Would your scouts ask an adult to show ID at accident scene?

[Stosh]

A merit badge is not a credential.

 

I am an experienced Health teacher and First Aid instructor, yet I would immediately cede control to a police officer, fire fighter, or EMT who arrives on the scene.

 

One has a legal obligation that once medical treatment has been started, it is illegal to turn over the patient's welfare to someone who has lessor level of training that the original provider. 

 

I have been told to get out of a scene of an accident by law enforcement and fire personnel, but I refused until someone with equal or greater training was there to take over.  Both instances where this happened (once law officer, one fire personnel), they were reprimanded by their superiors for their lack of knowledge in that situation.

 

I wouldn't necessarily ask anyone if they were certified, but I would have law enforcement acquire the name of the person taking over from me in case the situation made it to court.  In that case, all certifications and levels of expertise would be worked out by the legal system.  Although I was a volunteer (technically on duty anytime I volunteered) at that particular time, I did carry EMT-D national certification which I knew to be a higher level of medical training than what was offered to law enforcement and fire rescue personnel.

[gumbymaster]

This issue raises a good point.  I have always trained that the emergency care provider (FAMB / ARC First Aid, etc) would provide the care until more qualified help arrived (EMS or a better trained bystander).  Now when I used to teach the ARC Advanced First Aid course, we did ask the students to at least inquire into the level of training (The Advanced First Aid course at the time was very sophisticated, and just a step or two below EMT level training), but they were never asked to verify those qualifications.  With the changes in the CPR best practices, it would not be out of line to ask the bystander either how long ago they were trained or which method they were trained with before handing over control.

 

Just in the last month, one of the airlines got in trouble for not believing that an African American woman was a qualified physician when they asked for assistance.  This is not the type of judgement call our scouts should be making.

 

If the scouts are taking notes on their treatment - as they should be doing, I would believe it to be sufficient to record the time and the name of the individual asserting authority.

 

It is also important to encourage them to still remain on scene (1) to Call EMS if not already done or direct them to the scene when they arrive, (2) When EMS arrives, they may want debriefing, (3) There may be additional victims in need of care - check the perimeter of the scene, (4) If the new care provider may need assistance, take notes on condition and treatment, or the scouts may have better emergency materials (i.e. a first aid kit), (5) It is wise to observe the person who took control and at least feel comfortable that they know what they are doing, (6) To help control the scene - keep away the bystanders (not by any force or authority, but for respect and scene safety).

 

On a side note, the most qualified professional may not always be best suited for treating the injured.  EMTs, WFA, and community first aid courses are trained for in-field response, and generally have supplies and materials suited to their level of training.  A physician may have more medical knowledge, but may not always be able to provide the best care at the scene of an accident.  A respectful offer of help from a "less trained" individual may still be welcome or needed.

[frankpalazzi]

Treat the injured immediately, then worry about flashing your credentials, if any later.

Completely absurd.

[RememberSchiff]

Treat the injured immediately, then worry about flashing your credentials, if any later.

Completely absurd.

Yes, but who makes the call of what treatment? Remember, do no harm. 

[frankpalazzi]

You just do the best you can.  I hope I'm not the one bleeding in the street while 2 jokers are trying to out-do each other with their Red Cross cards and arguing about what to do.

[Stosh]

An EMT in the field of trauma may be better suited for the situation than the MD cosmetic surgeon.  The pedigree and law must always be taken into consideration.

[Pale Horse]

You just do the best you can.  I hope I'm not the one bleeding in the street while 2 jokers are trying to out-do each other with their Red Cross cards and arguing about what to do.

 

Completely agree. Many studies have shown that poor or incorrect CPR is better than no CPR.  Delaying treatment because a lack of credentials or waiting the "ideal" first responder is not the right answer.

[NJCubScouter]

I think asking for credentials in that situation is a bad idea.  The focus has to be on getting the injured or ill person the best first aid in the most rapid manner possible.  Aside from which, neither the Scout nor the EMT have the "authority" to control the scene and determine who does what.  One would hope that common sense will prevail.  Although this may rankle some people, any "authority" to control the scene would have to come from the government:  Either a police officer or a first aid squad or rescue squad or fire department, presumably dispatched by the local emergency management department or whatever similar kind of entity may exist in your area.  Otherwise we're all just citizens trying to do a good deed and we need to figure out on the spot, as best we can, who should be doing what.

[CalicoPenn]

I believe it is different in different States as to whether certain personnel have a legal obligation to act. As stated for some it may fall under general citizens, but for others it is specific to employ regardless of being "on the clock". Different states, different laws.

