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EMS, Letter in the File, Patient Care

A Letter in the File – “Bystanders”

For you new people, it’s been awhile since I’ve fired up the typewriter here at HMHQ to issue a formal reprimand, but this really got under my skin.


I was out as the supervisor when dispatched to a reported fainting on the sidewalk.  We get these calls all the time from out of town visitors not used to seeing the homeless sleeping off a bottle of $5 vodka in a puddle of their own urine.  I guess wherever they come from that’s abnormal.  This is not the reason for your letter.

Still lights and sirens because you never really know, I realize I am the only unit responding since there is a second alarm fire a few blocks away and all the local engines are at it.  Dispatch advises they are “out of medics” and will send one when it is available.  They call it “medic to follow.”  This is not the reason for your letter.

On scene there is a large line on the sidewalk for a concert at a venue a block away.  It appears a teen sensation is performing tonight (it’s only 1pm) and the line is already easily 10,000 deep.  Hidden within this throng of people both young and not so is a hand waving for my attention.  The crowd seems unwilling to part from their place in the 10 person wide line that wraps around the sidewalk and I have to literally push people aside.  This is not the reason for your letter.

A security guard from a block away sees my little buggy (that’s what we call our Chief and Captain cars) nearby and comes to help.  He removes the large gate the police have set up so that I can more easily access my patient, an elderly man who is unconscious in the arms of his maybe 14 year old grandson.  Of the HUNDREDS of able bodied men nearby, none step forward as, with ALS bag, O2 and Zoll M Series, I grab my patient (breathing with pulses) and carry him into a shady area out of the 90 plus degree heat about 40 feet away.  This is not the reason for your letter.

After my primary and secondary survey and the removal of some heavy clothing my patient is opening his eyes and talking about how hot it is.  A bit of cool water on a towel to the back of the neck and a 250cc bolus has him cracking jokes about the young pop star performing this evening.  As the ambulance arrives and takes a report I have a chance to stand up and take a better look around.  No one is looking at what is happening just outside the line to the show of the year.  This is not the reason for your letter.

Then you speak up.


You and your “girlfriend” sitting in the cafe not 10 feet from me the entire time.  Watching me call for an ambulance, check for pulses, apply the NRB, the monitor, start the line, have the crying 14 year old hold the bag so I could help his grand father…you.

Close to 12 minutes you watched this man in distress, the grandson too, not to mention a lone paramedic who could use one more set of hands…any hands.

You are an “Off duty paramedic” and she’s an “ER nurse” and NOW you ask if I need a hand?

A letter in the file for both of you.  Not for leaving me to help my patient alone, but for not coming over and offering your assistance to HIM or his grandson.  I was fine, but the kid needed someone to take the bag, hold his hand, anything, but you sat there within earshot the entire time, then jump in when the ambulance arrived?

If it was up to me you’d both be getting days off, but since you were both “off duty” and “drinking” I guess it was too far out of the question to help out doing something other than patient care.  Next time, just blend in with the crowd.

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  1. PSilva July 25, 2011 2:57 pm

    Further proof that the old adage “Better to remain silent and thought a fool than to speak out and remove all doubt” still applies.  If you wanted to give “a hand” why didn’t you when it mattered and likewise, if you wanted to just sit and chill, why didn’t you do just that.  Just managed to show how their level of  “jackwagoness”.

  2. Eako5150 July 25, 2011 3:13 pm

    Unacceptable. Not too long ago while dining, I as a police officer, and my girlfriend, as a RN watched a gentleman have a med emerg and fall out at the table next to us. As if without thinking both of our trainings kicked in and we worked ariund each other to tend to him…and I eyeballing the gathered crowd, until ems showed up. It was automatic. For them to ignore a moral duty like that (with training) is intentional..and just plain douchey.

  3. TwoWheelMedic July 25, 2011 3:14 pm

    Here’s hoping this goes further for those two. Even offering basic first aid advice or a pair of hands would have been something, and they would have been free of liability. 

  4. KrisFFEMT July 25, 2011 9:03 am

    This should be the Wake Up Call to them to find another profession. Obviously, their caring days are over. May the shoe never be on THEIR FOOT!

  5. KM_FF/EMT July 25, 2011 4:05 pm

    This should be their wake-up call to find other professions.  Obviously, they’ve lost their caring abilities.  Hope the shoe is not ever on the other foot for their sakes.   

  6. Lynda July 25, 2011 8:47 pm

    Karma will act in her own time; people almost always get that to which they are entitled.

  7. SKC Observer July 25, 2011 9:36 pm

    What was in their heads?  Not knowing what to do?  Fearful of consequences?  Lazy?  Not compassionate?  Too busy?  At the very least, they could hold your IV bag and the hand of the 14 year old–guess they just were afraid, or couldn’t be bothered.  Sad.

  8. Thaddeus Setla July 26, 2011 6:23 am

    I have always felt you should teach off duty expectations in school early. Instill this in people early. It doesn’t come natural unfortunately

  9. Mike "FossilMedic" Ward July 26, 2011 11:03 pm

    I spent a summer as a seasonal EMT in a beachfront resort town that was full of vacationing off-duty public safety providers. No problem if they did not get involved.

    On the other hand, never had so many “experts” on the scene. Always provided running commentary, yet rarely did they step up before or after we arrived.  Letters for all of them!

    However, there was this obsessed girl who claimed to be a trauma center nurse … kept showing up on calls …

    • Dina Scharnhorst July 28, 2011 1:04 am

      Sounds almost like my past week, working at a large convention.  Most of the time it was bumps, bruises and heat exhaustion, all easily and quickly handled.  But when one of the conventioneers starts handing out medical advice and I find out he’s a Veterinarian…

  10. Dina Scharnhorst July 28, 2011 12:58 am

    Unethical and inexcusable. Does this mean that when I’m “off duty” I don’t have a duty to act?

    • the Happy Medic July 28, 2011 4:19 pm

      Duty to act when off duty? Actually, technically, you don’t.  Lending aide to a person is not outside of anyone’s scope.  as mentioned above, when off duty we can only act at almost below the BLS level.  Without our gear, what can we really do?  I encountered a situation on an airplane where a woman was faint and I debated whether or not to step in.  When I realized all I would do was what the crew was already doing, I stayed put.
      Our job is to use our brains to make sure the folks with the tools are coming and gather information for them.  Not to intervene, offer advice or treat, but to hold hands, comfort, maybe a basic splint etc and gather information until the folks with the authority to intervene medically arrive.

      Thanks for reading!

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