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  1. #1
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    Default Stopping to help at MVC - PPE or not?

    I first implore those who choose to respond to this thread to not let it become a flame war.

    I have a hypothetical situation - yes, it really is hypothetical and has not yet happened to me.

    In the past five to ten years there has been a dramatic increase in the push for personal safety and protection. Among other things, for full PPE at all MVCs.

    So here is the hypothetical situation. What would you do?

    You are a fully-qualified FF/EMT. Under your local protocals you carry your PPE in your POV. You are not in your department's coverage area.

    You happen upon a traffic collision with apparent injuries. There are are no authorities on scene yet, it just happened.

    You automatically and habitually (I hope) do a scene size up from your vehicle. You determine that the scene is safe enough that you would enter it if you were on duty and pulling up in a big red truck. There are minimal or no serious risks of intrusion into the scene by other vehicles. So, as most of us would probably do (even if conditions were not ideal), you decide to pull over and render assistance.

    Now, you *know* that at any MVC you should wear full PPE. You have it with you. The reasons for wearing it have not changed just because you are out of district.

    If you don't wear it, you risk injury. If you do wear it, you probably come off as a call-jumping whacker, might pre-empt calls to 911 (a guy seems to be on the scene, you see), or maybe even prompt another fire officer or LEO to poke you with impersonation charges.

    So, do you drive away even though you are fully qualified and capable of giving help that is needed?

    Do you stop but skip the PPE to avoid confusion and bruising egos?

    Do you stop and wear it all, because you haven't the conscience to ignore the victims, yet your personal safety is important to you?

    Heck, if *I* were to drive up in my BRT and see some dude in turnouts at my call, I don't know what I would think about it myself..... and to answer the question for myself, so far when this has crossed my path I don at least my coat, sometimes my helmet. Makes me a candidate for firefighterclosecalls.com's gallery.

    And again, this scenario is a traffic accident where one guy can render reasonable realistic assistance alone. Donning your PPE at someone else's fire is an altogether different topic and not intended to be a part of this discussion.
    Last edited by ElectricHoser; 03-27-2007 at 12:17 PM.
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  2. #2
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    Quote Originally Posted by ElectricHoser View Post
    I first implore those who choose to respond to this thread to not let it become a flame war.

    I have a hypothetical situation - yes, it really is hypothetical and has not yet happened to me.

    In the past five to ten years there has been a dramatic increase in the push for personal safety and protection. Among other things, for full PPE at all MVCs.

    So here is the hypothetical situation. What would you do?

    You are a fully-qualified FF/EMT. Under your local protocals you carry your PPE in your POV. You are not in your department's coverage area.

    You happen upon a traffic collision with apparent injuries. There are are no authorities on scene yet, it just happened.

    You automatically and habitually (I hope) do a scene size up from your vehicle. You determine that the scene is safe enough that you would enter it if you were on duty and pulling up in a big red truck. There are minimal or no serious risks of intrusion into the scene by other vehicles. So, as most of us would probably do (even if conditions were not ideal), you decide to pull over and render assistance.

    Now, you *know* that at any MVC you should wear full PPE. You have it with you. The reasons for wearing it have not changed just because you are out of district.

    If you don't wear it, you risk injury. If you do wear it, you probably come off as a call-jumping whacker, might pre-empt calls to 911 (a guy seems to be on the scene, you see), or maybe even prompt another fire officer or LEO to poke you with impersonation charges.

    So, do you drive away even though you are fully qualified and capable of giving help that is needed?

    Do you stop but skip the PPE to avoid confusion and bruising egos?

    Do you stop and wear it all, because you haven't the conscience to ignore the victims, yet your personal safety is important to you?

    Heck, if *I* were to drive up in my BRT and see some dude in turnouts at my call, I don't know what I would think about it myself..... and to answer the question for myself, so far when this has crossed my path I don at least my coat, sometimes my helmet. Makes me a candidate for firefighterclosecalls.com's gallery.

