Assisting in out of district accident...

[S8ER95Z]

Hey guys... was on scene at an accident directly outside of work today and started to wonder where I stood as far as helping out...

This was in E. Moline (if any of you know the town)... Fire Dept was just pulling up (two blocks away when I got on scene) and I immediately identified myself and asked if they needed any assist. They had the first pt. taken care of so I followed the person in command over to the other vehicle to check for injuries. Since the other person was good and Illini was on scene within a few minutes afterwards I headed off back into work and let them be. Not my scene and obviously not wanting to be in their way since they had it controlled.

I started to wonder how much I can do and if I should have just stayed out of it completely. I am a newly licensed EMT-B and FFII here in IL so I don't have years of experience but I do know what I need to do back home when I go out on calls. My main concern was assisting with anything since I am not tested in to my department for SOPs but I do have a state license. (if that makes sense)...

Was also curious from experience how you guys treat people who are on scene assisting when you arrive and what you expect of them. I know in the neighboring town around here I have been treated rather rudely by their people for simply attempting to keep a pt. concious and talking... but E.M. thanked me politely for offering my assistance so I didn't know if it was different depending on the department.

Don't exactly want to step on toes if you know what I mean and want to cover my ***.

Thanks!

[trainer]

Sounds to me like you did things right. What did they say when you identified yourself and asked if they needed asst? Another question is did you have gear? Without it you should have been asked to step back. If you come on a scene with fire and ems present, for the most part they'll say thanks but no thanks, freelancing is not a good thing, unless your an MD. Now if you come up on a scene without fire or ems, that's a whole different ball game, then you do what you have been trained to do, and has fire or ems arrive, they may ask you to leave or stay, don't be affended by either, hopefully there not rude. Now I now your a newbie, and wanting to do anything you can, I've been there I know, but for the most part jumping another dept's scene in frowned on.

[jaybird210]

If the lawyers want to argue, you could "technically" get into trouble if you try to do too much outside of the boundaries of your EMS System. Even though we carry a state license, we still have to work under a Dr.'s medical license. When you test in, you should ask your EMS system what their policy is regarding this situation.

Having said that, there is an obligation, in my opinion, to stop and render aid to the level you feel comfortable with (but no higher that what you are trained to). As an example, an EMT-B who stops at a crash to render aid and comfort, who finds him or herself holding C-Spine, triaging and counting patients and reporting that info to a dispatch center, I would say is acting appropriately. As Trainer said, be careful not to do things that will jeopardize your personal safety. These are things that you must decide as an individual and it's inappropriate for others to tell you, Oh, don't do that, its dangerous.

I would agree that as a responder, when I arrive on scene and find a passing EMT or firefighter has stopped to render aid, I will thank them for stopping and politely guide them out of the hot zone. Other trained people are here with the tools and protective clothing to operate safely. And I would expect the same as a passerby who stops.

[DeputyMarshal]

Even though we carry a state license, we still have to work under a Dr.'s medical license.

FWIW, that may be the case in your state but it isn't universal. In CT, EMT certification is statewide and isn't directly linked to any particular doctor. There are some specific actions that require medical control which would only be provided through a sponsor hospital to an on-duty EMT but that's a very limited subset.

When you test in, you should ask your EMS system what their policy is regarding this situation.

Agreed. I would expect any EMS system to have clearly established policy on this.

One reminder though: if you lay hands on a patient, document it soon afterwards to the best of your ability. If there are any questions later you should be able to refer back to your notes about what you found, what you did, and who you turned patient care over to.

[ChiefReason]

I was always under the assumption that, if you weren't under the control of your medical director, you were basically "good samaritan".
You have to be careful if you provide assistance, because if you identify yourself with some level of skill, if you make a mistake, you could be in for rough times. What is covering you if you weren't duly dispatched?
I used to stop at scenes and offer assistance, but I didn't offer up my credentials, either!
I was just being a "good samaritan"!
CR

[DeputyMarshal]

I was always under the assumption that, if you weren't under the control of your medical director, you were basically "good samaritan".

Different jurisdictions, different rules. That's why I suggested contacting the local credentially office. They're the ones who should know best.

You have to be careful if you provide assistance, because if you identify yourself with some level of skill, if you make a mistake, you could be in for rough times. What is covering you if you weren't duly dispatched?
I used to stop at scenes and offer assistance, but I didn't offer up my credentials, either!

That also varies with jurisdiction. Depending on where you are you may be held to your standard of training whether you identified yourself at the time or not. So-called "Good Samaritan" laws don't necessarily relieve you from providing care at the level of your training once you initiate treatment.

