Got to use my neuro skills in real life!

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My husband plays hockey, and last night I was at his game when one of his teammates had a hard fall onto the ice. There were only a few of us in the stands watching, and I heard one of the players going to the opposing team's side asking if anyone was an EMT or a doctor. No one seemed to have any idea what to do and no one had medical training, so I jumped up and walked toward the ice.

My husband saw me walk up, and motioned for me to come on the ice. The ref wouldn't let me on the ice, but the player was able to get up by himself and come sit on the bench. I took his helmet off and did a neuro check on him and asked him what hurt. He never loss consciousness and his neuro check was fine, but was feeling dizzy, so I told his girlfriend to take him to the hospital down the street to get checked out.

It was kind of amazing how calm I was and how my learning in class became instinctive when the player sat down. It really felt good to be an asset and know what to do in those types of situations. Though, I keep replaying the situation again in my mind and wondering if I should have asked more questions or done things a little differently, but I know I did the priority items correctly.

I'm now re-considering this whole trauma nursing thing. :)

Specializes in ER.
Learning a lot from this blog. So... for the experienced EMTs etc. out there... what is the criteria for removing a helmet? It appears from the writers story, the injured person got up himself, and must have skated off the ice before any assessment was made. Therefore C-Spine precautions were already not-in-effect. Also, in a football game, for instance, I rarely, or maybe have never seen anyone put a player in a C-collar and take them away to the hospital. And... it seems concussions are not uncommon in this sport (I don't watch football much, so I could be wrong)... Anyhow, I know people are specially trained to assess them, but how is it different? I've watched a lot of boxing and seen many hit the floor hard after a knockout, and the neuro exam to determine if a player can continue appears short and sweet, done by a doctor. The boxer may go to the wrong corner, legs may be weak, may actually lose consciousness, but still they go on... I really have learned a lot from this blog, so wondering if anyone has more in-depth info as to onsite in the field care/assessment.

In general there is no reason to remove it unless it is obstructing the airway. You put them in manual c-spine. The c-spine doesn't do anything for concussions. The key about the boxing situation is that it is done by a doctor and therefore it is on his or her license if the person is wrong. Since we are not doctors, we do not diagnosis. Even if the 12-lead is clearly a stemi, we cannot say that it is a stemi but we can say there is ST-elevation in whatever leads. Adding the myocardial infarction makes it a diagnosis which we cannot do. The doctors at the boxing ring put themselves on the line for whatever calls they make in the field.

As for the good samaritan laws in my state, we are not legally responsible for not providing care off duty unless we advertise ourselves as a medical provider. Meaning those people who through up the star of life on the back of their truck's windows? They are advertising themselves as a medical provider. The license plates that have the fire department symbol on them? Not a medical provider as not all firefighters are medical providers. So basically, I don't wear or identify myself as anything except a normal person. We had a lawyer come in and discuss the legal ramifications to us about it in regards to our state laws.

This is why I strongly, strongly recommend people do not get shirts that say nurses. Do not get license plates that says RN4ever or whatever. Don't use coffee mugs that say best RN unless you're at the hospital or in your own home. That cute little RN window decal? Don't put it on your personal vehicle. I tell this to firefighters and other paramedics.

Specializes in Forensic Psych.
Good Sam laws still require competence and correct actions do they not? Or maybe the whole point of GSLaws is that a first aider can legally screw up without consequences? Our instructors told us to say we were not nurses when out in public. I think most states do not require nurses to act, even if we want to but are not sure quite what to do. But for OP: people are just trying to help you and all of us readers, not rain on any parade. Learn from this.[/quote']

The entire point is that the first responders can accidentally screw up without consequences, or why would we need a law? The law would protect...no one.

Like I said earlier, Texas law protects you unless you willfully or wantonly harm someone. I agree with you, Esme, that protection can still destroy your life with endless court battles and financial strain, so yes...we should always be smart and safe.

But really...none of us know what protections the OPs state offers, because we don't know where the OP is from. Legal advice should be left to the people who know what the heck they're talking about.

Yikes!!!!!

Your heart was obviously in the right place! Don't take everyones input so personally though.... its important to try to learn from every experience, what was right, what was wrong, and all the countless possibilities, no matter how remote, of what else could have happened in fall with impact to the head/neck.

Specializes in Complex pedi to LTC/SA & now a manager.
The entire point is that the first responders can accidentally screw up without consequences or why would we need a law?[/quote']

Good Samaritan laws were actually not created to protect trained medical personnel, nurses, EMS, or first responders. They were created to protect the general public should they elect to assist in an emergent situation with no trained personnel available. The protection is extended to off duty medical personnel who act prudently and within their scope of practice. For example a student nurse or basic EMT would not be covered for performing an emergency field tracheostomy.

http://www.heartsafeam.com/pages/faq_good_samaritan

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
The entire point is that the first responders can accidentally screw up without consequences, or why would we need a law? The law would protect...no one.

Like I said earlier, Texas law protects you unless you willfully or wantonly harm someone. I agree with you, Esme, that protection can still destroy your life with endless court battles and financial strain, so yes...we should always be smart and safe.

But really...none of us know what protections the OPs state offers, because we don't know where the OP is from. Legal advice should be left to the people who know what the heck they're talking about.

With all respect. We are not giving legal advice. We are sharing a lifetime of experience. Good Samaritan laws protect you only so far, depending on the law. You WILL ALWAYS be held ACCOUNTABLE and can be held LIABLE for your actions. The whole "is there a Doctor in the house" is for movies and prime time TV.