    And again, this scenario is a traffic accident where one guy can render reasonable realistic assistance alone. Donning your PPE at someone else's fire is an altogether different topic and not intended to be a part of this discussion.
    If you felt the PPE was unnecessary the ngo without it. At this point being in another district you are simply Joe Citizen. I would at least put on gloves if I was helping any victims.

  3. #3
    Forum Member DeputyChiefGonzo's Avatar
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    In my 26+ years on "da job" I have come across a few MVA's, MVC's, RTA's and such.

    First things first: do a quick size up.

    Second: notify the apropriate agency, identify yourself, and give the dispatcher the pertinent information.

    Third: leave the gear in the car, just take gloves and a brain bucket if necessary for head protection.

    Being in full gear with no truck or equipment rates a 10 on the whacker scale.

    Fourth: if safe to do so, start a quick triage of the victims and treatment within the scope of your EMS training. If there is a small fire and it can be knocked down with an extinguisher and you happen to have one, use it, then triage the victims. If you carry a first aid kit, you can use it.

    Fifth: when the FD/PD/EMS responders get there... back away quietly and let them work. Once the victims are extricated and on their way to a medical facility then give the responding agencies the information you have.
    ‎"The education of a firefighter and the continued education of a firefighter is what makes "real" firefighters. Continuous skill development is the core of progressive firefighting. We learn by doing and doing it again and again, both on the training ground and the fireground."
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    Forum Member KEEPBACK200FEET's Avatar
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    Full PPE. The threat to life safety is still the same regardless of whether or not your it's your call. I can let the guys who pull up on the big red truck handle it when they get there, but until then, I'll be suited up.
    Just know, I chose my own fate. I drove by the fork in the road and went straight.

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    Well, I think it depends greatly on the nature of the car accident. how bad are the injuries?

    Reguardless, i feel that it is your/our duty to help people. On duty or off, in district or not, if someone is injured, I would try to help them to the best of my ability.

    About a month ago, we had multiple rollovers on a snowy/icy night. When we go to the scene of one of them, the lady was in her car sitting (truck landed on its side, but was picked up by some kids (lady was already out) ) and there was a guy from a neighboring department who as talking to her and doing vitals. We got there and thought it was great. He had already collected her name, vitals, witnesses names. The lady didn't appear to be in serious condition but due to the MOI we backboarded her, and transported her anyway. (see my "Thread on backbaording on Rollover")


    anyway, my point is, it was very nice to have the off duty FF/paramedic there and already help out. He didn't have any gear on (im assuming he didn't have any) but it didn't bother us either way. It was a nice help.

    Either way, I would stop, ad do what I could until transfer of care.
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  6. #6
    MembersZone Subscriber dmleblanc's Avatar
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    I wouldn't think that PPE would be necessary under these circumstances. No, I would NOT turn around and leave (although I think under the circumstances you describe there is no legal obligation to render aid, although you may feel a moral obligation; you are not on duty and it is not your area....that's just me).

    Let's consider, for a minute, not just "We're supposed to wear PPE", but think logically about the reasons for wearing PPE:

    1. Fire hazard. OK, that's a possibility, but can we acknowledge that it's a very remote possibility? I've been to hundreds upon hundreds of MVA's...overturned, head-on, single, multiple, you name it. I can recall only one that caught fire, despite what you see in the movies. And if it is going to burn, it's probably already burning when you arrive. So I'd consider that extremely unlikely to happen.

    2. Extrication. You're not going to be doing extrication, right? Only checking on the patients, doing some triage, treating the most obvious life threats until the troops arrive. So you won't be breaking glass, cutting or spreading metal, etc. Yes, there may already be some broken glass and torn metal about, but again not likely to cause you great harm. The private ambulance company we respond with goes into wrecked cars all the time for patient care and they don't use any gear at all.

    3. Visibility (Reflective trim). You already stated that the location of the accident is such that vehicle intrusion into the area is unlikely, so that's already been answered.

