EMTs deny ignoring dying pregnant woman

Story here: http://www.msnbc.msn.com/id/34588001/ns/us_news-life/

I saw it on the news yesterday, and it seemed pretty cut and dried that these EMT’s were uncaring a-holes.
But, then their lawyer said they were dispatchers.
But, it seems that dispatchers are trained EMT’s; not just phone answerers.
But, they didn’t have any equipment with them, and the proper protocol would have been to call 911.
But, they could have checked on her and maybe stabilized her.

So, what’s the opinion of trained EMT’s (and others with an opinion.)?

[I didn’t see a thread on the front page about this, and it’s a relatively new story.]

I’ve heard stories of severely ill people lying right in front of hospitals, but yet due to some rules or regulations doctors, nurses, and other other hospital staff weren’t allowed to drag them into the hospital, so sadly this doesn’t surprise me much if the EMTs could have done more but didn’t.

The fact that dispatchers are required to receive EMT training and certification does not, to my way of thinking, make them EMTs. I used to have the same certificate (from California), and that 10 hours of field experience (during which you might very well see nothing at all) is a mighty slim reed. If I were presented with a pregnant woman in respiratory distress, and all I had with me was a dispatcher with the same level of training and no additional field experience, I’d be at a loss. I mean, not even a stethoscope! I think it’s reasonable to avoid taking responsibility for such a scene when you think you’re in over your head. I admit, though, that I don’t know anything about New York’s EMS, and it may be that they had a legally defined duty that I don’t know about. If that’s the case, though, I think the EMS has a duty to rotate out dispatchers to the field from time to time, or else drop the EMT requirement.

I started reading the article, and immediately had formed an opinion. Then I read my opinion:

Boom. Winner.

But then:

Duty to act, and all.

Speaking as an EMT and a dispatcher, I hate to hear that, since they’re in a cube instead of a truck, they wouldn’t know what to do. Part of dispatching is having at least the knowledge of how to deal with an emergency. Dispatching is not simply telling a truck to go somewhere; dispatching is in many instances the first point of assistance. We should be able to talk someone through, as examples, CPR and birthing.

Look, I’d like to say that these guys were jerks for semi-ignoring the woman. But I also think that in their situation, I might have called 911, waited for them to show up, and left the place also. When you don’t have the necessary tools, sometimes, there’s very little you can do!

This bears repeating. The EMT-B training is a very basic level of training indeed; for most EMT’s their medical knowledge comes from the experience of dealing with medical emergencies, not the classwork. Two classroom trained EMT’s without clinical experience aren’t going to do much to alter the course of a severe asthma attack, particularly without any available equipment.

From the information in the MSNBC article, from a a practical standpoint, in terms of getting this woman help, all they really could have said was, “phone 911!” or perhaps assist the woman in using an albuterol inhaler if she had one on her. Her death is unfortunate, but they did not cause her death nor was there much they could have done to alter the course of her disease with what was actually available to them.

I don’t think the dispatchers / EMTs were necessarily in the wrong. But I do think this incident throws a spotlight on an unfortunate fact of our times.

I’m not usually the guy to complain about our litigious society, and how people will sue at the drop of a hat. But in this case, I think they chose to follow the letter of the law as they understood it in order to stay out of a liability situation. And despite the bad press, they may well have been wise to do so. Without that mindset, however, they might have chosen to do something else.

That bothers me.

Understand, I’m not second-guessing the people in this incident. I wasn’t there, don’t have all the facts, etc. But I’ve seen enough of this attitude to think I’m recognizing it in this situation. Who’s to blame? Everyone. We’ve allowed the law to be structured in such a way that someone has to be blamed for just about everything.

When I took CPR they told us the “Good Samaritan laws” would protect us if we acted correctly within our training. Except then, several lawyers of my acquaintance told me they absolutely would not. That kind of thing causes people to pause instead of act, and that’s bad.

What do we do about? Hell if I know. But it’s still bad.

It would not be possible to render an opinion in this case without all the facts.
In general, calling 911 is the average right thing to do, with trained bystander support of any kind being possibly helpful but probably not all that effective without equipment.

Suppose the young woman had a pulmonary embolus, for example. There isn’t much bystander life support is going to do.

On the liability front, we’ve gotten to where no-one wants to intervene if it’s not protocol. Everyone gets sued regardless of what course of action they take. Good Samaritan laws follow a principle of acting within one’s training, so they almost never really protect. Here’s a California case: http://articles.latimes.com/2008/dec/19/local/me-good-samaritan19

Looking at both ends of the training spectrum, what could a seasoned EMT due differently in this situation and what could a novice do to make things worse?

