Even if Daryl Strawberry was right beside me you wouldn't want me standing at the plate at a critical moment during the world series. Some of the training involved in properly using something like an airway is the hands-on training of actually inserting one in a dummy and the supervised experience of actualling being on some calls in the ambulance as the EMT responsible. This isn't something that just any shmoe can do safely with a little coaching. If someone doesn't have the training then you are far better off giving them a CPR mask and some breathing instructions than trying to coach them through using an airway. Furthermore, if someone needs an airway they ned the ambulance too. If the ambulance isn't there then the airway probably isn't going to make much difference. Sometimes with an airway, BVM + Ox at 100% you might buy a couple of minutes. BTW, if you use an airway on a partially conscious individual, or one that becomes partially conscious due to restoring breathing, they will / may vomit violently and aspirate their vomit into their lungs which may cause bleeding depending upon stomach contents. Are you going to coach the individual with no experience through handling that?

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No, No, No. No way no how. They require skill and practice to use correctly. Pete

I am a member of a technical rescue squad. That means we perform Trench, Confined Space, Building Collpase, Rope, Swiftwater, Dive, and SAR. These require equipment not carried by typical fire or rescue. Our members tend to have a rather extensive list of equipment in their personal vehicles since most of us are severe rescue junkies.

One fella was telling the story recently where he had happened onto a vehicle accident on the interstate. He donned his turnout gear, grabbed a tarp and halligan tool and approached the scene. He performed patient assessment.
The local crew began arriving on the scene. He suggested they bring out specific equipment from their rescue truck and perform the extrication in a particular manner. Instead of cutting the posts supporting the roof which was supporting the overturned car, he recommened making non-structural cuts to create an opening to remove the victim. The locals did not yet have an officer on scene and followed his lead.

When an officer did arrive, he wanted to know who this guy was in different turnout gear and why he was running the scene! Luke has been on the fire departement for 20+ years as a training officer as well as a captain on the technical rescue team for 5 years. Luke understood he would not want someone on his scene not covered by insurance and bowed out.

All the tech rescue team members tend to have very full trunks. We have a friendly competition to see who has the most or newest gadgets. It is amazing to see what people will pull out of their vehicles. One guy pulls a 10' enclosed trailer behind his expedition. He is single and his vehicle is filled with so much equipment, so there is only room for the driver.

Hey Skater,

I work in NYC and EMTs are very against others helping them. Why? Law suits. And I’m not even talking about patients suing me. I am protected under Good Samaritan Law unless I abandon or neglect the patient. I’m talking about you (helpful bystander) suing me. Sleazy NYC lawyers want to get chunk out of everything. As a helpful bystander you are not trained in Body Substance Isolation or lifting techniques. There is a potential of you being injured. If something happened to you (hepatitis infection/thrown back) at the scene maybe later if medical bills escalated you decide to sue me. As the highest ranking and most qualified "official" figure on the scene I have to make the call of what to do. When right moment comes people rush in to help, sometimes all the reason goes out of the window. And later on when reality sets in everyone is looking to “get paid” and it’s very hard to prove that you do not have back injury or that you didn’t suffer from psychological trauma.

Now before you tell me that you would never do such a thing I will agree with you. But in NYC a lot of people look out to make a buck even if that's thru human suffering and trampling fellow man. I lived in Georgia and such thing would never cross anyone’s mind unfortunately this is Big Apple. I saw what people did after 911 and I don’t think that human beings can get any lower than that.

But if you and I found ourselves on the accident scene and it was serious I would be glad to have you around. Even for such things as monitoring the patient for signs of deterioration, keeping traffic clear, help in splinting, holding, etc etc...

Matt

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I absolutly agree that having non-skilled use equipment on hand for the bystander to use is helpful. For the moment, setting aside from the issues raised by Matt re: the legal ramifications of enlisting bystanders, anyone is qualified to take out a stack of sterile gauze and press it on a flowing wound to stop the blood, most would be competent in deploying flares to signal for help or direct traffic, many would be able to make the appropriate calls on their cell phones. If you are not a certified EMT and you enlist individuals to provide this type of first aid along with yourself while you await the EMT's then you are probably also covered by the good samaritan laws. OTOH, if you are certified and you enlist non-certified personnel there are BIG VERY BIG liability issues for everyone. Further if you enlist their aid in performing treatments that are restricetd by lisencing or certification (Airway management, CPR, administering drugs) for which they don't carry the credentials then you or they or both will end up owing people a bunch of money if not in jail.

That said.

In a true disaster survival situation where the EMT may be days away or not available at all and you have some training then you are operating under Mass Casualty Incident [MCI] rules of triage and if they won't make a day without intervention they probably won't be getting more than a minute of your time anyway. Under those rules many uses of bystanders are acceptable that are not normally. I'm sure that Matt can relate some stories about how the MCI rules were applied / ignored and the consequences to the involved individuals from his experience with 9-11.

You might look into your local volunteer opportunities in EMS. When I did (shortly after 9-11) I discovered that they would help fund the cost of the EMT-Basic course in return for a dedication of weekly volunteer service. 1 12 hour night per week and 1 24 hour weekend shift per month. Worked for me. Now, if I see someone on the side of the road in trouble I stop and if they need airway management I am equipped and if the vomit, I have a suction unit to clear the stuff. I carry a collar but not a long board. so I can stabilize them in-place in the vehicle while awaiting the ambulance.

Yes, it does feel good knowing that you are prepared to help.

I was working in the building on 9-11 (46th floor) but I wasn't an EMT at this time as much as I wish I was. I was in WTC 2 for both hits and got out of the concourse area when building collapsed. I stayed out of the EMS way because my minimal army training and total unfamiliarity with MCI protocols would just make me part of the problem not part of the solution. My experiences refer to people suing left and right, ripping of relief agencies, Red Cross and foundations...

But that being said… I think that people should use their common sense if faced with emergency situation. And after it is over there should be responsible for their actions.

Matt

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