Yesterday I was taking a break from studying. I just passed my state paramedic examination and I'm preparing for nyc remac exam. I took my girl out to the movies and on the way thre minivan in front of me flipped and rolled on the highway. By the time I got out of my car and run up 2 females crowled out of the wreck and stood up. I run up, yell at everyone to move back, clear the scene and check for additional victims. I got to 2 ambulatory victims that are surrounded by bystanders. I asked who called 911 and many people say they did. I instruct two bystanders to hold manual stabilization of the head and never let go. So guy comes out of nowhere and asks patients to sit down. I turn around and look at him like he is a retard and tell him that pts while standing up with no movement in the c-spine, heads are being held in line and when ambulance comes they just do rapid takedown. He starts yelling that he is a paramedic. Well so am I. So the vicxtims stand becasue I asked him where he works and he just said mumbled something under his nose. Off duty cop shows up and wants to be in charge. He tell the patients to sit down. I asked him about his level of medical training. He tells me he is a cop. In the meantime paramedic who was watching two victims tells bystanders to let go of the head anf cspine stabiliazation. I got really angry, called 911, made a report my way which I knew was being recorded, walked up to the paramedic asked him if he is in charge which he acknowledged, walked up to the cop who just gave me a dirty look, got in my car and went to the zoo becasue movie was sold out. How much of the ratard you have to be to issue "sit down" orders without cspine mobilization to a person who was just involved in rollover in car going 50 mph?

I haven't been an emt for a long time (2-3) years and my ink on my paramedic card hasn't dried out yet. But this was a basic call that anyone with some common sense would handle the right way.

I left. I followed the rules and had the smae level of medical training on the scene with off duty pd taking over. I just pray the god that if something like that happens to my friends somebody with common sense would be the first on the scene not two morons who probably never did a mva.

I'm not a lawyer, and I don't play one on TV. But as I understand it, good samaritan laws don't apply to people who have applicable training. I would think that would be covered by your training too, if not it should be. By trying to help, you are taking on a potential liability. I would think you should take any opportunity you can to hand off liability^h^h^h^h^h^h^h^h responsibility to someone else. You did the right thing by getting it on the record that someone else was taking charge.

I would have taken the cops badge number and broadcast it to the 911 operator if the cop did not want to be recorded and I would have asked the other paramedic to identify himself to the 911 operator with his license number (I am assuming the state has licensing provisions for accredited paramedics.) and then stood by to give facts to the first responders on the scene.

Not being and EMT or paramedic, I would not have been able to help to the extent you did, but I have a strong aversion to people who claim false or exaggerated credentials.

Bountyhunter

good samaritan laws protect you only to the point... if there is gross negligence (like in this case) than out the window goes any immunity you had...

I asked for shields but all I got back was: I'm a cop don't worry about it guy.

I can't really do much on the scene like that without proper equipment except manually stabiling the patients which was thrown out of the window by those two morans.

I never second-guess the actions of another EMS provider if I was not on the scene, or if I lack 1st hand knowledge of a particular patient. There are exceptions, where it is clear the actions or lack of action by an EMS provider clearly violated the standard of care.

I will say, that here in Maryland we do have a protocol for field clearance of possible C-spine injuries, which I have used, but with the greatest of caution. However, if there is/was any doubt, it is always better to be conservative and treat the patient as though they did have C-pine injuries.

I have, when 1st on the scene and without an EMS unit coming anytime soon, performed a quick neurological exam and in the absence of any indicators (pain, deformity, numbness, weakness, neuro-deficit) allowed the patient to assume a position of comfort, which might be sitting or laying down, especially to treat potential shock.

On a more positive note - Matt, congratulations on passing your exam.

Pete

In the absence of a clear authority figure, most PHRASECENSOREDPOSTERSHOULDKNOWBETTER. will follow whoever yells
the loudest, looks the toughest, acts the most confident, etc.

It doesn't sound like any of you had a uniform on, or other signs of your profession. So maybe
to the victims and bystanders, you were equal, and since you knew what you were doing and
were trying to be reasonable, you didn't seem as alpha as the other two.

Maybe in the future, could you carry a jacket with an official looking logo on it? A bag with
cool looking paramedic stuff? A big brick of a walkie-talkie couldn't hurt. Perception
is reality. Just a black jacket that said PARAMEDIC and a toolchest full of medical stuff would
have put you way ahead of two plain clothes morons, wouldn't it?

