An accident occurred behind me in traffic today, 18 wheeler vs car, luckily just a glancing blow to the front quarter panel. 


I called the accident in to dispatch and began assessing the patient to the best of my ability, Concious (Although I believe she may have just regained concious after a brief time when I reached her vehicle) confused (Where am I, what happened) but speaking very clearly.  no visible head injuries, no complaints of head pain, a complaint of shoulder pain, a notch/dent that looked to me like a possible broken collar bone and no other visible injuries.  The vehicle was stable, sitting in the grass off the road and no visible fluid leaks or other immediate concerns.  The patient also appeared pretty stable and was trying to exit the vehicle.  I asked her if should would please just stay seated for now until the medics arrived to check her out and she agreed.  A bystander had run up at the same time as I did and was standing nearby during this. 

 

I asked him to just stand there and if there was any change in her alertness or how she looked let me know right away and I headed over to check on the truck driver who I had yet to see emerge from the truck.  I got 15 feet from the car and looked back to see that the bystander had pulled the patient from the car, was supporting her by the left arm (Remember the possibly broken collar bone) and nearly dragging her to another vehicle.  I could see in her face that it was excruciating.  He made it to the other vehicle before I could intervene and when I asked what the hell he was doing he said "The air bag started to catch fire"  I tried to explain that some dust or what appears to be smoke is not unusual but he told me the airbag was actually on fire (It wasn't)  I resisted the urge to choke the living crap out of this guy for causing this poor woman this excess pain and potentially doing further damage to her, waited for PD, City fire (I'm with the county department and this one was in city limits) and EMS to arrive, explained to the PD that I had not seen the actual accident and that guy over there is a f'in moron and asked to be released and was on my merry way.


The more I think about it the more I want to go back and punch that guy.

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They do keep life interesting, don't they. We arrived on the scene of a car vs tree many years ago to find an unconscious patient on the ground near the car with a woman standing over her. The woman said she was an RN and proudly described how she dragged the victim out of the car. Later we found out the "nurse" worked in a psychiatric institution.
The most annoying bystander in the world are those ER nurses that are out and about and happen to see something and are on scene when you get there and go into a long "paient care report" and give a list of "interventions" that they performed before you got on scene.

I even had a nurse go as far as calling the ER herself and giveing them a report before we even had the paitent loaaded! Needless to say there were some meetings held over that and it never happend again.
Nurses are the worst at an accident scene and I'm not sure if it's the environment or what (not being in a nice controlled area of a hospital). As soon as a bystander informs me they're a nurse and can they help I kindly ask them to step aside everything is under control. Had an accident just the other day and as a chief I pull up give scene sizeup and start checking on the pt., one of our emt's pull up and starts walking up and I ask him which medic unit was enroute to give them a pt. update. Bystander tells me that she called for a medic, I ignore her and ask my emt which medic unit is enroute and again before my guy can answer the bystander says there is a medic enroute I called for one, I finally looked at the lady and in my "nicest" voice I told her that I was with the fire/ems that 911 dispatches and I'm asking my emt which specific medic unit is coming. She apologized and never said another word.
Haven't had to deal with a nurse since joining FD, but many years ago I had to tell an LPN to STFDown and STFup when my father was having a seizure and she was standing there screaming (literally screaming in panic) instructions at the paramedics. My father was an epileptic for my entire life and I knew the procedure, she was in full panic mode.

Now that I think of it I suppose it could have been worse than the sandwich artist I had to deal with this morning.
I can remeber one instance where are nurese was in a car involved in a MVA holding cspine. My rescue cheif (i was a young buck then) asked her to get out and let one of out emt's take over. She said whe was fine. My chief then asked her where here PPE or BSI was. Next look was a blank stare and the question "What is PPE?" At that point the nurse was "helped" out of the vehicle by a fire fighter.
I think you hit the nail on the head with(not being in a nice controlled area of a hospital). Most nurse's have never been in the controlled chaos of a MVA or a MCI or anything of that matter where the dynamics of the scence or the call can change in a second. I dont know if its just being out of a comfort zone of not being in a hospital or what but something makes them brain dump. However i have seen brand new EMT's shaking so bad on there first major call that they couldnt even open a NRB bag. So I guess it could go both ways. Nurse's on scene still suck!!!!
I've had some decent experiences with nurses. Not all good, but some have been very helpful.

There is definitely a difference between the ER and a scene, I guess these nurses were able to handle that difference.

Always a good idea to ask them their area of work though.

I witnessed a flight nurse who was more calm than the flight doc. Talked him through the whole procedure.

Question for the OP, I'm guessing\hoping your assessment didn't involve physical contact with the patient?
You are correct Mark that my assessment was completely based of visual cues and asking the patient a few questions like Did you hit your head. Are you hurt anywhere etc etc. I am not certified for any kind of patient contact other than CPR/AED, obviously neither of those were necesary here and there was no uncontrolled bleeding or other immediate obvious threat to her life.
Just out of curiosity Mark, what was the reason that you Trust/Hope that my assessment did not involve physical contact? I may have mentioned before that I'm not certified for patient contact in a post. Was that it or did you have another reason?
Did you identify yourself and your experience to this by stander or did they just assume you were another civvy with no more or less experience than them?
Thinking it has to do with the abandonment issue had you made physical contact and left the patient unattended.
Directly to him, no but he was standing right there while I identified myself to her and I was relaying information via radio to the dispatchers.

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