Rode up on first accident outside of hospital....

[shoegalRN]

Hey my fellow RN's! I need some advice.

I was on my way home from my moma's house and rode up on a car accident. Medics were not on the scene yet. I pull over, get out of my car and head to the first car. The guy is on his cell phone, says he hit his head, but otherwise ok. I hear medics running hot to the scene. I asked him if he knew what happened and he said "yeah". He knew what year it was and then he tells me to check on the guy in other car.

The other car is in the middle of the highway and traffic was stalled. I run over to the other car and bang on the window and he is also on his cell phone, he states he is not hurt and he is ok.

So, I leave since both guys are ok, the one who hit his head was A&O, and I heard sierens.

On the drive home, I couldnt help but think did the guy who hit his head may needed a CT? What if he had a brain bleed? Then I thought, I didnt even have any equipment in my car (only the kit the American Cross give you when you complete BLS) and even that was in my other car.

Would you have stayed? I'm wondering if I should have stayed until help actually got on the scene, although both parties "seemed" ok.

Now I'm beating myself up over this......

[missdeevah, NP]

...May all your orders be legible and all your patients compliant.

:yelclap::cheers:

[tyvin, BSN, RN]

If people do a search what will be found is a multitude of various training methods that demonstrate scene assessment for BLS. Depending on your instructor is how you get the training that is a constant with any BLS cert.

Initial Assessment Video - Introductory CPR Training Videos by ProCPR

[thmpr]

2727.5. Emergency Care; Immunity from Liability; Gross Negligence, from the nursing practice act, says that a licensed person " ...who in good faith renders emergency care at the scene of an emergency" blah blah " ...shall not be liable for any civil damages." You would have to be "grossly negligent" (grossly unintelligent) to lose a lawsuit. I have serious doubts that any jury would sink a nurse who was genuinely trying to help.

You don't have to be a medic to stop at an accident scene. An RN is a first responder who obviously has common sense. I totally understand if you don't stop. But if your reason not to stop is because you don't feel qualified, please consider a few first responder precautions: don't park or go anywhere that puts you in danger (use flares); don't leave your keys or your kids in your car, & be sure to lock it; look both ways before crossing the road; don't forget to stay low & slow when approaching inebriated victims; don't approach some creepy dude alone on a dark road; don't accidentally convert yourself with aed; don't play super nurse & attempt transport yourself (just say no to patient care while driving!); don't let the victim have your picnic basket; don't pull someone out of a car unless they will otherwise die (I personally run from fire, but you may be super nurse &/or much braver than I); wear gloves (some people don't shower often); practice universal precautions (don't eat or squirt blood in eyes or open areas of your skin); don't kiss the victim (use a mask!); don't d/c cpr until someone of equal or higher training takes over, or victim has pulse; etc; don't shove food further down choking victims throat. See you already know all of this. You don't need to push ACLS or PALS - just ABC's & maybe an occasional precordial thump if necessary. giggle

That said, I would like to suggest flipping through the American Heart Associations First Responder book so you can see for yourself that you already know most of what is written. I am not knocking the course. It is great if you want to practice cpr, secure your friends to backboards, get a good review, & learn a few new terms. :)

@ OttawaRPN: Yes, I have taken emergency management courses :) I heard you can take courses online now. Do you know anything about that?

Disclaimer: The content of this post was not meant to offend. If you are offended please blame my dog.

:nuke:

[harleyridingirl]

My son and granddaughter were in a head on collision at 5 pm on a busy street. When my son got my granddaughter out of the car, she was dead. A good samaritan stopped and administered CPR to my granddaughter and got her heart beating but he didn't stop until the EMS got there and took over. We ended up loosing her (4.5 years old) due to internal injuries but that good samaritan did a hell of a thing by trying to help and I would love to know who he was and give him a giant hug of appreciation for trying to save my angel.

So think about that the next time you pass by an accident without stopping.

[harleyridingirl]

As far as pocket masks go... in my ACLS course this year they were saying even chest compressions without breathing do more for circulation and oxygenation than stopping to breathe for the pt. My instructor said that every time you stop, the pressure in the heart and arteries goes down and it takes 6 or more chest compressions to get the pressure up enough to circulate the blood so if you don't have a mask, just pump because we don't use 100% of our spo2 every time we breathe in so there's plenty of oxygen in the blood even without breathing for the pt as long as there is nothing in the mouth or trachea to suffocate the person.

[ACook84]

I too am surprised by the number of people who choose not to stop. I'm not one to judge you, but having been hit by a car traveling 55 mph on a busy road makes me recognize the relevance of stopping to make sure all involved are okay. Surprisingly, my sister who was completely unharmed was the one that needed the help. She was standing/walking around...but she wasn't able to handle the stress of seeing her sister thrown from the hood of a car. Also...even though i was alert and talking to first responders, i had blacked out, so i COULD have had other issues that should have been observed. Point is, I am still thankful for the people who stopped to assist, and this was over 10 years ago.