I know, there isn't always time for that, or room for that, but...

I have all that stuff in my car (I'm forbiden to wear my paramedic identifing gear on the date since I was "stuck" for two hours in the ice rink with amputated finger. not that my date is insensitive but I get stopped and ask questions all the time")... Just when you see a car doing matrix scene in front of you wearing cool gear aint the priority. Whenever I enter the scene I identify my self and hang my badge on my neck.

But I see how would that make a point.

I'm not a lawyer, a cop, or a paramedic, just a First Aid instructor, and this is all 20-20 hindsight anyway. However, as I understand it, neither you nor the other paramedic were in uniform or on duty; the police officer was both. Therefore, he is officially in charge. Rather than getting into a machismo contest with him, I think you should have introduced yourself as a qualified paramedic or whatever your qualifications are, and stated "My recommendation is [whatever your recommendation is, e.g. "these patients should remain standing until the ambulance arrives"]" If he chooses to override/ignore your advice, or chooses to believe the other off-duty paramedic, that's his prerogative. (fwiw, before reading this thread, I think I would also have tried to get the two patients to lie down.) Look at it from the cop's point of view - he's probably attended hundreds of accident scenes, he's trained in first aid, at a minimum, he's the only guy there in uniform and he's trying to do his job, and some civilian comes over and tries to make him look bad in front of everyone. How would you react if it were you? Especially when there's another off-duty EMS provider who openly disagrees with you?

Did the other EMS provider have actual work experience? Did he have the same qualifications as you? Did he or the police officer know that you had only just completed your training? (Am I correct in assuming that, if you'd just passed the paramedic's exams, you must have several years of work experience as an EMR or EMT?) If I were in the cop's shoes and I were confronted with conflicting opinions from two equally qualified providers, one of whom worked in the field and the other who had "only just graduated", I know which one I'd be more likely to listen to. (So emphasize your work experience as well as your level of training; e.g. "I'm a paramedic with [name of employer] for the past [n] years." rather than "I just completed my paramedic training this afternoon and you're doing it wrong." which doesn't get across the message "I have 5-10 years of work experience as an EMT".)

Technically, as you were the first on the scene, you are in charge until you voluntarily relinquish control to another equally- or better-qualified bystander, or EMS takes over. From your level of training, you almost certainly know the legalities better than I do. However, the other off-duty EMS (a) may have had more experience than you, (b) may have seen something you missed, or (c) may not have known there was another off-duty paramedic on the scene.

Maybe it would have been better if you'd gone up to him and said "Hi, my name is ...., I'm a paramedic with [name of employer], I'm glad you're here. I have these two patients stabilised, but there are people trapped inside, I could use your help over here." or something like that. I know, I know, easy enough for me to say while I'm sitting here goofing off at work, not so easy when it's dark, cold and wet and there's six injured passengers and two off-duty paramedics who don't know each other, but that's why you asked the question, right? <img src="/images/graemlins/wink.gif" alt="" />

He was trying to help, you were trying to help, the cop was trying to help. If I interpreted your post correctly, it's a shame that you ended up getting into a shouting match in public.

With multiple casualties, I would not have left the scene until the ambulance showed up, I would have made my report to the on-duty paramedics when they showed up, then I would have gone to the zoo. This may be very unfair, but your post makes it sound like you took your ball and went home in a pout because the other kiddies wouldn't play by your rules. I'm sure you were far more concerned about the patients' safety than you were in proving you were right, but that didn't come across clearly in your post.

I feel sorry for the victims. If I'm injured and scared, the last thing I want to see is the first responders argueing about my treatment. If I was about to go in to shock then that would certainly make matters worse. Remember why you chose this profession. I'm sure it wasn't for the lucrative pay. The question you asked in your post was "what would you do". I supposed my answer is that I would have stayed on the scene to help as best I could have and refrained from any confrontation with anyone else that might make matters worse for the victims. I also would have reported it to the on-duty personel when they arrived if in fact this did not take valuable treatment time away from the victims. I suppose in a nutshell, I would have put the victims' best interest above all else.

Now, having said that... I realize that this is one of those "easier said than done" type of situations and I don't think you should be discouraged that I (or anyone else) dont agree completely with your decisions. Right or wrong, you're human and will make mistakes. Furthermore you are to be commended not only for stopping to help to begin with but also for chosing a profession in which you selflessly give yourself to helping others in need!