Accident Scenes: Do You Always Offer Assistance?

Energizer Bunny · Jun 25, 2004

cyberkat...yeah, we were told to assess the scene and if it was dangerous, just to call for help, but if it wasn't that we were obligated to ask if they wanted assistance. I think I would be nervous about doing it but wouldn't want the person to not have someone helping them right away, KWIM?

MattLloyd · Jun 25, 2004

As nurses here in the UK, we are bound by our Code of Conduct to offer assistance in any emergency outside of the workplace - especially if we are in uniform. We are expected to provide the same level of care as can be expected within the environment and with the facilities available to us at the time.

I am lucky, because I have done my 'First Aid at Work', which is a four day first aid and basic life support course. However, I would still think very carefully before offering any assistance in an emergency situation. And I would always ensure that I only carried out actions that I would be able to justify 100% if required at a later stage in a court of law.

jwk · Jun 25, 2004

1) There is no legal obligation to stop and render aid. There may be a moral obligation in some people's mind. Yes, I stop on occasion.

2) Rescue breathing is being phased out of "civilian" CPR classes. It's hard to teach, harder for non-medical professionals to remember the technique, bad technique=regurgitation and aspiration, etc. In cardiac arrest cases, early defibrillation is the key, and is being pushed very hard. Breathing expired O2 @ 14% concentration into someone else, with not much of that going in anyway, is not going to help much.

If you need an A/W for extended CPR, ya gotta have a tube or something close. Mouth to mouth won't cut it, and most professionals have horrible BVM technique (poor seal, low tidal volume). Bagging someone adequately is actually much more difficult than putting in an ET tube.

scobylover · Jun 25, 2004

I am starting a nursing program in August. This particular subject in one reason I decided to be poor for 2 years (single mother of one) and become an RN. I am compelled to stop at every accident I see( before ambulance arrives). All I can think about is how scared these people are! The last one was the day after Halloween, my daughter was cheering for the YMCA and we heard a car skid- It amazes me how many people will just go about their business like nothing happened. I stood there for a minute then noticed several men running and jumping over the "tall" fence. I couldn't jump but I went around. I swear, by the time I got there, I felt like I needed an ambulance! Anyway, One of they guys who jumped was a doctor and the woman who had been driving in front of the victim was a nurse practitioner. His SUV had rolled over him and broke his back( I believe he was stilll drunk from the night before), he was awake but bleeding bad from the face. The NP held a towel under his face and the doctor just sat there and watched(really nothing he could do). I felt so helpless because I realized that even with training, unless someone stops breathing (you could do CPR) you really don't know the extend of the injuries so you just wait. I did get his cell phone and wallet and call his mom. I told his stepfather he had been in an accident, was alert and what hospital they were taking him to. I even called the hospital a couple of days later and he was in SICU. Now, after that big "jabber" (sorry so long!) I have this to ask: I live in MS and a friend of mine is a nurse, She said here that you are required by law to stop at an accident. If someone sees you and knows you are a nurse and don't stop you could get in trouble, anyone else heard that about their state? :uhoh3:

jwk · Jun 25, 2004

I am starting a nursing program in August. This particular subject in one reason I decided to be poor for 2 years (single mother of one) and become an RN. I am compelled to stop at every accident I see( before ambulance arrives). All I can think about is how scared these people are! The last one was the day after Halloween, my daughter was cheering for the YMCA and we heard a car skid- It amazes me how many people will just go about their business like nothing happened. I stood there for a minute then noticed several men running and jumping over the "tall" fence. I couldn't jump but I went around. I swear, by the time I got there, I felt like I needed an ambulance! Anyway, One of they guys who jumped was a doctor and the woman who had been driving in front of the victim was a nurse practitioner. His SUV had rolled over him and broke his back( I believe he was stilll drunk from the night before), he was awake but bleeding bad from the face. The NP held a towel under his face and the doctor just sat there and watched(really nothing he could do). I felt so helpless because I realized that even with training, unless someone stops breathing (you could do CPR) you really don't know the extend of the injuries so you just wait. I did get his cell phone and wallet and call his mom. I told his stepfather he had been in an accident, was alert and what hospital they were taking him to. I even called the hospital a couple of days later and he was in SICU. Now, after that big "jabber" (sorry so long!) I have this to ask: I live in MS and a friend of mine is a nurse, She said here that you are required by law to stop at an accident. If someone sees you and knows you are a nurse and don't stop you could get in trouble, anyone else heard that about their state?