Knowing nothing of the the job skills the only thing I can think of would be to ask around for anyone with an inhaler to see what’s available at the scene. If someone had an inhaler the EMT’s would be able to coordinate whether or not it was the appropriate medicine to use much like one would use an epi-pen in an emergency.

It doesn’t sound like the EMT’s abandon the woman and would have been able to give CPR if needed. Baring that, I’m not sure what they were to do beyond observing basic conditions such as pallor, symptoms, lucidity, pulse…etc and reporting them to the EMT’s en-route. That seems like a reasonable course of action.

This. I think the real problem is their behavior seemed so callous. If they had called 911, stayed with the woman and explained to the people in the restaurant that they didn’t have the training/equipment to help but that an ambulance was on its way, this wouldn’t be front page news.

There really is not yet sufficient information in this story to have a legitimate debate.

It sounds a bit like a Recreational Outrage Pitting, although it is still fairly polite and actually seeking opinions, so I am moving it to IMHO.

[ /Modding ]

From what the EMTs are saying, people asked for an ambulance for the woman, and they radioed in that request. There doesn’t seem to be an indication that anyone thought there was an emergency at that point.

On the other hand, I can’t imagine a scenario in which professional EMTs wouldn’t check the patient before leaving the scene, though. I’m sure such a scenario is theoretically possible, but at the VERY LEAST they would be able to give the responding ambulance crew a better idea of what they were walking into. When an ambulance gets a call for “someone needs help at XYZ restaraunt” they’re much less effective than if they had a complete briefing by a professional EMT who knows what’s important. Breathing rate, skin condition, level of consciousness, pulse rate, age, and medical history are all extremely important for recognizing and treating patients, and the EMTs could have gotten all of that (and passed it along to the responding crew) without any special equipment.

I recognize that the news article might not be providing the most accurate or complete information, though. I’ll withhold judgment and let the legal system figure out whether they acted incorrectly.

This. I’m not a professional EMT, I’ve only received emergency training in the context of university work and of work at chemical factories. I’ve had to call ambulances twice and both times I was seeing the patient as I called, in order to be able to describe the symptoms as accurately as possible, consult possible courses of action with the dispatcher and later the crew, etc.

If they’d seen her, maybe they wouldn’t have been able to do anything to relieve the respiratory distress, but at least they would have been able to report it properly.

Right. Even with paramedic-level training, there’s really not much that could be done without any equipment. There wasn’t much they could do, but leaving was still the wrong thing to do. One of them could have stayed with the patient and another could have flagged down the ambulance outside and we never would have heard about this, regardless of the outcome.

St. Urho
Paramedic

I recall I had a temp job at Children’s Memorial Hospital in Chicago, which has an Emergency Room and is a trauma center. Some guy came in (a grown man) and he was having a heart attack. Now here you are in a hospital, with an ER, full of doctors that are able to treat heart conditions in kids, what happens…

They called 911 and the ambulance came, picked him up and took him down the street to Lincoln Park Hospital. They didn’t make any attempt to help at all.

I guess that is just the way things go.

From their website.

It might also be that as they are a children’s hospital, they don’t have certification(or whatever) to treat adults. (WAG)

I just want to clarify that I was not intending this to be anything resembling a pitting, and am absolutely seeking (educated, or otherwise) opinions.
I was surprised that there was not already a thread on it (in GD…maybe there was in IMHO), and wanted opinions that didn’t come from a news report that likely was more interested in a shocking story than in fair reporting.

This is sounding to me like the dispatchers on lunch break were faced with a “damned if you do, damned if you don’t” situation, and they chose the one their union will support (don’t get involved past the level of your training). I’d be very interested to see if this type of situation will result in further clarification of what dispatchers can be expected to do, out in the public.

What is very suspicious to me is being suspended WITHOUT pay. If there is any question if you acted 100% incorrectly in a situation, it is always with pay so you don’t get sued later.

Ex-EMT here.

In my area, you have to work for a year in the feild before applying to be a dispatcher.

I generally operate under the assumption that most EMS types help because its part of who they are, not just what they do for a living. Some people do sign up for the guts, glory, and semi-superhero status. These guys should have at least gone through the basic BLS ritual, (identify problem, try to make patient comfortable, begin rosary praying for ALS to arrive). Activating the system is the first step, just doing some good observation before on duty crews arrived could have helped better direct them to the specifics of her problems.

One other thing I am loathe to bring up, but is medical reality. The articles make a big deal out of that she is pregnant. IF you have a patient in severe respiratory distress, the fact that she is pregnant is WAAAY down the list of “stuff to worry about TM” You only have one patient until she delivers.

What’s protocol in something like this? No autopsy because there was not evidence of foul play–and if you want to know exactly why, then you have to pony up the money yourself? Aside from the situation with the dispatchers, it would seem that someone would have wanted to know just what her problem was before they buried her.