Emergency Care in the Streets: Assessment in Action
By Nancy Caroline
You are in training to become a paramedic. You are not yet certified, but you do run rescue with a local rescue squad as an EMT-B.
You come upon a car crash near your home. No rescue personnel or police are on scene yet. You have your own personal “jump bag” with rescue supplies in your vehicle, including advanced life support supplies you would use as a paramedic. There are two patients, both with significant injuries. They were both unrestrained in the vehicle. One patient is having noticeable trouble breathing.
1. Even though you are not “on duty,” what should you do first in this situation, assuming a bystander has already called for help?
- A. Call 9-1-1.
- B. Put on gloves and any other personal protective equipment you may need.
- C. Call medical control and get permission to treat the patient.
- D. Assess the ABCs.
2. Which of the following are you allowed to do based on the training you already have?
- A. C-spine stabilization, pressure to stop bleeding, talk to victims to calm them and let them know what to expect.
- B. Put a c-collar in place, bandage bleeding wounds, use a Combitube if necessary to help the patient who is having trouble breathing.
- C. Help stop bleeding, and intubate if necessary.
- D. Call medical control and ask for permission to treat patients as necessary, including intubation.
3. If a physician arrives and offers to help, is it appropriate to turn over care to that physician?
- A. Yes, a physician is a higher authority than you are.
- B. Yes, but only if the physician is willing to take responsibility for the patients, including riding with them to the hospital and signing paperwork.
- C. No, you are not authorized to turn over care until an ALS unit arrives.
- D. It is the option of the EMS crew that arrives on scene.
4. When EMS arrives on scene, it is your responsibility to:
- A. Explain quickly and accurately your assessments and any treatment or intervention you have administered.
- B. Help prepare the patient(s) for transport in any way you can under the direction of the paramedic on scene.
- C. Maintain patient care unless the person on scene has the same authority as you or higher.
- D. All of the above
5. Are you legally allowed to perform ANY paramedic treatments in this situation?
- A. Yes.
- B. No
6. Because you are not on duty, is it appropriate to tell the patient “everything will be fine,” or do anything else you would not be allowed to do in uniform while working with your agency?
- A. Yes, you’re not on duty, so those sets of rules do not apply. You are acting as a Good Samaritan.
- B. No, you are a health professional whether on duty or off duty, which means being professional at all times.
Challenging Questions
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