Accident Scenes: Do You Always Offer Assistance?

Nurses General Nursing

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8mpg

153 Posts

This was a pedestrian that SHE hit. It would be great if there were someone there trained in emergency to take over or handle it, and of course that would be the best case scenario, but it isn't what existed! My question was if YOU were an RN and there was nobody there to render aid, in an accident that YOU caused, would you feel obligated to offer ANY assistance in the face of NONE?[/quote']

If Im not trained as EMS or for any type of trauma/emergency training, I probably would only offer to call 911. While we do have good Samaritan laws that do protect us, you must remember that you are only protected under YOUR scope of practice and training. If you are not trained to take care of a person with a femur fracture and move the leg, you could possible cause major bleeding from a punctured femoral artery. You may not have proper equipment (even gloves) to protect the patient and yourself. EMS training will ALWAYS tell you safety first (your safety before patient safety). Just because someone is a nurse or doctor doesnt mean they are qualified in emergency situations. You will find many doctors will not get involved as they assume liability and as a more qualified practitioner than EMS will be obligated to care for and assume responsibility until the patient is turned over to a hospital ER physician.

RNperdiem, RN

4,592 Posts

Sadly with head injuries, even with all the equipment and training in the world, we are all delicate creatures.

CrunchRN, ADN, RN

4,530 Posts

Specializes in Clinical Research, Outpt Women's Health.

Whether I caused it or not if I saw that the injured were dying (not breathing, bleeding out, etc...) then I would take action because you would not face the risk of additional harm.

If they appeared stable I would keep them still until EMS appeared on scene.

I am so sorry that you do not have even the comfort of the human touch for your child. I would hope though that all the wonderful human touch and love he experienced all his life from you and his family filled up his heart and head.

Flare, ASN, BSN

4,431 Posts

Specializes in school nursing, ortho, trauma.

I know that I personally would try and render help, but then again, i've had pre hospital training (EMT) and i'm a trained firefighter. If I were the one causing the accident, though, i don't know how i'd react. I'd like to think i'd be calm enough to try and do some sort of basic assessment on extent of injuries or simply living or dead, but i know a lot of people, regardless of training, regardless of licenses, degrees or certifications would not be capable of being calm enough to even call for help. A person may be an RN, but that doesn't mean they will use their training in a panic. I am sorry for your loss, there is nothing I can say that will make this any less painful for you. May your son be at peace.

CrunchRN, ADN, RN

4,530 Posts

Specializes in Clinical Research, Outpt Women's Health.

Good point by Flare. They may have been rendered useless by the horror if the situation. Many people have that reaction - even medical professionals.

JW2011

20 Posts

Thank you all for your responses. I do know for a fact that he died alone, that she never touched him, and EMS were significantly delayed in their reponse time due to her inability to relay the needed information, and EMS told me how frustrating it was trying to get that information from her. I guess any thought of instruction on assistance was out of the question.

I think what has kept me in this "trying to understand" mode is that I really WANT to understand, and WANT to move on from it, but these facts that I have shared, along with the knowledge that there was likely impairment and inattention, and a person that has never uttered "sorry", and in fact lied to our family and to the police in an effort to gain sympathy, proven lies now, but they go to character and came too late to change what law enforcement did or didn't do, and because she has demonstrated that she learned NOTHING, and has continued to drive in a manner that is endangering people's lives. A violation just months after the crash that killed our son, where she was charged and found guilty of negligent driving. Different state, and different cop...

Loopholes and lack of laws in our state allowed this person to face no legal consequence, and now I am involved in trying to rectify that status, by engaging those in the position to change laws in this effort. I know it won't bring my son back, but hopefully will prevent another family from enduring not only the pain of losing a child, but hopefully hold persons responsible accountable.

CrunchRN, ADN, RN

4,530 Posts

Specializes in Clinical Research, Outpt Women's Health.

I hope you succeed. For all the mothers out there. And again, I am really so sorry for your loss.

CountyRat

323 Posts

Specializes in Wilderness Medicine, ICU, Adult Ed..
Thanks for your feelings of wanting to stop & help. You are right, however, on being a potential distraction if you actually do stop at the scene.

Whether you'd be of value on a scene or not, it is almost certain that by showing up, you will distract the crews from performing needed pt care.

If you really feel the draw of helping on EMS scenes, you might consider getting certified as an EMT or EMT-Paramedic. One of our local trauma center docs actually got certified as an EMT/Firefighter, and performed in that role as a volunteer.

