I was the first responder to a car accident today

Nurses General Nursing

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i was driving in my car when i witnessed a 3 car accident. a truck ran a light and two other cars were hit. the truck flipped over to its side. my immediate reaction was:eek::eek::eek::eek:. i pulled over, got my cpr mask ( which was conveniently in my purse:rolleyes:) and ran over to the scene and started to assess all persons involved. i went to each car to make sure everyone was alert, breathing, and etc. thankfully no one was seriously injured. one guy involved was c/o chest pain and neck pain. another guy was limping and c/o pain to his ble, i sent someone to get ice and i applied it to his legs. i stayed until ems came and gave them report. i also encouraged everyone involved to go to the hospital. one bystander asked what kind of nursing i do. i said currently peds. he said " wow, how were you able to handle all those grown men"? i said once a nurse always a nurse no matter what your specialty is.

i always used to ask myself would i ever stop to aide in an accident. i guess i answered my question today. if it were my loved one i would want anyone with any knowledge of basic first aid and cpr to assist.

it felt really good to offer my assistance today. :nurse:

Specializes in ICU, Telemetry.

Thanks for stopping. It could have been any of us in that wreck, and I can't imagine how I'd feel if I was injured and bleeding after a wreck, and just watched everyone drive on by....

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Specializes in CCT.

I hate to be the downer but...

There's a valid reason not to stop at accidents, especially in urban areas. Anyone that stops and plays in interstate traffic without enhancing their visibility and having a mechanism to block traffic is inviting trouble. Furthermore, most nurses have little or no training in triage scene control and organization, or opperating in the out-of-hospital environment. All of these are critical components of out-of-hospital care. Finally, there's really only two circumstances in which you could make a "life-saving" intervention as a bystander. Airway obstruction in unconsciousness and exsangunating EXTERNAL hemorrhage. Outside of those, you now become another component of the scene that must be managed by (hopefully not overloaded) responders.

I've been in EMS for 10 years. Outside of extremely rural areas, or someone on the ground unconscious, my course of action when I witness an accident is to pick up my cell phone and call 911. Why? Because it's safer and when I was newer and did stop I rarely, if ever actually did anything other than stand around and be in the way. Calling 911 is the best course of action. Pre-hospital care is it's own specialty for a reason. Medical knowledge overlaps greatly but the logistics and concerns are hugely different.

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Specializes in Med Surg/ Rehabilitation.

I have a similar story. I'm still in the program, and graduate in Dec. A 20 yr old boy was driving recklessly through our neighborhood on his dirt bike and hit a brick mailbox. I was there along with an older lady who didn't know what to do. His helmet was found about 40 feet from the mailbox, blood was pouring from his mouth, his first tooth was knocked out and he was very confused. As soon as I got there, I told the lady to call 911, she did, I assessed and after my assessment stabilized his neck in case of a spinal cord injury! My instructors were very proud and I was happy to be a part of something like that.

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You sound like a very compassionate person and nurse. Just be careful when in such situations that you don't get in over your head. Also, you have to be careful what you do and say to avoid involvement in lawsuits, especially related to Good Samaritan issues. If you declare yourself to be a nurse, you are bound by nursing standards, if you just act as a good samaritan, the standards are much less. Not that you would knowingly not do your best, but no nurse knows everything, and you could very well miss something that a lawyer will fry you for.

I wonder if you are one of those nurses, like me, who says a little prayer before going into a restaurant--"Please, Please, let me get through this meal without having to do CPR or the Heimlich!! Please!! I'm getting up there in age, and I don't think I would survive much better than the victim if I had to do CPR in public!

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Specializes in Med-Surg, Emergency, CEN.
I hate to be the downer but...

There's a valid reason not to stop at accidents, especially in urban areas. Anyone that stops and plays in interstate traffic without enhancing their visibility and having a mechanism to block traffic is inviting trouble. Furthermore, most nurses have little or no training in triage scene control and organization, or opperating in the out-of-hospital environment. All of these are critical components of out-of-hospital care.

