I had just left the locker room at the fitness center and was standing at the information desk when a man ran out of the men’s room and said, “Somebody call 911, he’s having a heart attack!”
Now I hate these situations. I am in “plainclothes.” I am anonymous, yet I carry a card that says I am a licensed paramedic. I have a certain duty to act, yet at the same time, I have a duty to not get in the way because legally even though I am a paramedic, unless I am working, I am not a part of the 911 system, so I am not even a first responder, I am just a bystander. Consequently, I rarely stop at auto accidents, or even announce my presence at medical scenes I happen upon — unless it looks like someone is in dire straights. Most of the time I can eyeball it and see that it is really not a big deal.
When I had just become an EMT I stopped at a crash on the highway, and found a woman who’s face had hit the windshield. While she was conscious, she was quite shaken up and badly bruised. I stayed with her until the police arrived. I told the state trooper I was an EMT, he said, “Big fucking deal! So am I,” and pushed right past me.
Now whenever I happen to get involved in something, I give a quick report to the first responder, and then excuse myself, unless they need me. I also, whenever I respond, make certain to acknowledge and thank anyone — EMT, doctor, nurse or layperson — who is with the patient and has something to tell me.
No one stepped forward and seeing the panic in the eyes of the female staff person on duty who was fumbling to dial 911, I walked back in to the locker room to check it out. I saw a man in the shower now sitting on a chair, surrounded by several people. He looked okay. He was young, healthy-looking. I remembered him from the sauna. He’d been in there before I’d gotten in and was still there when I’d left. I guessed he’d probably overheated himself.
“Keep back, keep back, give him space, give him space,” one naked man in the shower, assuming the role of general, announced to those looking on.
The man, although pale, looked in no serious distress so I went back out and told the female staff person he appeared all right, he wasn’t dying just then, but to keep 911 coming so they could check him out. “Yes, he’s concious,” she said to the operator.
Just then another man came out of the locker room and shouted, “Hey, where’s that ambulance? He’s bad, he’s really bad!”
I told the staff person I’d go in and sit with him, which I did. He said he was okay now. He’d just gotten dizzy. I tried to ask who had seen him pass out and whether he hit his head. One man — who I heard later from the medic was a doctor — said “I don’t know. He passed out three times. He has to go to the hospital. Don’t let him get up.”
I sat there and wrote out a little info sheet to give to the crew when they got there — name, DOB, meds, allergies, address.
Then in came the cops — the first responders. I introduced myself and gave a quick report. The officer nodded, looked at the man and asked “Are you a diabetic?”
“No meds, no history,” I said again. “He had a syncopal episode. He’d been in the sauna. He’s probably dehydrated.” The cop nodded and then asked the man “What happened?”
A few minutes later the fire department came in — also first responders. I handed them my notes, gave a quick report, and then excused myself while they started taking vitals.
Out in the lobby, everything was back to normal, people checking in at the membership desk, buying drinks from the juice bar, reading the announcements on the bulletin board. I saw the ambulance crew coming in on my way out of the place. I knew the crew and gave them a quick report.
It was interesting seeing the incident from the other side. The bystanders reactions, the panic, and then the progressive waves of responders, and a gradual sense of calm. My first EMT instructor used to say the emergency ends when you arrive. I can see that. The public doesn’t know if someone is dying or not. They call 911 and wait anxiously. 911 arrives and life goes back to normal.
Man are you reading my mind? I’m the same way. After 17 years in the field I really try to avoid scenes if at all possible. My wife will see something happening and say, “Aren’t you going to go over and help?” My general response is something to the effect of “If they need my help, they’ll ask.” I used to keep a scanner on 24/7 at my house. Now it is only turned on on rare occasions if I am bored and hear a siren in the distance. Even then I know that I’m not going anywhere. I’m just being a bit nosey and listening in on what is going on in the neighborhood. You spoke of the calming effect that responders can have at a scene. That’s true if those responders will actually enter a scene calmly and rationally. So many times i have seen responders make things many times worse than they innitially began by rushing in like Superman to save the day. I REFUSE to get in the kind of hurry that I see some people running at on a daily basis. I have found, over the years, that to really see what is going on with your patient you have to take the time to see everything that is going on. A hasty decision in our business will kill someone. That someone could be you, your partner, ypur patient, or a bystander. EMS has evolved today to a point where we must think ahead so that we don’t have to run and play catch-up. It’s no longer a business that is run alongside funeral homes. It’s time for us as professionals to act as such, on or off duty. Sorry, I got off topic, but I agree with you 100%.
I’ve always heard that the emergency stops when you get to the ED, but I like your saying much better….BRM
Seems like your system has major problems.Any law that makes it a difficult decision whether or not to use your skills to help someone off duty needs changing.Here in New Zealand there would be no problem with stopping at a scene and helping out. If I thought the scene couldn’t wait, I’d help out until the first crew arrived, identify myself and my qual, handover then ask what help they wanted (if any)?And that Trooper needs a major attitude adjustment – what an unhelpful prick.
Thanks for the comments.In our state you can only use your skills if you are acting as part of the emergency medical services system with a emergency medical services organization that is certified at your level and officially dispatched on the call.An example I can work with a partner who is also a paramedic and we can both do paramedic skills on the same call, but later in the week I can respond as a paramedic to a call in the town where he works as a firefighter/EMT or a call that he is a bystander at, and he cannot use his paramedic skills to help me. On one day he can push meds for me as a fellow paramedic/partner, on the next day if he pushed meds for me as a firefighter/EMT we both could lose our licenses. Part of the reason for the law is to prohibit freelancing and make sure the system is accountable and lines of authority are clearcut. I know of cases where medics have looked the other way in the interest of saving lives and I know of cases where even alone in the back of an ambulance, shielded from bystanders eyes, paramedics have either refused to help or refused to allow help from other medics becuase of the regulations.And I know of cases where EMS people have reported this type of help and people have been suspended and faced state investigation.
In my state we are protected if we choose to stop and assist on something like a car crash or a medical scene we happen to come upon. The laws protect us as long as we do no more than what we are trained and licensed to do within the state.