No shouthing match in public had taken place. I learned long time ago that shouting leads to panic and confusion. I was very calm thru the entire event.

Now the cop was off duty and not in uniform... First aid trainging for police officers in NYC doesn;t really consits of much since EMS units are never more than 5-10 min out or even faster if they get shot. Scene should be controlled by the highest medical authority until unfiromed unit arrives.

This wasn't a Paramedic call. It was a basic EMT call which I am for a while. Paramedic status would matter if somebody needed to take charge and it happened to be that two paramedics were on the scene.

Now I do understand your point about taking my toys and going to play in my sandbox since other kids don't want to play by my rules. The thing is that when I see gross negligence and breaking of the rules it is time to repeat clear directions one more time and since I'm not an advocator of shouting and screaming it is time to go. I can't stand besides somebody who is hurting a patient since now my cartification is on the line because of somebodys else actions.

For some people especially in NYC EMS is a afternoon hobby since they are protected by Good s. laws by volunteering which there is nothing wrong with that since I started that way but it doesn't give you much experience in the field. For some it is a profession and gateway to other stuff such as PA or Medical school. For others it's a full time job. And I honestly belive that second paramedic was a member of volunteer organization and not much experienced.

I value your word guys that's why I posted it here so I can get some opinions regardless of them being negative or positive.

Based upon what Matt has given us in terms of how the event unfolded, I will say that Matt was the highest medical authority on the scene.

Unless the other medic was on duty or since both were off duty, Matt was outside his jurisdiction and the other medic was within his jurisdiction, Matt had, by his action assumed responsibility and authority of patient care. His initiation of treatment (c-spine stabilization) was in keeping with the standard of care, his treatment should have continued until the EMS units dispatched arrived and assumed patient care.

The LEO, unless he was also a paramedic should have concerned himself with control of the accident scene and not patient care, since Matt identified himself as a paramedic.

An accident scene can be utter chaos, it is up to the highest ranking EMS or Fire official to assume control of the scene, until relived by a superior or higher trained individual. In Maryland, by state law, fire line-officers, not EMS officers are responsible for incident command of the accident scene; EMS personnel are responsible for patient care.

Pete

Sorry, I just re-read your post and realized the cop was off-duty too. My understanding of Canadian law is that all of you were legally considered to be first aiders (I could be wrong) and that, as the first on the scene, you were in charge until you chose to hand the scene over to (a) another first-aider, (b) EMS (on-duty), or (c) qualified medical personnel (e.g. a doctor or nurse).

If you were the highest qualified person on scene, you did not have to relinquish the scene to either of the other two. If they ignored your advice and risked injury to the casualties, knowing that you were a paramedic with several years experience, I think they should both have been reported to their respective superiors. The police officer probably would/should have been subject to disciplinary action, the other paramedic could have his certification pulled. If he didn't have any certification, he might well have been subject to legal action.

I don't see how your certification would have been in danger if you stayed, as long as you had clearly stated your qualifications and that you were in charge in front of witnesses. Any subsequent investigation would reveal that any mistakes made were made in spite of your actions, not because of them.

My biggest concern would be that the police officer and the other paramedic will probably not have their behaviour corrected unless someone makes a formal complaint. By leaving, you legally seem to have agreed that the casualties were in competent hands.

Again, this is based on what little I know of Canadian law; your laws may well be completely different. However, having gotten another paramedic to state, for the record, that he was now in charge, was technically the correct thing to do but may not have been in the best interests of the casualties.

Sadly, some professions with legal or social authority are prone to overwhelming common sense with the fearfull 3 letter word EGO. During our liferaft testing, Doug assembled no less than the senior Coast Guard PJ, a crew of survivalmen from Luke AF base and numerous active,reserve and former service and civilian emergency professionals. I had humorous visions of my own obit in all this " former coastguardsman drowns in Arizona wavepool. Stomach cramps from eating to much food blamed. " Who WAS in charge? The certified, designated and employed lifeguard who was still a teenager. Perhaps you should take this experience, distastefull as it is and bring it up in various EMT journals and public venues.

You also have to realize you are dealing with a NYC cop (off duty or not) - you know they walk on water, their poop doesn't stink, and the demand that you listen to them, or they will have you arrested when the motor unit shows on scene

Matt congrats you passed the test. You have worked hard for it.