Funny that you should mention that, CrufflerJJ. In addition to being an RN with pre-hospital care training and experience, I am also an Advanced Wilderness Life Support Provider, which includes training in paramedicine. However, knowledge is not enough. Working an emergency scene requires a high level of team work and coordination. EMS professionals train and work together so that they can work as an effective team. Since I have not trained with my local EMS colleagues, I would end up getting in the way. So, to put my skills to use, I have joined my local search and rescue team, where I can serve as an RN/Medic in a setting in which I can help a patient effectively. Knowing the right time and place in which to use one's skills is as important as the skills themselves.

CountyRat

323 Posts

Specializes in Wilderness Medicine, ICU, Adult Ed..
You can render first aid or CPR until EMS comes. You can't move them without proper immobilization but you can prevent them from being moved. Youcan keep them calm until the proper authorities arrives with the proper equipment to transport and move the patient.

Esme, when I teach wilderness and disaster medicine, I emphasize that one of the most important functions an off-duty provider can provide an an accident victim is that of body guard, protecting the victim by stopping well intended but poorly prepared Samaritans from doing harm, their good intentions not withstanding!

JW2011

20 Posts

Yes, I know how delicate we as humans are. She may have not been able to change the outcome no matter how experienced, but I can't tell you how much it hurts me that she didn't even try. We don't know what thoughts if any go through a victim's heart or mind during those moments, and it would have been a great comfort to me to know someone was with him and cared enough to speak to him and at least let him know help was on the way.

I don't think EMS had a clue of how long it had been since he was hit, as it was a 2nd caller that finally gave the needed info to get them there at all. They got there 10 minutes after that call and still tried to save him. I wonder if they knew he had been there for 16 minutes or more instead of the 10 since they were dispatched, if they would have pronounced him there instead of trying unsuccessfully to restore breathing, heartbeat etc., and then transporting to nearest hospital. where he was pronounced within 10 minutes of arrival.

Sadly with head injuries, even with all the equipment and training in the world, we are all delicate creatures.

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Yes, I know how delicate we as humans are. She may have not been able to change the outcome no matter how experienced, but I can't tell you how much it hurts me that she didn't even try. We don't know what thoughts if any go through a victim's heart or mind during those moments, and it would have been a great comfort to me to know someone was with him and cared enough to speak to him and at least let him know help was on the way.

I don't think EMS had a clue of how long it had been since he was hit, as it was a 2nd caller that finally gave the needed info to get them there at all. They got there 10 minutes after that call and still tried to save him. I wonder if they knew he had been there for 16 minutes or more instead of the 10 since they were dispatched, if they would have pronounced him there instead of trying unsuccessfully to restore breathing, heartbeat etc., and then transporting to nearest hospital. where he was pronounced within 10 minutes of arrival.

It sounds like she lost her mind.....being unable to give directions, make sense of things. The mind is a powerful organ especially when it doesn't work right.

I have been a trauma flight nurse and where a child is involved resuscitation begins. Children can be amazingly resilient.......you just never know the outcome at the scene. I have seen children that were obviously injured with I would call an unsurvivable injury.......recover.......maybe not to baseline but they recover.

I have seen children that didn't appear to be "that injured" have injuries that no one could recover from. Depending on the EMS and the requirements of the state and whether they are Paramedics the may be obligated to transport and not able to declare deaths at the scene.....maybe they panicked too and just wanted to try to save him. I would not have left him on the side of the riad either......I would have transported and tried.

It is all so complicated.

Most of the time......at the scene of an accident, even with experience there is nothing that can be done without the proper equipment, medicine, blood and MUCH greater harm, even causing death, can by trying to "Help". In trauma there is a "golden hour" where trauma has an opportunity for resuscitation it is the EMT's obligation to try everything they can to get the patient to a hospital ASAP to receive that life saving care.....if their life can be saved.

I have attempted resuscitation when everyone "knew" it would not be successful because the child deserves that chance and so does the family.......at least one "round of meds" so that even we can deal with the sadness at the loss of one so young.

I know it has only been a year. Take this energy you possess to affect change.

I cannot change what happened to your son. I cannot change what the driver did or didn't do what she was or wasn't doing. The driver will have to live with herself and someday she too will face her maker......therein lies the true judgement and there is nowhere to hide then.

i wish you peace.

JW2011

20 Posts

Thank you for taking the time to explain, and I hope peace is attainable. I will continue to fight for change, as I would not wish this on anyone else, and hopefully can do something to prevent it.

Can you tell me how to change my username?

I know it has only been a year. Take this energy you possess to affect change.

I cannot change what happened to your son. I cannot change what the driver did or didn't do what she was or wasn't doing. The driver will have to live with herself and someday she too will face her maker......therein lies the true judgement and there is nowhere to hide then.

i wish you peace.

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