Nurse performs tracheotomy

[ProgressiveThinking]

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!!!

[Vapermedic]

To me it illustrates the obvious need for tort reform....

[GilaRRT]

To me it illustrates the obvious need for tort reform....

Yes and no. Yes, for providing basic care until help arrives; however, amateur surgeons night in the field is a different situation. Clearly, I am trying to tie this back into the phantom scenario at the beginning of the thread.

In addition, here is a follow up post on the other lawsuit. California is going to allow such law suits to occur. Apparently, pulling a patient from a burning building or out of an icy river is NOT considered "medical" care in California, therefore all bets are off if you decide to get somebody out of a dangerous situation. Makes me think I should read the laws in my state. A sad state of affairs when I have to read the law prior to pulling a kid out of a burning car.

http://articles.latimes.com/2008/dec/19/local/me-good-samaritan19

Hey all you guys in California, good luck!

[carolinapooh, BSN, RN]

Not trying to contribute to a hijack, but for the person in the article to say that this decision to go forward with the suit won't have an affect on people choosing to render assistance at the scene of an accident in CA - he's an idiot living with blinders on. Hope HE'S never in a burning car on the side of I-5...

Back to the thread....

[BabyLady, BSN, RN]

So I have to assume since these flight nurses had the protocols to do the trach and the training--then if they made the decision not to do it they would have been sued also--right? So damned if you do and damned if you don't--How scary---Let's hope we see tort reform soon.

I agree with this.

I don't see how you can lose your nursing license if you were acting within a protocol...just because the patient had a bad outcome.

That would be like every time a code was performed on someone that died, trying to say that the people running the code were incompetent.

[GilaRRT]

I agree with this.

I don't see how you can lose your nursing license if you were acting within a protocol...just because the patient had a bad outcome.

That would be like every time a code was performed on someone that died, trying to say that the people running the code were incompetent.

You can visit the thread for more information because this may go way off topic. However, things went really wrong with these nurses. They ended up transecting the trachea and causing massive hemorrhage. In addition, the patient was alive on scene, then coded after they performed interventions. In addition, after coding the patient, the flight crew turned care back over to the ground EMS crew and left the scene. The ground crew continued to code the patient on the way to a local hospital.

So, a very strange situation. Working under protocol is one thing; however, if your actions lead to somebodies death, then we have another situation on our hands. However, I do not have enough facts to make a definitive decision about the said situation. Again, my point is performing a cric is serious business. If things go wrong, you could go down. If this can happen to a trained flight crew, just think what would happen to John Q. RN who who decides to do a cric at an accident scene while off duty.

[BabyLady, BSN, RN]

You can visit the thread for more information because this may go way off topic. However, things went really wrong with these nurses. They ended up transecting the trachea and causing massive hemorrhage. In addition, the patient was alive on scene, then coded after they performed interventions. In addition, after coding the patient, the flight crew turned care back over to the ground EMS crew and left the scene. The ground crew continued to code the patient on the way to a local hospital.

So, a very strange situation. Working under protocol is one thing; however, if your actions lead to somebodies death, then we have another situation on our hands. However, I do not have enough facts to make a definitive decision about the said situation. Again, my point is performing a cric is serious business. If things go wrong, you could go down. If this can happen to a trained flight crew, just think what would happen to John Q. RN who who decides to do a cric at an accident scene while off duty.

Without reading the thread, this sounds more like a trach performed incorrectly.....if that is what they did, then that is malpractice.

You are not liable just because you help someone in a critical situation and they go downhill...if that was the case then every flight nurse, ER nurse ICU, whatever, would be getting sued on routine basis.

Your state pratice act, your profession and the Good Samaritan Laws only cover you if you perform to the level of your training.

If you don't...then that is when you are liable...not because someone just went downhill.

There is a very, very fine legal difference.

[GilaRRT]

So, pulling somebody out of a potentially dangerous situation is considered out of our level of training? The legal difference appears to be all over the place and varies significantly from state to state. This Good Samaritan concept is rather nebulous and apparently does not account for common sense "non medical" actions.

Unfortunately, flight nurses (the company they work at to be more specific) are sued quite frequently. However, many cases are settled out of court, and you may not even know you were involved.

As far as the improper comment; there simply is not enough information for me to say such a thing. Again, performing a cric is not a benign procedure. Much can go wrong. You should read up on the case at hand. Too many things complicate the picture IMHO. For example, the patient apparently had glass or foreign debris impaled in his neck and face. Therefore, it is possible these nurses encountered a nightmare scenario. We are quick to bury our own without waiting for the rest of the story.

Perhaps there were mistakes; however, two of our own are looking at felony convictions with hard prison time. This is a show stopper and a humble reminder of the serious consequences we face.

[BabyLady, BSN, RN]

So, pulling somebody out of a potentially dangerous situation is considered out of our level of training? The legal difference appears to be all over the place and varies significantly from state to state. This Good Samaritan concept is rather nebulous and apparently does not account for common sense "non medical" actions.

Unfortunately, flight nurses (the company they work at to be more specific) are sued quite frequently. However, many cases are settled out of court, and you may not even know you were involved.

As far as the improper comment; there simply is not enough information for me to say such a thing. Again, performing a cric is not a benign procedure. Much can go wrong. You should read up on the case at hand. Too many things complicate the picture IMHO. For example, the patient apparently had glass or foreign debris impaled in his neck and face. Therefore, it is possible these nurses encountered a nightmare scenario. We are quick to bury our own without waiting for the rest of the story.

Perhaps there were mistakes; however, two of our own are looking at felony convictions with hard prison time. This is a show stopper and a humble reminder of the serious consequences we face.

A forensic pathologist would have been able to determine if the procedure was performed correctly and if there were other healthcare factors...that is why autopsies are performed.

I'm also surprised that you think that "flight nurses" are sued "frequently" when you turned around and stated that you wouldn't even know about it because they are settled out of court.

If they were sued more than other nurses, then their malpractice insurance would be significantly higher.

[GilaRRT]

We are involved in suits quite frequently; however, companies tend to settle out of court. I suspect the same is true in the hospital; however, many staff members have no idea because the hospital just settles out of court.

From what I read, pathology stated the patient in this case experienced a "therapeutic misadventure"; however, no other details are definitively known. Therefore, I will hold off on judgment until we have a better picture of the situation.