But aren't nurses at risk if they don't stop? I don't know the legalities, but I was under the impression that you are required to stop and offer assistance until someone better qualified came to relieve you.

I agree about visibility, calling 911, etc, but I still think that as trained medical professionals, we are obligated to help in medical emergencies if no one else is available.

Also, in my states there's the "Good Samaritan Law" that protects nurses stopping to assist.

That being said, I know several nurses who would not stop in such an event.

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Specializes in LTC.
I hate to be the downer but...

There's a valid reason not to stop at accidents, especially in urban areas. Anyone that stops and plays in interstate traffic without enhancing their visibility and having a mechanism to block traffic is inviting trouble. Furthermore, most nurses have little or no training in triage scene control and organization, or opperating in the out-of-hospital environment. All of these are critical components of out-of-hospital care. Finally, there's really only two circumstances in which you could make a "life-saving" intervention as a bystander. Airway obstruction in unconsciousness and exsangunating EXTERNAL hemorrhage. Outside of those, you now become another component of the scene that must be managed by (hopefully not overloaded) responders.

I've been in EMS for 10 years. Outside of extremely rural areas, or someone on the ground unconscious, my course of action when I witness an accident is to pick up my cell phone and call 911. Why? Because it's safer and when I was newer and did stop I rarely, if ever actually did anything other than stand around and be in the way. Calling 911 is the best course of action. Pre-hospital care is it's own specialty for a reason. Medical knowledge overlaps greatly but the logistics and concerns are hugely different.

I understand where you are coming from. In this instance 911 arrived 20 minutes post the accident. If there was someone not breathing that needed CPR at least, someone was there with a CPR mask and knowledge of basic CPR. The main thing is for nurses to become familiar with the good sam. law in their state. I was fully aware of my scope ( which is extremely limited) and limitations. I would NEVER do anything to put my life or license at risk.Once again, to each its own. EMS was also happy to get a detailed report of possible injuries and what occurred so I didn't feel "in the way" at all.

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Specializes in LTC.
You sound like a very compassionate person and nurse. Just be careful when in such situations that you don't get in over your head. Also, you have to be careful what you do and say to avoid involvement in lawsuits, especially related to Good Samaritan issues. If you declare yourself to be a nurse, you are bound by nursing standards, if you just act as a good samaritan, the standards are much less. Not that you would knowingly not do your best, but no nurse knows everything, and you could very well miss something that a lawyer will fry you for.

I wonder if you are one of those nurses, like me, who says a little prayer before going into a restaurant--"Please, Please, let me get through this meal without having to do CPR or the Heimlich!! Please!! I'm getting up there in age, and I don't think I would survive much better than the victim if I had to do CPR in public!

I always pray that I don't have to be a nurse outside of work. Once again I was very careful and very well aware of everything that can go wrong in those situations. Every nurse does not know everything but every nurse does know something that can help someone, even if its just holding a hand or making sure everyone is breathing. I don't regret stopping at all and would do it again in heart beat... ( ofcourse if the scene were safe).

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Specializes in CCT.
But aren't nurses at risk if they don't stop? I don't know the legalities, but I was under the impression that you are required to stop and offer assistance until someone better qualified came to relieve you.

I agree about visibility, calling 911, etc, but I still think that as trained medical professionals, we are obligated to help in medical emergencies if no one else is available.

Also, in my states there's the "Good Samaritan Law" that protects nurses stopping to assist.

That being said, I know several nurses who would not stop in such an event.

The majority of states have no duty to act statutes. Meaning outside of calling 911 (which most stares require of all motorist), you have zero requirement to stop and render aid.

Obligated to stop and offer what aid? There's very, very little outside of hand holding to be done without equipment and transport.

A few years ago a nurse is Floridia was struck and killed when she stopped at a MVC. Multiple responders are struck every year despite warning lights and high visibility vest. Please consider this. You can easily turn a minor MVC into a fatality accident. Working around traffic is not as simple as it seems.