Burak

Several members of this forum are police officers in their real lives, so I'm not about to get into an "I hate cops" debate. <img src="/images/graemlins/wink.gif" alt="" />

But regardless of the personality of this particular off-duty peace officer, if he knowingly overrode the medical instructions of a qualified, off-duty paramedic and thereby caused injury to any of the casualties, he opened himself and possibly his department up to a lawsuit.

At this point, if I were in Matt's position, I would probably go to my governing/licensing body and seek clarification. I find it ridiculous that he would jeopardize his professional certification by staying to help, but not by abandoning a casualty to the care of someone who was clearly incompetent. If that is, indeed, the case, then perhaps it's a situation that needs to be amended. If it's not the case, then perhaps the licensing body would be willing to issue a clarification in writing, as it's unlikely Matt would be the only one who'd have trouble knowing what to do in these circumstances.

Although I think it's a great compliment to the members of this forum to be asked for their opinion on something like this, it's really a question best answered by the ethics committee of the official certification body.

To me the most stupid and at the same time most amusing thing that was told to me while doing my last first aid course was: If you have to deal with an emergency, the beter trained you are the more likely you are to be faced with a lawsuit. Basically the way the law works (at least in my country) if you are someone operating in an unoficial capacity (say a paramedic / doctor / nurse off duty at the time) and you assist in a situation as you would if you were a lay-person then chances are you will end up facing a law suit at the end of it, because of potential mishaps. If your are a totally untrained person (i.e. without qualifications) then you will not receave such lawsuits as you are not expected to know beter. The result ofwhich is that the law encourages people who have zero medical training to help out in an emergency situation, and punishes people who do have medical training by allowing them to be subject to lawsuits that would otherwise not effect them if they had not receaved such training (which is probably the on ething that gives them the ability to actually help in such a situation). One of my friends is a registered nurse and she has been told specifically by a superior that if an incedent occurs while she is off duty, she should ignore it, because she would end up being filed against if she attempted to help in anyway. I'm sorry but I find this sort of situation ludicrous.

Aparently the only solution is to get trained but refuse any form of qualification, that way you have the knowledge to help out, but without any qualifications you don't run the risk of a law suit

An off duty EMS provider, whether career or volunteer is generally covered by Good Samaritan Laws in most of the US. The law does not prevent anyone from being sued, but unless there is merit to the lawsuit, the suit it generally dismissed or found in favor of the defendant. Even an on duty EMS provider is generally covered by Good Samaritan Laws, since they are not receiving direct compensation, i.e. “fee for service”. This would still be true in jurisdictions where the EMS service charges for their services, since again the EMS provider is not receiving direct “fee for service” compensation.

There are several legal obligations that an EMS provider must abide by, to be covered by Good Samaritan Laws.

1st: There must be a “duty to perform”, most states require certified or licensed EMS providers to act whether they are no duty or not. To fail to stop and render aid, if it was found out that the EMS provider did not render aid, could be grounds for legal and possibly criminal litigation. On the other side of the equation, a medical procedure (i.e. emergency C-section) that is beyond the scope of the EMS provider’s training insulates the provider from a “duty to perform”.

2nd: The provider cannot cause harm through causative action or inaction. An EMS provider, who causes injury or harm through their action or inaction, can be held responsible. Basically – “Do No Harm”

3rd:They must provide the “Standard of Care” to which their level of training dictates. Generally, each level of EMS provider is responsible for the care provided at their current level of training as well as those below. An on scene paramedic is not only responsible for ALS care, but ensuring all BLS care is appropriate and compliant with the “Standard of Care”.

There are a number of other factors that need to be considered as well as the above, when determining whether an EMS provider is covered by Good Samaritan Laws. Some of the hard fast “laws/conditions” may be softened in times of catastrophe or a Mass Casualty Incident (MCI).

Pete

Do these laws apply to non-EMS people also? Let me try a hypothetical: let's say I observe a person who has been shot in the leg and their femoral artery is severed. They are already unconcious. If I do nothing they will bleed to death in minutes and there is no one else around. Drawing on my 30 year old Boy Scout training I apply a tourniquet which I leave on until the ambulance arrives. But because I never loosened the tourniquet they lose their leg above the knee.

Am I liable even though, had I done nothing, they would have died? If so, I can understand why people don't get involved.

Vince