The last time I did this was after a Georgia Tech football game. An elderly lady went down on the sidewalk about two blocks from the stadium - full arrest. From the spectators leaving the stadium, within about 60 seconds, there were three nurses, an anesthetist, and an ER doc. About a minute later, a medic that had been on duty at the game came up with a jump kit and AED. This lady got immediate CPR, defibbed, and tubed all before EMS and fire dept arrival. They couldn't believe it when they got to the scene. It was amazing how many medical professionals were there willing to help. This lady would not have gotten better care if she has arrested in the ICU.

As for a legal responsibility to stop - I'd be surprised if that really is the law somewhere, and if it is, I'd be willing to bet there has never been anyone arrested or prosecuted based on that law. Like it or not, there are still too many lawyers that would be more than happy to assist with a lawsuit.

missmercy · Jun 25, 2004

Befroe I got married, I made an agreement with my dad that I would stop and assist at an accident only under 2 conditions -- if I had seen the accident occur or if it was on a rather well traveled roadway. We had a friend who was mugged when he stopped to help a gal who's car was in the ditch -- and her goon buddies were hiding in the bushes. My husband thinks it's a good agreement too. If I have someone with me I am a little more prone to stop -- even in the boonies -- I usually leave my cell phone with them so they can call 911 if things get ugly (or if it hasn't been called already). I do carry a first aid kit and CPR mask in the trunk of my car.

Side note: In my first aid kit, carry thin maxis-- individually wrapped, clean, absorbant -- EMS arrived once while I had aplace one over a laceration on a guys arm.... EMS says" Is that a maxipad?!" When I said yes, he said " that's a great idea I should.... no way! I would never hear the end of it if I kept a pack in my car for emergencies!":rolleyes:

stressednurse · Jun 25, 2004

I was a paramedic prior to becoming a nurse. I also worked as a flight nurse and have my Pre-hospital RN certification. I stop if it looks like no one knows what to do or if it looks like someone is doing something unsafe. Otherwise I leave it up to the professionals. Unfortunately the local police know my training and so do the local EMS services so occasionally they will pull me aside and ask for my assistance (hold c-spine, help lift, start this IV for me while I intubate please) I do feel an obligation to help if I can though and that includes showing people how to use the self check out at the grocery store, how to change a flat tire, help put large items on the roof of the car at Home Depot etc. I am a friendly outgoing person and that must show because people often come up to me in public and ask for assistance.

I don't fear being sued for being nice, I fear the loneliness of those who live in fear and uncertainty.

LadyBugLass · Jun 25, 2004

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.

missmercy · Jun 25, 2004

I was a paramedic prior to becoming a nurse. I also worked as a flight nurse and have my Pre-hospital RN certification. I stop if it looks like no one knows what to do or if it looks like someone is doing something unsafe. Otherwise I leave it up to the professionals. Unfortunately the local police know my training and so do the local EMS services so occasionally they will pull me aside and ask for my assistance (hold c-spine, help lift, start this IV for me while I intubate please) I do feel an obligation to help if I can though and that includes showing people how to use the self check out at the grocery store, how to change a flat tire, help put large items on the roof of the car at Home Depot etc. I am a friendly outgoing person and that must show because people often come up to me in public and ask for assistance.
I don't fear being sued for being nice, I fear the loneliness of those who live in fear and uncertainty.