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Specializes in CCT.
I always pray that I don't have to be a nurse outside of work. Once again I was very careful and very well aware of everything that can go wrong in those situations. Every nurse does not know everything but every nurse does know something that can help someone, even if its just holding a hand or making sure everyone is breathing. I don't regret stopping at all and would do it again in heart beat... ( ofcourse if the scene were safe).

How did you know this scene was safe?

The only other problem I had with your story was that you "encouraged everyone involved to go to the hospital". If the patient didn't want and apparently didn't need transport based on assessment than this is inappropriate.

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Specializes in Complex pedi to LTC/SA & now a manager.

When I did EMS training years ago, the one line that had the most impact was " A dead (or injured) EMT/First Responder does no one any good" Same reason airlines tell you to give yourself oxygen before your child in an emergency.

I was on a high volume volunteer EMS squad for 10 years. Most of the time first responders (nurse, new first aid card, good Samaritan, whatever) were more helpful than a hindrance. There were issues when a walking wounded (no obvious injuries aside from a minor scrape, no complaints, mechanism of injury was not too concerning) was satisfied with scene treatment and didn't want transport, yet a first responder was "strongly" encouraging the person to go to the hospital and get checked out. The police officer had to step in as the patient was more than competent to refuse transport and was getting upset with the interference of the "Samaritan".

There were other occasions (few thankfully) when self declared nurses would try and dictate prehospital care that was not within standards or protocols for EMS, but may be within the scope of inpatient care. It was clear they had no pre-hospital training other than BLS CPR and were focusing on the less urgent assessment needs.

Most nursing programs do not include pre-hospital care training or even first aid training. Sure some is common sense (direct pressure for active bleeding, don't move anyone unless immediate life is in danger--and cars RARELY explode.) but others are not. My father was nearly paralyzed when those who stopped at his t-bone roll over accident were erroneously over concerned that his car might explode and decided to remove him from the vehicle before trained responders arrived. Fortunately in his case the local PD required first responder training for all officers & his accident was directly witnessed by an on-duty officer who stepped in before harm could be done.

Very few states (if any) have legal obligations for off duty nurses or even paramedics & EMT's to stop/treat/assess for accidents other than calling 911.

That said, if I was direct witness to an accident I might stop. The nursing news article where the nurse stopped leaving her 2 year old child in the car alone (!!!) is something I would NEVER do! I've recently witnessed an accident with no obvious injuries but a crazed driver yelling at the other driver in the middle of the street. I called 911 and reported my concern about possible altercation more than injury and police responded quickly.

My now 9yo son knows I am selective when I will stop. I have a simple first aid kit in my purse & car. I also know the availability of resources (like the location of the AED at the Little League fields). I have no problem initiating CPR (especially now since the recommendation is CBA) if someone drops in front of me and in fact have 2 "field" CPR saves--one a CPR only save, one a CPR+ACLS save in my history--something I know that is very rare.

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But aren't nurses at risk if they don't stop? I don't know the legalities, but I was under the impression that you are required to stop and offer assistance until someone better qualified came to relieve you.

Also, in my states there's the "Good Samaritan Law" that protects nurses stopping to assist.

It's interesting to me how such misinformation continues: I think you are confusing the nursing standard that you don't stop CPR once you start, with having to stop for an accident. You are under no legal or professional obligation to stop to render aid. It is up to you if you feel morally or ethically obligated.

Also, many people are unclear about "Good Samaritan" laws--you are only protected if you do not identify yourself as a nurse. Once you do, you are held to nursing standards and practices. If you are a psych nurse like me, for example, you may not be up on the latest emergency standards and procedures, so you don't go announcing, "Stand back everyone! the Nurse is here!!" when you stop to assist, you do your best as a layman. If you put yourself out to be a nurse, you are taking the injuree as a patient, and have the same responsibilities (and liabilities) as you would in a hospital (especially not abandoning them before better help arrives).

Dave Dunn, RN

[email protected]

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