    4. Protection from biohazards/body fluids. A legitimate concern. Put on some gloves. Again, you probably won't be moving patients from the vehicle, only treating them in place, so you're far less likely to be exposed than if you were having to lift, drag, or otherwise physically move them.

    5. Identification. OK, you may have to introduce yourself as an EMT. Big deal.

    In short, if you're responding with your fire department, you may be required to perform extrication or be very close to ongoing extrication. That's a good reason for turnout gear, but before the FD arrives and all that begins, you should be fairly safe initiating patient care, in my opinion.
    Chief Dwayne LeBlanc
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  7. #7
    MembersZone Subscriber MalahatTwo7's Avatar
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    I'm one of those who has a full set of spare gear in the trunk. As for wearing it, depends on the situation. I've run across a couple MVC's now, and have only taken my jacket out of the bag once. Mostly because it was winter, pertty dang cold, and starting to get dark. My dark blue winter coat was great weather protection but not much in the way of being visable. The other times, I've taken and worn a reflective vest - same as I would to pretty much any dept response event. Makes good safe sense there.

    I always carry a small FA kit - nothing special just enough to plug any significant holes if needed. And a mid range FE. Only had to use that once, and it was for my own engine fire. {didnt even bother to dismount the PPE for that one. Although a mask would have been nice, after some guy from the nearby apartment block shot the engine compartment with a frigg'n water can from about 15 feet away!}

    After that, just hang around and tell the boys you story, then quietly slip away and let them get on with it.
    If you don't do it RIGHT today, when will you have time to do it over? (Hall of Fame basketball player/coach John Wooden)

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    Get it up. Get it on. Get it done!

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  8. #8
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    When I was younger, we stopped at more accidents than I can count on our travels. One time we were hundreds of miles away from home and the dept was kinda redneck and just got their first set of hydraulic tools and had not had any training in their use. So, they gave my Dad a set of gear and the IC told his guys that whatever my Dad said went. But at all the other MVA's we stopped at my Dad never had PPE with him, just a reflective vest.

    As far as me personally, I have only been in this situation once by myself. It was a t-bone collision at the intersection for the expressway on/off ramps and a busy state route. The accident happened just as we were getting off the highway. As we came around the ramp we saw the accident. The one vehicle had moderate damage on the drivers side, but when we got there she was out of her car and didnt look too bad. The other car however looked pretty bad and I expected to have my hands full. I pulled up, let my brother (who is also an explorer) call 911 etc, then I ran around to the back of my car to put my gear on. I had my shoes off and my feet almost in my boots when out of nowhere a guy comes and yanks a woman from the worse car. At this point, she looked real bad, so I did something that I now in retrospect should not have done and will never do again, which is say "screw the gear" and grabbed my first aid kit and set to work. Of course I had BSI on, etc, but in hindsight, the gear would have afforded me visibility (its a pretty busy intersection), protection from fluids from the cars and bodily fluids, and would have identified me to responding crews. The accident happened in a neighboring jursidiction. When the chief and crews got on scene, I introduced myself, gave them the pt. assessments, vitals, etc and then they asked me to help out. So I was incharge of backboarding the one pt. that had been taken out of the vehicle. So I took up c-spine and a few of their FF/EMTs came over and we got her backboarded and into the ambulance. (she actually was in pretty bad shape) Then the chief came up, thanked my brother and me for all of our help and then we were on our way. Got a bit of a hassle from a PO as we were trying to leave, but once he realized that we had been helping he apologized.

    I've handled plenty of medical emergencies, but this was my first real experience I guess you could say with a trauma emergency (beyond your cuts, scrapes, etc), but I think in the future, the only thing that I would do differently would be to wear my gear.
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    These opinions are mine and do not reflect the opinions of any organizations I am affiliated with.
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  9. #9
    Forum Member DeputyMarshal's Avatar
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    Quote Originally Posted by KEEPBACK200FEET View Post
    Full PPE. The threat to life safety is still the same regardless of whether or not your it's your call.
    Okay. Here we go.

