first on scene of accident did I do all I could have?

[Robbin M]

Hi,

I am new here and a student nurse. I would like some input to a situation I was in yesterday. I saw a young man get hit by a van as he was running across the street. It was horrible. He flew up into the air and landed on his head.

I was right behind the woman who hit him. I was the first person at the scene. I need someone to tell me I did all I could to help the young man. I checked to see if he was breathing by putting my hand under his nose and mouth. He was so twisted I could not check the way you are supposed to. He seemed to be breathing, it was shallow but he was able to blow blood onto my hand. He was unconscious. I checked for his pulse and it was rapid, but he had a pulse. He had blood pouring out of his nose and ear and I believe his mouth also. Someone came up and asked me if I knew CPR. I told her I did, but he did not need it because he had a pulse and seemed to be breathing. I sat with him and put my hand on his shoulder and told him EMS was on their way. The EMS were there within 2 mins.

There was an enourmous amount of blood under his head. When the EMS got there they rolled him onto his back and placed a plastic tube in his mouth and throat..i do not know what it is called. They did not bag him or start any kind of emergency breathing nor compressions. So I believe he was breathing, just blood in his throat. What do you do if someone stops breathing but has blood pouring, not trickling, out of nose and mouth?

I was calm and did not panic, but I was so scared. Today I just feel weird. Did I do all I could have done? Since the emt's did not start rescue breathing does that mean he did not need it?

[Cathy Wilson, RN]

Robbin, you may have those flashbacks for the rest of your life. With more education and experience, your perspective may change. Instead of being the frightening event that occurred recently, with time and experience, your perspective will allow you to remember the event confident in the fact that although it was awful, you were the ONLY person on the scene who was able to help that man and provide comfort until EMS got there. Liek Russell said, sometimes the best thing you can do is nothing, and prevent anyone else from doing anything that might cause injury. Always remember the phrase from the Hippocratic oath for Physicians, "first, do no harm." That applies to yourself, as well as any patient.

LPN & EMT CT gave you very good advice, too. First Responder or EMT training will be invaluable to you. Always remember to survey the scene of an accident, whether it is indoors or out. Be sure there are no noxious odors (or absence of, such as CO), live electricity, gasoline spill, etc. Until the scene is secure, it may be fatal to you to try to render aid. Sometimes, all you can do is stand back, call 911, tell the operator what you see or smell, and that the power company, gas company, police, etc. will be needed to secure the scene.

Best of luck to you. We are here, anytime!

[Dave ARNP]

I would like to congratulate you on your performance!

Considering your training, you went above and beyond the call of duty!

With the quick arrival of EMS, and assumably a transfer to a tramua center, this patient would have faired no better, even if someone else had arrived on the scene.

The two minutes that you had, wouldn't have allowed much time for interventions. Considering that the pt. was breathing, CPR was not indicated, and just you stopping; stopped somone with lesser training from possibly seeing the seriousness of the injuries and automatically beginning CPR, which could have caused un-due harm.

I am sure you provided great comfort to him in the time that you were with him. As a Nurse Practitioner, I commend you on your performance!

Now, take the time to make sure that you are OK with the events. Talk to your NSG instructors about what happened, and possibly speak to speak to one of them about the impact that it has had on you.

Perhaps speaking to your Primary Care Provider about some coping skills for the flash-backs would help.

You truely did a wonderful job!

David Bass

-ACNP, FNP

[KaroSnowQueen, RN]

Robbin,

Six years ago my mom died in a car wreck. In her belongings given to me by the cops afterward was a man's jacket with an unfamiliar name on it. I found out it was the name of the guy in the car behind her. I contacted him and we had a wonderful conversation as he told me of seeing the wreck, and sitting by her and using his jacket to cover her. She was dead before the ambulance got there, and it was so comforting to me to know there are wonderful people like him (and YOU) out there who will be good Samaritans and help the injured. You did the best you could and I am so proud of you for stopping to help.

[renerian, BSN, RN]

It is very scarey when you are first at an accident scene with no equipment. You did fine.

Hoolahan that sounds scarey too.

renerian

[Liddle Noodnik]

Originally posted by Robbin M

this man died last night. I just found out. I am so sorry his life ended that way.

Robbin

If you are feeling bad that he died, STOP. One of my first deaths was sudden on a young man. I had to go to the AUTOPSY to assure myself I hadn't missed anything (I hadn't)

God bless you

Kathy