March 20, 2009

Bystander Affect/Effect

This is another question sent in by a reader.
I was on my way back to the school, after a student's parents had asked me to lunch and something terrible happened. A woman was hit (hard) by a truck about 50 feet from where we were getting into the car. She had a child (about 2 years old) who she had been carrying who landed maybe 15 or so feet away from her. I was appalled, as I have never seen anything like that. A bystander went and picked up the child.

I seriously doubt there is much I could have done to helped, but of course it tortures me that she picked up the child. I feel like maybe if I had gone into the road to help I might have been able to stop her. I kept thinking of what I would have done ("help call 911" and realizing that wouldn't work at all, and I don't even know the number).

I thought... I remember stuff from first aid and the army. I could have checked for a head wound, with my hands first then checked for breathing, then... wait. I realized if I had done anything, and my hands come back with blood on them, that creates a whole new problem. I am not a medical professional, and I'm not even in my own country. I don't have gloves, or one of those safety masks for giving CPR. I've heard lots of horror stories about getting tested, and re-tested for HIV because of touching someone else's blood as a teacher.

How do you (as a soon to be professional, and yet not an EMT yourself) reconcile the two, the safety of the individual, and potentially comprising your own health by doing so.

I've got good friends here who made me immediately snap out of any bad feelings that I had after seeing that, but I am curious about what you think would be an appropriate response by someone like me (with a little relevant medical knowledge)... or what you would do if faced with a similar situation outside of the hospital.
There's a few levels I can address this. The legal one is the most clear, since it has been spelled out in the Good Samaritan law: bystanders are protected from liability in acting to help someone else when it is "in good faith and in accordance with their level of training."

The level of training is important for a health professional like myself... because if I were to rush over and pick up the child, I might be at risk for a lawsuit if the kid had a broken neck and I just paralyzed him or worse. We'll ignore the issues of compensation and volunteerism or I'll just get sidetracked.

So an accident just happened. It's something that's unexpected and you were in shock. That's totally natural! I dread the day when everyone looks to me when a crisis is happening and I don't know what to do. (I'm hoping that I'll be ready and able!) Your situation is complicated by a cultural and language barrier. I imagine knowing the phone number for an emergency "911" call should be the first number you learn when you go to a new country (or at least know where to look, i.e. travel book) to be prepared. Disclosure: I went to Spain and Japan and I even visited a bunch of hospitals in Japan and I don't recall how to call "911" offhand.

Regarding the blood exposure... it's not that bad to get tested for HIV, but turning HIV(+) after helping someone in an accident... that would be a major bummer. Universal precautions are nice, but not everyone has a set of gloves and a bag-mask in the trunk of their car. Don't worry about that. There are other measures you can do like towels and shirts that can limit exposure risks too. There's a lot of prophylactic drugs you can take as long as you request testing of the victim and yourself in a timely manner. If someone is bleeding and you are worried about getting blood on your hands... well, there'll just be more blood the longer you worry about it. There's a few things to do BEFORE rushing over and stopping the bleeding though.

The ABCDE of trauma should be a starting point for figuring out what to do. I've talked about it before in my trauma call post.

I think it's good that you are thinking about what you could have done in this situation. If it ever comes up again, maybe you'll be better prepared to take action.

1 comment:

  1. Good advice. Thanks for the reminder on the trauma post.