In reality, when you are a health care provider you are held to higher standard and what the "standard of care" is as determined by what "another reasonable and prudent practitioner" would do given the same scenario. Joe the plumber actually has more protection than a medical practitioner because of their lack of knowledge for while you might be "protected by" good Samaritan laws you can still be sued for malpractice and performing outside your scope of practice....the victim just can't sue you civilly for personal damages.

Joe the plumber gets off easy because they didn't know better....you do. The practitioner is held to the standards of care.

But, each person needs to make the decision for themselves if the risk is worth it by using all the information out there what is right from them.

Once again OP....I am so happy for you that it is all making sense to you! It is very cool when it finally begins to click and make sense. Just be aware that you are now held to a different standard than the general public...you now have medical knowledge.

To the OP, I understand that responses to this post turned out to be different than what you had expected, but I hope you can appreciate that your post resulted in not only you but the rest of us learning a lot about the best/correct way to handle this type of situation.

Specializes in Hematology/Oncology.
Good Samaritan laws were actually not created to protect trained medical personnel, nurses, EMS, or first responders. They were created to protect the general public should they elect to assist in an emergent situation with no trained personnel available. The protection is extended to off duty medical personnel who act prudently and within their scope of practice. For example a student nurse or basic EMT would not be covered for performing an emergency field tracheostomy.

HeartSafe America - Good Samaritan Laws by State

Bingo

ANOTHER story, which happened with someone from the class previous of mine went to a dubstep concert.

Now at those concerts some people go for music, some people go for drugs, some go for both.

I am sure the student wasn't on it. but someone was having a seizure and she ran over there and turned them on their side and protected their head from slamming against the ground.

This would be more of an ideal intervention for a student nurse to do. We cannot critically do assessments. We would still be protected under the good Samaritan laws. In regards to advanced assessments, neuro checks. broken arms and legs. its a little different. We cannot do head to do. We are being trained to critically think, but we lack experience and a license.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

LOVE THIS REFERANCE Thank Beachy for the addition to my list of must haves HeartSafe America - Good Samaritan Laws by State

As you may notice my state doesn't include nurses and doctors in the Good Samaritan Law.

Massachusetts Good Samaritan Law

Note: MA has a number of laws providing exemption from liability to EMS

and other medical personnel.Click here for the search results from the MA General Law Database

Chapter 111C: Section 14.

Liability of emergency medical technicians, police officers or firefighters.

Section 14. No emergency medical technician certified under the provisions of this chapter

and no police officer or firefighter, who in the performance of his duties and in good faith renders emergency

First aid, including, but not limited to, the use of any semi-automatic or automatic external defibrillator or

transportation to an injured person or to a person incapacitated by illness shall be personally in any way liable as

a result of rendering such aid or as a result of transporting such person to a hospital or other safe place, nor shall

he be liable to a hospital for its expenses if, under emergency conditions, he causes the admission of such

person to said hospital

Praemonitus praemunitus or forewarned is forearmed

He had a concussion. U made the right decision because he was alert when u saw him. Obviously if he was unconscious, 911 would've been called. When u post things expect negative comments, it goes with the territory. Toughen up!

He had a concussion. U made the right decision because he was alert when u saw him. Obviously if he was unconscious, 911 would've been called. When u post things expect negative comments, it goes with the territory. Toughen up!

How do you know he had a concussoin? How do you know something more serious wasn't going on? (Someone mentioned a slow bleed early in the conversation). The point of PPs on the thread was that without definitive diagnostic testing, you don't know what was wrong with him. He may have died in the car on the way, and then what would his wife/gf have done?

The Good Sam laws do not mandate the same standard of care for every first aider or responder. They require you not to exceed YOUR training and experience/standard of care, and not to leave the patient until relieved by someone with a higher level of training.

A nursing student has no higher standard of care than any lay responder, and cannot be held to (or attempt to perform to) a nurse standard of care. However, as opposed to a lay person, a nursing student might be expected to know a little more first aid, such as keeping an airway open prn ...and first aid training will invariably teach that you call someone more qualified than you.

This does NOT mean telling the wife to drive him anywhere. The fact that he was discharged from the ER without further care means nothing, because 1)sometimes head injuries don't declare their severity right away, so the patient returns to the ER later, and 2) sometimes head injuries declare their severity so damn fast that even a 5-minute car ride is fatal. The liability issue is a completely different matter.

The OP left in a huff because we didn't fawn all over her for applying her "skills," when in reality she made a decision she was not qualified to make. We have but attempted to explain how to keep herself and her patient out of trouble the next time she is asked to provide first aid. In the fullness of time I think she will see the wisdom doled out here, gratis.

Specializes in Hematology/Oncology.
How do you know he had a concussoin? How do you know something more serious wasn't going on? (Someone mentioned a slow bleed early in the conversation). The point of PPs on the thread was that without definitive diagnostic testing, you don't know what was wrong with him. He may have died in the car on the way, and then what would his wife/gf have done?

Thats what I was thinking.

He had a concussion. U made the right decision because he was alert when u saw him. Obviously if he was unconscious, 911 would've been called. When u post things expect negative comments, it goes with the territory. Toughen up!

You cant auto diagnose someone.

"Oh they sneezed, they had the flu."

its not that it goes with the territory, what she did was not right.

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