On Vacation - Would You Intervene?

Published

While on vacation outside of the US a few days ago, I had two chances to intervene in medical situations. I'm curious what you would have done if you had been in my situation.

Case 1: In a southern coastal city in the UK, an elderly woman reportedly "just fainted and fell" while crossing a street. No one there knew her. Several bystanders were trying to help, including a man who identified himself as a "medic" and woman who worked at a pharmacy. The injured woman was obese, lying awkwardly on her right hip with her torso twisted, her upper chest on the pavement and her head twisted toward her left shoulder. Her head was lower than her body, and she was bleeding from a scalp laceration. The medic knelt beside her and held pressure on the scalp wound. She denied any pain and tried to get up several times, but they held her down even when she vomited, insisting that she should not move. Her breathing was heavy. EMS had been called, and I could hear a distant siren.

Case 2: Halfway between Amsterdam and New York, they paged overhead for a doctor to come to the back of the plane. No one moved. I went back and told the flight attendant I was an ER RN, not a doctor. Apparently, I was their best option.

He took me to an elderly man who was worried about moderate swelling and mild redness in his right lower leg and ankle. With his daughter translating, I learned the swelling had started during our flight, but he'd been on a plane for three hours prior to ours. He had a large scab on his lower right lower shin from a scrape three days ago but denied any pain. He was sitting on a jump seat with his leg propped up on a window well, straight and level with his hip. They were applying cool compresses.

I've second guessed myself a bit on one of these two. What would you have done?

Specializes in ER OR LTC Code Blue Trauma Dog.

I moved people around all day long in the ER but it's done in a methodical and very controlled situation. So unless you have the required training, cervical collars, portable traction equipment, spinal boards and other medical equipment available at hand to properly immobilize the victim for the purpose of transport or movement to another location, I would never attempt moving anyone at any accident scene.

Unless there's an imminent threat of danger, do not attempt to move the victim and wait for EMS to arrive.

Specializes in ER.
On 7/27/2019 at 2:39 AM, Crash_Cart said:

I moved people around all day long in the ER but it's done in a methodical and very controlled situation. So unless you have the required training, cervical collars, portable traction equipment, spinal boards and other medical equipment available at hand to properly immobilize the victim for the purpose of transport or movement to another location, I would never attempt moving anyone at any accident scene.

Unless there's an imminent threat of danger, do not attempt to move the victim and wait for EMS to arrive.

I think the discussion has moved on to various other situations, but my concern in the original post was that those attempting to help were preventing the woman from moving herself from an extremely award position even though she was alert, denied pain, and asked them several times to allow her to sit up. There is a huge difference between allowing (or in this case disallowing) an alert oriented, oriented person from moving herself and actively moving the person.

Specializes in NICU/Neonatal transport.
On 7/26/2019 at 3:41 AM, Crash_Cart said:

Respectfully, I don't think this is entirely accurate. There's been situations reported where lawsuits occured because the attending off duty nurse did something that's later proven to be something they were not "specifically trained to do" at the incident scene. The court held them legally accountable and the rest of the story involved the transfer of lots of money in the usual manner.

I'm not discouraging anyone from attending an incident to offer help, but be aware good Samaritan laws don't necessarily protect and stop lawsuits from occurring in every situation. You know, people are always happy to see a nurse stop and help, but the same people sue when the person they are helping dies. Guess, that's how people show their gratitude for some apparent reason. ...I dunno. So probably best to forget about the pen knife and bic pens, and just do the minimum necessary until EMS arrives. They usually show up pretty quickly anyways.

Can you please cite that case? Often cases are cited as excuses to not intervene, but when you actually read the case, it is not how it was presented.

Specializes in Advanced Practice, surgery.
On 7/2/2019 at 5:14 AM, RobbiRN said:

The quotation marks around medic were not intended to be diminutive or pejorative. I emphasized his stated title because I'm not sure what "medic" means in the UK. I've heard "medic" used in the armed forces, but in the US we have EMTs and Paramedics in our EMS systems. My uncertainty about his level of expertise was one reason I chose not to assert myself further.

My guess would be the medic was either military (maybe) or a volunteer medic /first responder

A paramedic, nurse or doctor would have identified thier profession.

I've worked with UK rescue charities who have advanced first aid responders, they may identify themselves as medics but thier skills still tend to be at a basic level.

Personally I would have interfered, but I live and work in the UK so on home turf, my professional body states I have a duty to assist, I work in the Pre hospital arena and i know UK law around responding ?

Specializes in ER OR LTC Code Blue Trauma Dog.
3 hours ago, LilPeanut said:

Can you please cite that case? Often cases are cited as excuses to not intervene, but when you actually read the case, it is not how it was presented.

I was paraphrasing instances (situations reported) where these kind of situations occur.

Well let's take this recent situation as an example of a nurse coming to the rescue and then we can walk through it a little more later:

https://wreg.com/2019/05/09/nurse-describes-rescuing-driver-after-pole-crashes-through-car-on-i-240/

Then a few days later the "ambulance chasers" start arriving to get in on the action to make themselves some serious cash.

So now the same story above, is changing into this story...

https://wreg.com/2019/05/21/family-sues-mlgw-after-pole-impales-car-on-i-240-leaves-driver-with-brain-injuries/

So here's a question to ponder...

Do you think anything is stopping these lawyers who filed this lawsuit, from involving the nurse who helped out too? Not saying that will actually happen in this particular case, and yes the case is still evolving, but just ask yourself if could still happen? You have to admit, lawyers have a bad habit of dragging everyone involved into these sort of things even if they are just there trying to help.

Speaking of just trying to help, this is a similar "Good Samaritan" story demonstrating how helping people can in some cases make you legally liable for the person's injuries.

https://www.latimes.com/archives/la-xpm-2008-dec-19-me-good-samaritan19-story.html

These are some real life stories from off duty physicians who ran into some trouble before:

https://epmonthly.com/article/good-samaritan-statutes-when-do-they-protect-you/

Again, I am not discouraging anyone from helping out anyone if you can. But I think it's a fair assessment to suggest that it can become a complicated legal matter if you're not careful about it. You're sometimes navigating through some thick weeds and you're not always necessarily protected from lawsuits when things go awry.

I always remind myself how people are always happy when things turn out good, but the same people have no issue about suing others when things don't. No I suppose I don't agree or like that either, but that's just the way it is.

Specializes in ICU/community health/school nursing.
On ‎6‎/‎30‎/‎2019 at 3:07 PM, CharleeFoxtrot said:

Scenario 1- nope.

Scenario 2 - nope.

Any scenario short of a full code I mind my own business.

I used to jump in. Now I agree with you. Nope. Unless it's a code or a little kid in distress.

+ Join the Discussion