    "Full PPE" Good theory but let me suggest that PPE =/= "Structural Firefighting Gear." Full PPE really means, "Full PPE appropriate to the hazard."

    I think we in the fire service tend to suffer from the syndrome best summarized by this old saying:

    "If the only tool you have is a hammer,
    everything starts to look like a nail."

    We know that there are things out there we have to protect ourselves from. One of the ways we protect ourselves is PPE. Since most fire departments tend to issue only one flavor of PPE -- bunker gear -- we (sometimes mistakenly) assume that one size fits all and insist on using it for everything.

    Does every MVC warrant wearing bunker gear? Probably not. Let's be honest; most probably don't really require nearly that much overkill. I might even suggest that bunker gear is sometimes outright inappropriate. Do you really want to contaminate or tear a set of expensive bunker gear when something as simple as cheap, durable coveralls and exam gloves under work gloves might be all the protection you really need?

    Let's face it: The reason so many are taught that they must wear their bunker gear for every hazard is that (a) it's the only PPE they've been issued and (b) it's easier to issue a blanket rule than to expect people to make appropriate PPE choices on their own. Break the mold -- make a choice.

    Choose and use the proper PPE for the hazards of the job at hand.
    "Nemo Plus Voluptatis Quam Nos Habant"

    The Code is more what you'd call "guidelines" than actual rules.

  10. #10
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    Posted by DeputyMarshal

    Choose and use the proper PPE for the hazards of the job at hand.
    Roh roh rhaggy...
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    If I happen upon a crash outside of my jurisdiction, I generally assume the role of "well-informed civilian." I'll size-up the scene (in detail) and the victims (as best I can), call 911, render aid to victims if there is an immediate life-threatening condition I'm qualified to deal with (which isn't much, since I'm not an EMT and have no desire to be one), and maybe get on the radio and converse with an officer of the appropriate jurisdiction to give detailed information (if they ask me to do so). None of this entails doing much more than any other bystander, so I don't gear up to do it.

    Although this has never happened to me, I suppose I would gear up and try to knock the fire down if I had a fire on my hands, if there were no apparatus on scene or closeby, if I could get ahold of a suitable extinguisher, and if the fire was actually threatening someone's safety (I'm not dashing in ill-equipped to extinguish a car that's just sitting out in the open and burning, with no danger to anyone who has the sense to stay back)...but that's a lot of "ifs" coming into play.

    When the responding units get on location, I certainly would gear up and help them out if they requested it, but that has only happened twice that I can remember in my 20 or so years of doing this. Usually, I'll just check in with the OIC and CIC to make sure they don't need any info from me, and go on about my business.

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    If the job's worth doing, it's worth doing right, and that means full ppe. Size up the scene in your civies first, and if there is any need for immediate intervention,( i.e. vehicle stabilization, c-spine control, or other life threatening/environmental hazards), then throw on your gear. If anything else, the arriving crews will realize they are dealing with one of their own, so to speak, and won't be critical for the assistance you rendered,that is providing you didn't act in a negligent manner. The good samaritan act may protect you if something goes awry, unless of course you were intoxicated at the time. Be sure to carry a pocket mask,airway,and latex gloves in your vehicle, in case you encounter an incident involving a full arrest, while off duty. Finally, if you determine that your assistance is necessary and you must stop, be sure to leave lots of room for the responding equipment to spot their rigs. Remember, sometimes less, is more.

  13. #13
    Forum Member DeputyMarshal's Avatar
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    Quote Originally Posted by polecat View Post
    If the job's worth doing, it's worth doing right, and that means full ppe.
    Doing the job right means the right PPE.

    Quote Originally Posted by polecat View Post
    Remember, sometimes less, is more.
    Precisely.
    "Nemo Plus Voluptatis Quam Nos Habant"

    The Code is more what you'd call "guidelines" than actual rules.

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    The responses are affirming my conclusion that there is no right answer.