On that note, I am still in nursing school and we learned in week 4 or 5 that in the state of MI we are required to stop if we witnessed the accident. My instructor stressed the fact that when she approaches the scene she says the following "Hi, my name is ____, i am an RN, and i am here to help under the good samaritan law." She mentioned that if somebody witnessed you driving away and they knew (somehow) that you are a nurse, you CAN be penalized for it. Just something to consider.

Also....one of my favorite parts of my med first responder course (outside of NS) was the assignment to make a GOOD first aid kit to leave in the car. We were also taught how to use different things that you can find on the scene to substitute other materials. So, i would highly recommend taking a first responder course, since they are much more thorough than the basic ABC's that are taught in your CPR courses.

[nursel56]

:rotfl: Baahaha!

My last BLS for Healthcare Providers renewal class featured an educational video done by the cast of "The Office" too. California thing? But since I've never seen the show itself I get some when I say I saw them at a class about how to do CPR. lol

[CJMR]

I would absolutely stop. I don't even think I could force myself to drive by knowing someone might need help. Liability be damned, I just couldn't leave. I know whatever I do is because I think it gives the person the best chances of surviving so I should be able to argue that point under the Good Samaritan law if I end up going to court. I have first responder training and FEMA certification so I have a good idea of what needs to be done and how to triage. That being said, I would not mention any training I've received or certifications I hold just in case the people involved have some sort of superhero expectations.

This all reminds me, I really need to stock up and expand the first aid kit I keep in my car.

[Hospice Nurse LPN, BSN, RN]

I have stopped and will continue to do so if EMS has not arrived, yet. None of the times were the people hurt bad, but you just never know. I have stopped at 3 or 4 accidents, one involved an infant sitting on her mothers lap. It was raining hard that evening and the driver lost control of the car and I saw it roll over. The child wasn't breathing when I got to the car and I took her from the mother and as soon as the cold rain hit her face, she started to cry. Thank goodness! Sometimes you can call 911 or just comfort the person and WAITING FOR EMS is all that's needed. I would hate to think of one of my loved ones (or myself) having an accident and nobody stopping to offer assistance.

[OttawaRPN]

@ OttawaRPN: Yes, I have taken emergency management courses :) I heard you can take courses online now. Do you know anything about that?

I wouldn't be surprised, you can take most any course online now.

Years ago when my son started competitive downhill bike racing, I got to play medic for a few years after realizing I wasn’t comfortable with these kids going hell bent down the hill at breakneck speed w/o proper first responders around which prompted me to brush up on my skills. But as several other posters mentioned, the basics are included in BCLS so we really do know more than we think.

On a related note:

Someone sent me a link to a YouTube video last year of a traffic cam that caught a pedestrian being struck in a hit and run. Guy's lying on the side of the road, not moving. Numerous cars drove by, many did slow down, but nobody stopped, mostly just rubbernecking. Even some pedestrians could be seen walking by, a few stopped at a distance to take a look but not one person came to see if he was even alive. I think the video ran about a full 8 minutes before finally someone approached and leaned over him, then a minute later police cars could be seen coming.

I was absolutely horrified watching this poor man being treated no better than roadkill. What happened to humanity? I’m ashamed to say I share the same planet as those people in the video.

[bjaeram]

I don't keep PPE in my car. With the way my hands are chapped, there is simply no way I am going to expose myself to blood/body fluids at an accident scene. Sure, it would be nice if I stopped and helped, not so nice if I wound up with Hep C or HIV as a result.

Comparing stopping at an accident to a choking person in a restaurant is like the apple v orange comparison.

I have no idea how this turned into an RN/LPN thing. The OP was an RN. No need to take offense.

Why don't you throw a couple pairs of gloves in your car. What an easy thing to do that could save someones life. I think as nurses (or medical people in any capacity to be pc) we have some obligation to help.

Even if you are unwilling to touch the patient you could dircet them or another person how to hold pressure. You could talk to them and reassure them.....

[OCNRN63, RN]

Why don't you throw a couple pairs of gloves in your car. What an easy thing to do that could save someones life. I think as nurses (or medical people in any capacity to be pc) we have some obligation to help.

Even if you are unwilling to touch the patient you could dircet them or another person how to hold pressure. You could talk to them and reassure them.....

I personally don't feel comfortable stopping at accidents for numerous reasons. I will call 911, but I will not stop. I don't think I deserve to be bashed for it.

On a side note, I used to do it. One time while traveling out of state, I witnessed an accident. I stopped. Flash forward a couple of months and I got dragged into court (not related to anything I did on the scene, but because I witnessed the accident). Not only did I have to pay for my expenses to travel back to the state where the accident occurred, I lost several days wages since it happened while I was on vaca. and not related to work. Then I had to endure the defense atty. questioning my integrity (yeah, the guy defending the very man who 's reckless driving caused the accident, who I had stopped to help).

While this really has nothing to do with why I don't stop at accidents, it's an example of what you can get yourself into when you do choose to stop.

So think less of me if you wish. I just don't feel that I have the expertise to manage accidents at the scene. It's a personal decision and I don't think I should be condemned for it.