[lilyogi]

I used to work with this dept and still do from time to time. I am sure they had no problem with you assisting until they got there. that is where I would back off unless they ask me to stay and help. I have come upon a couple accidents in EM and have stopped. I don't usually stop unless it looks like someone is could very likely be injured and if no fire or ems is on scene.

[S8ER95Z]

I used to work with this dept and still do from time to time. I am sure they had no problem with you assisting until they got there. that is where I would back off unless they ask me to stay and help. I have come upon a couple accidents in EM and have stopped. I don't usually stop unless it looks like someone is could very likely be injured and if no fire or ems is on scene.

Thannks for the info everyone. The intersection where I work gets an accident or two every month so I wanted to be sure I wasnt in the way when I offered to help out. A few months back ( i had the day off) a vehicle was flipped on its roof at this intersection so I definately want to make sure I can be of assitance when needed.

[jaybird210]

FWIW, that may be the case in your state but it isn't universal. In CT, EMT certification is statewide and isn't directly linked to any particular doctor. There are some specific actions that require medical control which would only be provided through a sponsor hospital to an on-duty EMT but that's a very limited subset.

That would be why this is in the Illinois Forums. I am not familiar with the EMS laws in Connecticut or any other states, so I won't post an opinion there. I know that in this state, to function as a state-licensed EMT at any level, you must be part of and tested into an EMS System.

[lilyogi]

I know that intersection well, as i was involved in a crash there in an ambulance when i worked for the EMS that covers EM. I was not driving, but it still sucked! Oh and it was the van that t-boned us who was at fault.

[S8ER95Z]

I know that intersection well, as i was involved in a crash there in an ambulance when i worked for the EMS that covers EM. I was not driving, but it still sucked! Oh and it was the van that t-boned us who was at fault.

No good man... I hope nothing happens out here to cost a life, people seem to run the lights constantly... Short of moving our building I don't see it ending anytime soon.

Jaybird,

According to what you are saying (just trying to get this right)... even though I am state licensed I am essentially not an EMT-B until I test into a system in Illinois? Is this correct?

[jaybird210]

No good man... I hope nothing happens out here to cost a life, people seem to run the lights constantly... Short of moving our building I don't see it ending anytime soon.

Jaybird,

According to what you are saying (just trying to get this right)... even though I am state licensed I am essentially not an EMT-B until I test into a system in Illinois? Is this correct?

Not exactly; you are an EMT-B. You just can't legally function to the full extent of your license until you are in a system. It's actually a pretty simple process in most systems for an EMT-B. Where did you take your class? If it was through a hospital or at a college with a hospital association, you may already be tested in and don't know it. Most systems just have a simple written test and a brief interview. Some places even waive that. They may spend some time going over their patient care reporting software/system. The process is usually much more involved and difficult for medics.

[kprsn1]

How about this scenario guys. Let's say that S8ER95Z is a paramedic from another EMS system that is on scene of a motor vehicle accident. Fire and EMS roll up and they are a BLS service. Now what? The paramedic has no gear or ALS equipment but he is the "higher level of care." Please Medics don't take this the wrong way but do you know what some of them do or say if you ask them politely to step back? We've had this situation happen several times and it just never goes well. Any suggestions?

Chad

[nmfire]

My personal theory for stopping at out-of-district emergencies is this.

If my being there will have some significant impact on either patient condition or scene safety (traffic protection, fire, etc), I will stop and do what I can until services arrive. This goes for pretty much anything, not just MVA's. If it is something minor and stupid and there is no major traffic hazard, I'm not stopping.

I should also note I am from CT as well so I don't need to worry about if it is legal.

[S8ER95Z]

Not exactly; you are an EMT-B. You just can't legally function to the full extent of your license until you are in a system. It's actually a pretty simple process in most systems for an EMT-B. Where did you take your class? If it was through a hospital or at a college with a hospital association, you may already be tested in and don't know it. Most systems just have a simple written test and a brief interview. Some places even waive that. They may spend some time going over their patient care reporting software/system. The process is usually much more involved and difficult for medics.

I just finished my class at a local fire department and took the national registry (which in turn I automagically recieved my IL license).. This all just happened recently (test in december, results and license arrive mid january).
I am with Trinity System out of the Quad Cities and I am to be 'scheduled in' for my SOPs sometime soon.. but as of right now I am not in the system.

Conversation so far has been enlightening... this is something I will face more than some medics just because I work close to an hour away from home and spend those 2 hours a day on a 2 lane highway during the commute. So far this past year I've been witness to several accidents, fires and misc things (fainting, possible cardiac, etc).. it wasn't until recently that I had the 'ability/knowledge' to actually do something to help. Its good to know where the lines are.