    You can choose to risk having someone break your balls for violating their brand and flavor of safety standards (might be the OIC or your own officer if word gets back that you wandered in without PPE), or risk having someone break your balls for being a whacker even though you acted in a completely professional manner and desire to remain alive.

    Whether or not PPE is required is clearly not always black and white, but the responses in the field to what you are or are not wearing are rarely tinted with any shades of gray at all. I lean towards better safe than sorry, but I also understand opposing views and can argue either side. And as I said in the past, when I have been in this situation I tend to under-dress for the occasion.

    Makes the "keep driving" option seem a little more tempting, but even so not many of us could do that.

    Oh well. Good discussion, though. Thanks for the thoughts so far.
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    I dont have the option to just drive by. the Texas ems bylaws require all ems certified personnel to stop and render aid up to the level you are certified for in the state. I also do not carry PPE in my vehicle but do however carry an EMS jump bag with OPA's, bvm, BP cuff, stethoscope, trauma dressings, flashlight, cpr mask, etc.. (for my side job as an on field emt for sporting events at the local fields)
    But all i would be able to do is maintain cspine and take vitals and pass off care when the brothers show up. Unless the victim is in an IDLH situation i would NOT remove them from the vehicle.

    as far as the level of PPE, id rather wear my bunkers then nothing if i didnt have extrication gear. Better to ruin the gear then me, know what i mean.

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    Forum Member HeavyRescueTech's Avatar
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    depends on a lot of things. 1) is it a MVC with entrapment? 2) how involved in the scene do you plan on getting? 3) what type of road are you on?

    In general, for a simple fender bender on a local road, I agree that only gloves are need. maybe a coat if visibility is poor.

    if you are are a busy expressway/interstate, I would say coat and gloves.

    for a major crash, with entrapment, full PPE would be appropriate if you plan on holding stabilization while the local FD is cutting (been there, done that).

    but the most important thing, if there is no other emergency responder at the crash already, call 911 and report what you have (where you are, number of vehicles involved, and if there are injuries or not, (pin job, fire, hazmat, any unusual stuff) that's all the 911 dispatcher really cares about. even if you think others have already called, better to have 2 people call in the same accident than both people think the other person called it in.
    If my basic HazMat training has taught me nothing else, it's that if you see a glowing green monkey running away from something, follow that monkey!

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    A couple years ago in my area there was an accident on a stretch of rural interstate. The State Director of EMS was the first person on scene. The only injury was the driver, there was no danger of fire. The MOI was such that EMS would take C-spine precautions and the driver was complaining of head and neck pain. The Director got in the back seat and provide manual immobilization of the C-spine.

    A few minutes later, State Trooper and BLS ambulance arrived. The EMT ordered the "interfering bystander" out of the back seat. The Director tried to explain that he was holding C-spine and would be happy to get out of the way as soon as someone took over from him. The EMT was not happy how the exchange was going and asked the State Trooper to arrest the interferring bystander. At this point the Director said, "My name is _____, I am the State Director of EMS, I am holding manual C-spine until someone takes over from me, and I will get out of your way." The state trooper realized that maybe he was about to do something wrong. One of the EMT's finally agreed to take C-spine and the director got out of the vehicle and went back to his own car.

    The next day, he initiated an investigation into that ambulance service. It resulted in the service's license being suspended for 6 months. They were only allowed to go on calls with an outside observer present to monitor. Both EMT's lost their licenses.

    Moral of the Story - If you show up on scene in your BRT and a bystander is helping - make sure they aren't doing something essential before you kick them off the scene.

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    Forum Member ndvfdff33's Avatar
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    I always stop. Never know when someones life might just depend on it
    If someone with multiple personalities threatens to kill himself, is it considered a hostage situation?

    Ryan

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    Forum Member Weruj1's Avatar
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    time for some devils advocasy..............if you have NO gear /PPE do you stop ?
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    Quote Originally Posted by Weruj1 View Post
    time for some devils advocasy..............if you have NO gear /PPE do you stop ?
    Yes, not only because im required to, but because it would be immoral to just to drive past without at least insuring help is on the way.
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