 

Yeah, I know that it makes sense that an licensed EMS person would have a legal obligation to act even if off the clock but that runs up against an even more important principle - that a government - at any level - can force you to do something for free that you would normally be paid for, not even as a requirement of licensing.  Barbers and Cosmetologists are licensed by most states - but the state cannot force them to give people free haircuts.  A state can require someone to disclose if they are licensed in some instances (for example, I am required to provide written notification when I sign my apartment lease every year that I am a licensed real estate broker) but they cannot force me to act as a broker without compensation. 

 

That same principle is true for everyone, even those folks that might hold licenses for important things like emergency services.  If the State can force an off-duty Paramedic to provide care (by making it a legal obligation), the state is essentially putting them in a position of involuntary servitude to the state - and guess what Amendment to the US Constitution that violates? (Hint - it's the Thirteenth Amendment). 

 

So no, there is no state in the United States of America where an off-duty EMS person or an unpaid volunteer EMS person is obligated by law to provide their specialized services and in states that require citizens not to abandon people in need of help, to provide any services above those required of any citizen.  Again, most folks who are EMS trained are going to stop and help anyway - but that's not the question - the question is can the state force them to do so if they are not paid and the answer is very clearly no.

 

As to the question of who controls care at a scene of an accident?  For EMT's of pretty much every level - the doctors they are talking to at the hospital that are telling the EMT's what to do.

[David CO]

I actually know of a real situation in which an off duty lifeguard refused to jump into the hotel swimming pool to save a drowning man.  

 

The drowning man's young children managed to get the attention of a non-swimmer passing by, who promptly jumped into the deep end of the pool and "bunny-hopped" the drowning man and himself safely to the edge of the pool.

 

The rescuer won the Carnegie Medal for Civilian Heroism.

Edited November 3, 2016 by David CO

[blw2]

One has a legal obligation that once medical treatment has been started, it is illegal to turn over the patient's welfare to someone who has lessor level of training that the original provider. 

 

I have been told to get out of a scene of an accident by law enforcement and fire personnel, but I refused until someone with equal or greater training was there to take over.  Both instances where this happened (once law officer, one fire personnel), they were reprimanded by their superiors for their lack of knowledge in that situation.

 

I wouldn't necessarily ask anyone if they were certified, but I would have law enforcement acquire the name of the person taking over from me in case the situation made it to court.  In that case, all certifications and levels of expertise would be worked out by the legal system.  Although I was a volunteer (technically on duty anytime I volunteered) at that particular time, I did carry EMT-D national certification which I knew to be a higher level of medical training than what was offered to law enforcement and fire rescue personnel.

 

I was gonna say.....

An EMT in the field of trauma may be better suited for the situation than the MD cosmetic surgeon.  The pedigree and law must always be taken into consideration.

but you beat me to it!

 

The higher level of cert thing is for sure a sticky wicket

[CalicoPenn]

David,

 

Yep - that does sometimes happen - but it's rare enough to be newsworthy - that says far more about the lifeguards lack of common decency than anything else.

[CalicoPenn]

An EMT in the field of trauma may be better suited for the situation than the MD cosmetic surgeon.  The pedigree and law must always be taken into consideration.

 

Not to mention ego.

 

 

Back in the 1970's, when paramedic services were just getting started, it was very common for MD's who might not have done a trauma rotation in years to push aside paramedics in the field - It wasn't easy to get MD's to accept EMT's - it took a lot of work (a bit of trivia - remember the show Emergency back in the 1970's about a squad of Paramedic Rescuers in LA - the show's technical advisor, the LA Fire Department's Battalion Chief in charge of the department's fledgling EMS services saw it as a platform to get both the medical profession and the public to accept the legitimacy of paramedic services - paramedic training in LA started in 1970 - Emergency was shown starting in 1972.)

 

Nowadays, not so much - most MD's are more than willing to step aside and let Paramedics handle incidents in the field - and will fall back in to the role of providing medical oversight.  The old "Is there a doctor in the house (on the plane)" line should really be changed to "Is there an emergency medical responder in the house (on the plane).

[David CO]

David,

 

Yep - that does sometimes happen - but it's rare enough to be newsworthy - that says far more about the lifeguards lack of common decency than anything else.

 

I was a YMCA lifeguard, so I find it difficult to imagine that a real lifeguard would ever do such a thing.

 

I have heard that some hotels will have one of their minimum wage employees pose as a lifeguard, rather than pay for a fully trained and qualified lifeguard.

[resqman]

The only ID needed is a statement I have first aid training.  Most EMTs are Certified, not licensed.  Semantics, I understand but it it is a legal difference.   I have been a certified EMT in two states, taken an EMT training course three times.  Let my certification lapse so had to go thru course again to get certified.  I have certificates that hang on the wall but don't remember ever having a wallet card.  

 

Just like in any other field, those with actual knowledge can usually very quickly identify someone who is not knowledgeable.  Whats to say the bystanders should believe a Scout has adequate training?