Thank God there are still people out there like you!! It's so nice to have people smile back at you or say "Good Morning " back!! A little older lady was wandering around our parking lot yesterday -- couldn't find her car -- obviously upset and worried that she was "losing her mind". REALLY wanted to get into my car and get out of here like gangbusters, but took a few extra minutes to ask some questions ( turns out that she had come out a different door and was looking in the wrong lot), offered to take her over to the right lot -- got her to her car and she said "God bless you my dear! There are far to few people in this world who would do what you did! " I AM SO GLAD THAT I TOOK THE TIME!! Yes, it helped her -- but I got the blessing. My new motto -- God bless all those who do the extra things when only He is watching!

LadyBugLass · Jun 25, 2004

Befroe I got married, I made an agreement with my dad that I would stop and assist at an accident only under 2 conditions -- if I had seen the accident occur or if it was on a rather well traveled roadway. We had a friend who was mugged when he stopped to help a gal who's car was in the ditch -- and her goon buddies were hiding in the bushes. My husband thinks it's a good agreement too. If I have someone with me I am a little more prone to stop -- even in the boonies -- I usually leave my cell phone with them so they can call 911 if things get ugly (or if it hasn't been called already). I do carry a first aid kit and CPR mask in the trunk of my car.
Side note: In my first aid kit, carry thin maxis-- individually wrapped, clean, absorbant -- EMS arrived once while I had aplace one over a laceration on a guys arm.... EMS says" Is that a maxipad?!" When I said yes, he said " that's a great idea I should.... no way! I would never hear the end of it if I kept a pack in my car for emergencies!":rolleyes:

The maxi pad thing is a good idea! It won't stick to a wound! Hey, if they can use a tampon in the ER to stop a nosebleed.....:imbar . I stopped at an accident a couple of months ago after I had been to Target; I ended up using a roll of toilet paper to apply pressure.

Another good thing for a first aid kit is the little restaurant packets of honey or jelly for diabetic emergencies. Even if you can just rub it on their gums, it can make a difference.

Trauma Columnist · Jun 25, 2004

I'm a pre-hospital RN (I volunteer with my rural EMS/fire dept) and also an experienced ED RN so yes I do stop. I always ensure scene safety - (a dead rescuer isn't much help) and do the basics. I keep gloves and CPR masks (varying sizes) in my car as well as a disposable blanket and bags to dispose of these in. Like another poster stated, I just couldn't drive past - if EMS wasn't there.

Agnus · Jun 25, 2004

I carry a cell phone most of the time. If I see someone in trouble or appears possible stranded I call highway patrol or if an obvious emergency 911.

It is not safe to stop alone on a lonely road or any other road these days. Getting EMS there fast is first priority.

If I stop the bleeding say, but EMS is delayed because of it I still might loose the patient depending on the circumstance.

If I do not have a cell I drive to the nearest place, where I can make the call.

It is unsafe these days to stop. By the same token if it were I stranded or hurt I would want someone to call for help.

When I come upon a scene on foot where someone is in need of medical help I ask if some one has called 911. If I assess from a distance things are stable or ok enough until they arrive then I do not get involved.

If someone tells I am a nurse or ask me to help because I am a nurse I do an assessment and do what is required.

I do not jump in I do not announce I am a nurse.

Just walking down the street and seeing a stranger hurt if no one is around who can help or make a call then I make a call but don't get involved.

I do not feel a call to rescue people even when they know I am a nurse.

I had someone ask me to check out a mutual friend (elderly) who fell on the ice at a club event.

I did a visual from a distance and talked to her asking questions. She was OK and I did not insist on more of an assessment.

I am not the one to rush in if someone is choking. Usually there are too many people willing to do this and I let them.

If it is know I am a nuse and there are people at a social event helping someone who is having a medical problem I will watch from a distance. Put on my concerned face and let them handle it unless they get in over thier heads. Then I will step in.