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. :)

[VivaLasViejas, ASN, RN]

I'm with you guys on rescue breathing......I'd rather keep the circulation going than worry about breaths-to-compressions ratios in the heat of the moment. That, and I don't care to risk exposure to God-knows-what.......I haven't been in many code situations in the field, but I've never seen anyone NOT vomit during a resuscitation attempt. I used to have a couple of pocket masks in the glove box, along with a couple pairs of gloves and a stethoscope, but haven't carried this equipment routinely for several years now. I figure a cell phone to dial 911, the ability to stay calm, and my knowledge of CPR and first aid are sufficient for most, if not all, emergent situations I'll encounter in my lifetime. Including today's. :)

[nursebedlam]

I was driving on a lonely country road years ago. When l drove around a corner there was a car on it's roof in the middle of he road. I stopped as nobody else was there. Thank gawd the driver was ok, just a bit shaken up.

[ham22]

Being from a small town I don't usually see many serious accidents so I don't have to worry about making a decision to stop or not. However, I was on my way to work a little over a year ago and came upon a very bad accident . It was so foggy I could barely see the Ambulance on the side of the road, I did see the vehicles involved in the wreck and knew that it was bad. Something inside me told me not to stop, that EMS was there and to just keep going, there was probably nothing that I could do to help anyway. So I went on to work but had a very sad eerie feeling all day. To make a long story short, the victim of the accident was a good friend of mine and she did not make it. It was very tragic and sad and I am so thankful that I did not stop that day b/c that image would have haunted me the rest of my life. Because of that I don't know if I will ever stop to assist someone.

[mandykal, ADN, RN]

Like with others only if no rescue team on-site is when I would stop especially if the accident just instantly happened. One time I heard a loud bang while outside my home...I immediately went to the scene and saw a disoriented guy walking to nowhere with blood gushing down his temple...I saw people trying to ask him if he's okay...It was an instinct for me to just ordered him to sit down....Than I checked out the other driver who was totally unconscious...It appeared to be a head-on collusion. I phone 911 but there was not much to do except apply pressure to stop the blood. Scary situation because of the unknown that the person may carry. Another situation happened when I was in a 5pm traffic hour, I notice a bunch of people surrounding a car and it looked like a dog underneath the car...that didn't want to come out...it was biting in all directions as people tried to use anything they could think of to chase the dog out. As my car neared to the scene I just rolled my window down and yelled, "That dog aint coming out because everyone is blocking it's exit!" As I passed I saw everyone go to one side, and a few seconds the dog came out. The dog didn't get hit. The traffic had cars stopped and the dog went under the car for shade. It was just another instinct of common sense.

[Dixiecup]

A couple of years ago my husband and I along with three other couples were sitting on a river bank just soaking up sun and watching people go by in their canoes. A man in a canoe pulled up on the bank and asked if anyone there was a nurse. I never let it be known I'm a nurse in public for obvious reasons. But of course every one I was with immediately started pointing to me and said "she is!" I cringed and wondered what he needed. He had somehow got a fish hook caught in his upper arm and it was all the way through his skin. He wanted to know if I would take it out. The first thing that went through my mind was 'lawsuit' . I told him the get out point was about a 1/2 mile up the river and then he needed to go to the local ER. After he paddles away all my friends were all over me for not helping him, they thought I was awful! I explained my thinking, as lay people usually don't think in the same terms as medical people. They still thought I should have helped him. When I went to work that Monday I took a poll of all the nurses I worked with (about twelve) and only one said they would have taken the fish hook out. And that one would because she lived in the country, spent a lot of time hunting and fishing and had taken fish hooks out before. How about it? Would any of you taken it out?

[carcha]

Our hospital has covered us in the event that we come across an accident to not do mouth to mouth. This is following the death of a nurse who contracted meningitis and died. Would I help out?. Like many of you I think it would depend on the circumstances. I would certaintly be wary of a lawsuit yet I would want someone to stop and help me or my children if they became ill. So I guess on that basis yes I would stop. Are we obliged to declare our profession at the scene or not, can anyone tell me?

[PA-C in Texas]

When I became a Paramedic, the dept. that I worked for also provided volunteer first responder service for the area. The medics were issued bags with standard equipment and a few ALS supplies, and our medical direction covered us as first responders, so I was usually able to get some treatment going on scene before the ambulance arrived if I saw a wreck.

Where I recently lived, and where I worked as a PA in the ED, I was also involved with EMS, so I did usually stop if it looked bad and it was in our service area. I carried some things in a bag that I kept in my car that I used and which the other medics did not use- I would just carry the bag with me if I ever got a shift on the ambulance of helicopter. However, one time I stopped at a wreck that the medics were already at, and I forgot it. I ended up doing a thoracostomy with a 9.0 mm ET tube and some duct tape on the way to the hospital. It was PURE magic- I even have some pictures.

One time, however, I was oustide of Houston and happened on a really bad wreck. Since I was not a member of the responding EMS nor did the supervisory agreement with my physician as a PA cover my practice there, all I could do was essentially try to give comfort. But I think that me telling the lady that "I'm a paramedic and the ambulance will be here soon" hopefully made her feel a little better. Sometimes, even with the best skills and technology, all we can do is try to comfort people. Even though we can't do what we could do, sometimes just doing SOMETHING can provide people with peace of mind.

[Energizer Bunny]

I was told in my CPR class that as a "professional rescuer" I am obligated to help. Is this true? Could I actually get in "trouble" for not helping at a scene?

[rjflyn, ASN, RN]

Being a medic and a nurse I will stop if no emergency service is there. If the police are on scene I will identify myself and offer to assist- most times they decline.

Having said that what we ran in to more often than not was people who didnt do that.

If one is going to stop one also needs to know when not to stop.

I cant tell you how many times Drs stop and offer to help. Its to the point were some EMS have a card they give to the Dr. I tells them what resposibility they are asuming if the do help ie: they have to go with the patient all the way to the ER- in the middle of nowhere this can be some distance.

The other thing is when EMS gets there and takes over get out of the way. They know what they are doing more often than not. You may have been trained to do something one way but they have to do it their way because of protocols and regulations that effect them- these are totally different than the ones in the 'relative sterility' of the hospital or office environment.

Rj :)

[suzanne4, RN]

Taking a CPR class does not make you a professional rescuer. They did not teach you first-aid, splinting, etc. in your class.

When I lived in the US, I always stopped at any accident, or emergencies is resturants when they were announced, same as on airplanes.

Over here, because of where I live and work, there are always police at the scene almost immediately. Luckily enough it is usually a motorcycle accident with a minor spill because of wet pavement. And nothing more serious. I also have a communication problem as I only speak a little Thai. Not enough to try to explain anything. Emergency medicine services here as far as pre-hospital are almost non-existant. Due to traffic, it is hard for ambulances to get thru, there is no place for the card to pull over...........There is no emergency medicine training program in Thailand. Most ER doctors are actually GPs which means that they have only done an internship........

[Energizer Bunny]

Suzanne....my CPR class is first aid as well...required by our school. And we are titled professional rescuer when we pass.

[Katnip, RN]

I was told by my CPR instructor that no we are not in any way obligated to stop and help especially if it puts us at any kind of risk.

I probably would stop and help, but I'd keep the help limited to anything that did not require exposure if I wasn't carrying gloves and a barrier.

I know a doc who saved a life with an emergency trach. The guy was basically dead, the obstruction totally occluded his airway. The hospital didn't give antibiotics and his vocal cords got infected. He could talk, but his voice was different. Now this man did not make his living speaking or anything, but he sued the doc, EMS, and the hospital and won millions. So it really is a consideration these days unfortunately.