Nurse performs tracheotomy

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Specializes in Anesthesia.

Hello,

I'm a recent LVN grad here in cali. I haven't even taken boards yet, but I passed an advanced placement exam and plan on starting my 1 year RN bridge in February...so I really don't know the answer to this question. My buddy is an EMT and told me a story about a couple of nurses stopping at an emergency scene before an ambulance arrived. The injured person was going to die, but the 2 nurses performed a tracheotomy, and fled the scene. The patient lived. Would these nurses have been protected by the Good Samaritan law had they stayed? I said..most likely not since they performed out of their scope of practice, but he says they would be protected since the patient survived and would have died if the tracheotomy wasn't performed. Any input here is appreciated. Thanks!!!

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Specializes in Hospice, LTC, Rehab, Home Health.

I am not so sure they would have been protected since I think the litmus test is that the person performed as any other PRUDENT person with the same training would have under the similar circumstances. Not sure any other nurse would have done a trach on their own. If they had had 911 patch them through to an ER and done the procedure under the guidance of an MD then maybe?:confused:

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Whether or not they had training to do this is not the question. They may have had specialized training.

You stated, "...and fled the scene." In order to be protected under the Good Samaritan Law, they must stay with the victim until can hand off care to a properly trained individual. Otherwise, it is abandonment.

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Specializes in Anesthesia.

Yeah..they obviously arent protected since they fled the scene, but the questions was would they have been protected IF THEY STAYED?

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Health care workers are expected to deliver the level of care according to their educational level and as long as they act appropriately, they are protected if they deliver care according to standards and available equipment at the scene.

If a nurse performs a procedure for which she/he has no training and injury results, the nurse is not protected by the Good Samaritan Law.

So, if the nurse is trained, she/he is protected.

If there are injuries and nurse is not properly trained, it doesn't matter if the victim lives or not.

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Sounds like material for a cheesy medical drama. I would be rather suspect of your friends story. As for a tracheostomy? If a surgical airway is required, a tracheostomy is not the typically performed. You would typically look at puncturing the cricothyroid membrane in a procedure known as a cricothyrotomy. Then, comes the question of how these nurses actually performed the procedure and what exactly did they place to keep the puncture site patent. Anybody see logistical issues with this story?

Perhaps a good story to spark debate. Nurses who actually know how to perform this procedure should be reluctant to resort to a surgical option in the clinical setting let alone on the side of the road. The morbidity and mortality for going down this path can be quite high. Just look at what is happening to the two flight nurses in California who attempted such a procedure while on shift. A poor outcome resulted, and these nurses are facing the loss of their licenses, prison time, and a probable civil suit.

Any nurse in their right mind would not do such a thing off shift.

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The Good Samaritan laws state that anyone assisting in an emergency must stay within their scope of practice.

It does not sound like these nurses would be protected in this case. There is good reason for this. The Good Samaritan laws protect those who stop to help, but they do not give them a license to open their own surgical practice.

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Specializes in Flight, ER, Transport, ICU/Critical Care.

I'm going with Gila on the validity issue. Me thinks this is an URBAN legen - heck, it might even be a rural one. ;)

As for the "surgical" airway option - I know that my eyes bleed deciding when looking at such an event in actual, compensated and required employment situation.

I can think of NO, NONE, NADA, HU-UH, etc - situation where as being an OFF DUTY BYSTANDER would I perform such an action. I will generally not even stop at accidents unless extraordinary circumstances are present. I will be certain and call for help though - :)

Folks, flame away - but, I do care about "humanity" and my fellow man and all that - but, I cannot bet my house and future on even if things go great that someone that I assist may not find their way into a lawyers office. A lawsuit does not have to have merit, hit a jury or anything even close to COST the DEFENDANT many many dollars. And for all the fantasy dwellers that plan to use the "I did my best and didn't do anything wrong" defense to a lawsuit - let me know in what court that they just dismiss you as a defendant on your "I'm not at fault" defense alone. I'm certain that any lawyer you wil get (innocent or not) will wants lots of moola. In reality any DEFENDANT will have years and many dollars into a dismissal - for a bonus, you may suffer a reputation hit as well. It is just not for me. Think I suck or whatever - I have been places few dare to go - so, my NO is well-thoughtout.

I am reasonable and even the best plans change - so, no one knows (even me) what they will do until tested - but, I am confident that TRACH would not ever be done by me OFF-DUTY.

Practice SAFE!

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Specializes in Flight, ER, Transport, ICU/Critical Care.

Forgot to add on GOOD SAMARIATIAN Law issue.

Argue all you want - this as a sole defense will still cost you plenty. Most GSL are NOT constutional in their limitations of rights. Sure, there may NEVER have been a SUCCESSFUL suit against a "GOOD SAMARIATIAN", but the same GS may have had to spend many tens of thousands of dollars making sure they were "covered".

Tread carefully folks - we live in a world that the "original Good Sam" did not - not too many 1-800-WHO CAN I SUE in biblical times.

Knowledge is POWER.

Not trying to change anyone's mind or keep you from acting in any situation - JUST making sure that you stop and think - tough any way you look at it.

;)

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Specializes in Flight, ER, Transport, ICU/Critical Care.

Hey OP - big question here?

Any explanation on where they "got their stuff" to do it or what they used? Pocketknives and ink pens are popular in the movies, but hard for most nurses to Macgyver that one through in a "real life" field TRACH.

Fishy tale to me.

;)

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Must have watched the episode of Grey's Anatomy where the guy makes a trach out of a ball point pen... :)

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.
hello,

my buddy is an emt and told me a story about a couple of nurses stopping at an emergency scene before an ambulance arrived. the injured person was going to die, but the 2 nurses performed a tracheotomy

i saw this on the "mercy" preview to air on nbc this fall. maybe he did too??? if it is a true story, it is possible that they stepped out of their scope of practice and fled for fear of being caught.

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