Accident Scenes: Do You Always Offer Assistance?

[VivaLasViejas]

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. :)

[Shamrock, BSN, RN]

The way I understand the "new" technique for CPR is that lay people that call 911 and need instruction over the phone will be told to do chest compression only. I'm thinking as a nurse, etc.. and you stop, if CPR is needed, it would behoove you to do the full cycle.

[sdg]

The way I understand the "new" technique for CPR is that lay people that call 911 and need instruction over the phone will be told to do chest compression only. I'm thinking as a nurse, etc.. and you stop, if CPR is needed, it would behoove you to do the full cycle.

.

This was my impression too. The reason for this is someone who did not know CPR would need more time to be instructed on how to perform mouth to mouth (approx 2:40), and then the victims have a 10% survival rate. It takes less than one minute for a dispatcher to instruct some one on compressions. Because of this time difference, victims who receive compressions only have a 15% survival rate.

[tonchitoRN]

for those who are afraid of being sued, just remember nowhere does it say you have to give your name. i knew someone who stopped to give first aid to someone after an accident. she said she gave a fake name because she wanted to help but feared the reprocussions (sp?).

it is true the good samaritan laws will protect you however, you will still have to pay for your legal defense and your lost time from work.

if confronted, i would help a person in need because i always think if it were me or one of my family i would want someone to help them.

[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.

[SC RN, RN]

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. :)

[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!!

[VivaLasViejas, ASN, RN]

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. :)

[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.

[VivaLasViejas, ASN, RN]

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.

[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"!

[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.

[Dixiedi]

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.