proud that I was able to assist someone in need! I sure as heck would someone to stop if I were hurt and needed help.

I wouldn't even think about it..........well, maybe I would for about 2 seconds if it were my ex..........................but seriously, I made my husband turn around and drive back to a car that was pulled over and the lady was throwing up all over the side of the road. She was alone and got car sick.............how terrible.........we both felt better!!

Just my 2 cents!! :rolleyes:

By TeeitupTom

By the rules of golf I could take a drop and play a round you

OR................You could play it as it lies.

I think there is an exception and you would be wise not to incur a penalty stroke by moving the victim out of your line to the hole hastily. In my oppinion the body is a loose impediment if the victim is clinicaly deceased. If they happend to inconvienience your foursome by collapsing in a hazard.......well then you just cost yourself a penalty for improving your lie in a hazzard my friend.

Of course, when in doubt, wait for a rules official for clarification if the beer cart is close by.

:rotfl:

I don't necessarily have a 'professional duty' to anyone unless I have accepted that responsibility. Now...at an accident scene, once it is recognized you are a doc or nurse AND if you lay hands on them, THEN you have a professional duty. Putting your hands on a patient in a facility or out can be construed as accepting responsibility and constituting a duty legally. Which is likely why the paramedic in an earlier post chose to give a card to the physician responding to an accident scene...a card saying the doc would need to accompany to the hospital if they chose to stay....not speaking aloud gave the doc the opportunity to decline duty if he hadn't yet announced he was a doc and hadn't touched the patient.

After we've been in this field awhile we tend to get a bit jaded after we've watched goodhearted coworkers screwed for their good deeds. No matter how 'nice' you are at an accident scene...people tend to forget later and become critical if the outcome is not perfect. And there's always an ambulance chaser to help point that out.

Very well put mattsmom

BTW,

If you are capable of rendering medical intervention, then stop and assist.

In other words, if you paid attention in CPR and know how to do it correctly then you are likely the most qualified person on the scene even without any other medical training.

It's as simple as Airway Breathing Circulation.

If you're thinking of stopping because you're a nurse, don't. Take a First Responder level course if it concerns you. A policeman has that level of emergency care training. Render aid because you care enough to be qualified to do so by taking the initiative of some medical training.

That will relieve any doubt about what you should do. You will know what you will do because you have prepared for it.

Specializes in Emergency.

Just of note my comments above are based on a 16 year history as a professional rescuer (Paramedic) and emergency nurse. Typically one cannot be held to their professional standard at an accident off duty because you dont have your typical supplies and equipment with you.

Having said that you can get ones self in to legal issues if you try to do something you know full well you shouldn't be attempting. As far as the leaving the scene of an accident noted above, that law generally applies to one who is involved in the accident, it is in the states I have lived/practiced.

Rj:rolleyes:

Specializes in ER, ICU, L&D, OR.
By TeeitupTom

OR................You could play it as it lies.

I think there is an exception and you would be wise not to incur a penalty stroke by moving the victim out of your line to the hole hastily. In my oppinion the body is a loose impediment if the victim is clinicaly deceased. If they happend to inconvienience your foursome by collapsing in a hazard.......well then you just cost yourself a penalty for improving your lie in a hazzard my friend.

Of course, when in doubt, wait for a rules official for clarification if the beer cart is close by.

:rotfl:

I will take a drop

My best friend and I both passed a nasty wreck this afternoon in seperate cars. She is finishing her RN this semester and I have high school first responder training. I was so glad to see that EMS unit ahead and the fire engine coming up the fire lane behind us. I have never had a critical patient before. I hope and pray that I am not alone when I do. One of the ER docs was there in his own car getting out to offer help. If I am first on scene I will call for help, get out and see if anyone needs help. I have a tool box first aid kit in the trunk with general stuff. Not gonna put the county ambulance service out of business anytime soon. I am kinda freaked out about it all. I hope that if I am in an accident that someone would please stop, even if it was just to reassure me.

As a paramedic and an RN, I feel pretty qualified to answer some questions and give a little advice!!!

Can you be sued? Sure, anybody can get an attorney and try to sue you...but it is unlikely that anything will come of it. Attorneys look for deep pockets (hospitals, cities, businesses that will likely just settle), not average Joe bystanders. The MOST important thing that you can do to protect yourself and the injured parties AT THAT MOMENT is to work within your scope of practice. Do not attempt an emergency tracheotomy or field amputation!

Protecting yourself is priority one!! When the ambulance pulls up, we don't need any more patients!

1. Gloves are important.

2. When you pull over, be careful!! Use your hazard lights, get off to the side of the road, make your vehicle VERY visible, and BE CAREFUL out in the road...don't get run over!!! Also, please avoid driving through any accident debris or trackmarks; the police need those to investigate the scene and the glass and metal can tear up your car.

3. Note any hazards to yourself when approaching the scene...is the vehicle stable, gas leaking, etc.( Note: cars very seldomly explode like in the movies, but please don't SMOKE at the scene of a car accident.:nono:) If you do get any injuries, please tell the paramedics and get followup care (stitches, tetorifice shots, blood exposure treatment)...auto insurance from the person who is a fault might take care of the expenses.

4. Your presence is very soothing...staying calm and just letting people know that you are a nurse cuts the chaos in half! Try to determine who all the injured parties are and a quick idea of what happened. Gathering everyone who can move into one safe spot is helpful. Maintaining C-spine and an airway in the people who cannot or should not move, controlling bleeds, and keeping everyone calm is the most important thing.

5. When EMS or the fire dept. arrives, introduce yourself, give a brief report, and leave. If the crew seems rude or brusque or doesn't say thank you, please try not to be offended, we really do appreciate you! We're just trying to process alot of information and prioritize.

Ultimately, if your conscience says stop, then do so. That's what you have to live with at the end of the day. I have stopped at accident scenes with my kids in the car; I think it is important that they see people helping each other. I do, however, IMMEDIATELY locate the most responsible-looking bystander at the scene and ask them to go keep an eye on my kids ( giving people tasks to do also helps control the mayhem!) I have never had a problem with this.

Very valuable advice!! Thanks so much for the tips! After all, the most any of us (regardless of degree, experience, or education) can do is quickly triage the situation for ABC's, and wait for the Pro's! (EMS)

As to the poster who declined to remove a fishing hook-- I'm with you. I would not have done it either. How big was the hook? What if it were lodged in the brachial artery and the second you remove it this guy starts to bleed out or develops a hematoma later-- and what are the chances this guy would bother to go to the ER after you removed the hook and gets a tetorifice shot? You were correct not to remove the hook, IMO-- even if the guy never knew your name and there was no risk of a lawsuit had you removed it, you should rest easier knowing that he pretty much *had* to go to a hospital or clinic to get it removed, and received the care that you--off-duty, were simply not equipped to provide. :coollook:

I know it is hard and difficult when off and having a rest to rush to someones assistance

You have your own private life to lead also

But Please take a bow from me for your unselfish help to this person

If it was me lying there I probably woud not have forgotten your face

or your rush to help me

She was lucky you are a nurse and had immediate help

Please

Take a bow of respect from me

My brother in South West Africa is a trained paramedic

I am just about to contact Red Cross to take a similar course

I wanted for a long time to become a Nurse but many factors stood in my way

I am busy now with the beginning stages of studying

And want to do the Paramedics course so I can help another

I say thank you to you from all you have helped

And may your hands that help others be blessed

Carol in Holland :balloons:

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