Emergency physician with 35 yrs experience here. Contrary to “what everyone knows” it is very rare to be offered any freebies or compensation when you step in during an in-flight emergency. I got vomited on during one such episode and Delta wouldn’t even let me into the Club Lounge to clean myself up after deplaning. It was gross. No upgrades No free drinks and certainly no free miles.
Try Lufthansa next time, totally different experience. Helping someone on a flight or assisting the crew in any medical case once they call for a doctor definitely won't stay unnoticed!
Good to know...I'm a cardiologist, and I've helped on a plane thrice so far... no Miles, no upgrades no free drink...good to know that I'm not alone here!
My mom is an anesthesiologist or was for more than 40 years and had saved a woman on the plane from choking on some food. Was given nothing in return by the airline and the woman she saved never once thanked her or contacted her after the incident. The daughter of the woman did find and call my mom but only to try and have my mom verify untruths about the airline's food in an attempt to sue the airline. Some people are just ridiculous....
@@acmhfmggru nope, she isn't obliged to help, and she deserves the recognition fro saving that woman's life. Don't be stupid here. Give recognition where it is due.
@@acmhfmggru people with “expensive degrees” are people as capable as everyone that decided to invest more than 10 years in training, sacrificing youth, time, family time and opportunity cost to study a degree that made them able to do what they did. You don’t have to give praise or a thank you to anyone, but it’s very entitled to feel like giving a “thank you” or any kind of praise to someone else that helped you doesn’t matter because they are “wealthy and with expensive degrees”. They are people just like you
Former flight attendant here. I've been in several situations where a physician (or anyone with healthcare knowledge, really) was needed during a flight. Usually, it's not a problem to find someone. The only times we had trouble getting ANYONE to come help was on flights to or from the US, likely because people are so unsure of the legal situation. And we even carried legal papers explaining that there would be no consequences to anyone offering help, even in the case of injury or a fatality of the patient. Coming from Germany, where it is illegal to NOT help, this is just absolutely ridiculous. It makes me sad to think that a qualified person might not offer to help someone experiencing an acute health issue because there's the possible threat of legal action should they fail to save the person. Edited to add the following: "Helping" in this case means at the very least calling emergency services, similar to how another person in the comments described it being in Switzerland. Technically though, one might be required to help more than this. And everyone should be able to do so anyway, as any person with a driver's license acquired in Germany has to have taken a day-long first aid and CPR course and is required by law to carry a fully-stocked, non-expired first aid kit in their car at all times. I really wish the US, or rather its states, would loosen the legal barriers to providing aid in the case of an emergency, and require people with drivers licenses to obtain a minimum qualification in first aid.
Well in CDL schools (at least some in PA) they make you take a CPR course and they get you certified. Anything else after that 🤷♀️. But, it would be nice if the states did the CPR stuff regardless of the type of license. That's useful for multiple reasons.
Yep, I’m a doctor as well and very happy that in our country it’s also mandatory for me to help those in medical need, even if it’s in the streets when I have the day off. I’m actually bound by law to stop other activities. I’m all for that. I didn’t take an oath to please attorneys.
To add another aspect: "Helping" = bare minimum calling an ambulance refers to the general public. A doctor in Germany is by law bound to do more; if they don't endanger themselves of course, and if they're in a condition to help (so not intoxicated etc).
I disagree. No one should be required to take first aid classes and carry a firs aid kit. That all should be by choice only. No damn government forcing more requirements on people...
I was on a flight from Atlanta to Seattle and a flight attendant asked for anyone with medical training. A young man next to me pushed his call button and was asked to go to the back of the plane. He returned moments later complaining that he had never before been required to show his medical license, but retrieved it and rendered aid. It was just someone having a panic attack, but when we were all on the escalator in Seattle going to baggage claim, a couple of guys said "If he's a doctor, what's he doing riding in coach?", so I informed them that he was one of those poorly-paid residents just returning from a medical conference. Sheesh - the expectations of the uninformed public! Not every physician is a multimillionaire with his own plane!! Great video, thanks.
@@gaditproductionssome people overestimate the amount of education and training required for certain specialties, such as psychiatry. Why would you do 8 years of school when you could do 6 instead and make more money right off the bat doing the same thing as a np
@@reddbendd for many people, their work in medicine is a passion which just happens to pay. Np could pay more in some world, but if someone's passion is psychiatry, it's not worth leaving it. And in medicine, many times passion is very personal; ignited from personal tragedy or experience.
As a paramedic of 25 years, I can tell you that, when on an aircraft, if you decide to provide medical care, the airline has physicians on call and available to consult. As a paramedic that works under the license of an MD at home, this allows me to provide much more care than I could legally without that resource. it also takes the liability off an MD, Nurse, or Paramedic on the flight that decides to assist.
Dear Max, you should be proud of what you did! I am not a doctor, I encountered a drowning of a 16-year old this summer - when he was pulled out of the pond by the heroic people who rescued him, he was unconscious, blue in the face and his red eyes were not responsive. I was not a certified lifeguard back then (which I am now), so I called my doctor, put him on loudspeakers and did what he said until the ambulance arrived. Thankfully, the boy is alive and well
@@sciencewithcats2274 when a person’s life is at stake the best you can do is call a specialist and do exactly as he says instead of guessing what to do and probably hurting him more if I did the wrong thing. The boy is alive which is what matters. Doing as the doctor said until the ambulance arrived is what mattered to keep him alive until professionals could take over. Now that I became a certified lifeguard I know exactly what to do in a situation like that. You might want to get certified yourself (the most important skills can be learnt in less than a day) and be more pre for if you ever witness someone drowning
@@TerryReedMiss I’m afraid I don’t think so. He doesn’t have a father. When I found his profile in social media and wrote to him wondering how he was, he just blocked me. But that doesn’t matter, the main thing is he is alive and well. And Irina, the woman who saw he was drowning and was first to leap into the water to save him and raise commotion, as well as the people who followed her, my doctor who was on the line and the ambulance crew are true heroes of that day
Awesome video, thanks! Having a dual MD/JD is amazing. You quite literally picked the most qualified person to help answer this question. Thanks for all the great content too! 25 years ago I narrowed my career choices down to either wanting to be an anesthesiologist or my current career. So now I get my "dose" of anesthesia from watching yours and other anesthesiologist's RUclips videos!
there was a documentary about this dude. he has other degrees as well. it was something like the person who has the most degrees on earth. he is not just any old person.
Different in every state and every country. In Switzerland, the laws says anyone should help someone in need, and try to save the person with all the capabilities and knowledge they have. If you don't stop, even if the only thing you know what to do is call emergency services, you go to jail. At the same time, the good samaritan rule protect the helper.
'I am both an attorney and a physician' 😬 Yep MD/JD is very, very impressive! Informative video, thanks Max! In France, we can be prosecuted for non assistance to a person who is in danger. Ugh. It's complicated.
Former EMT, now long time ED/trauma PA putting in my two cents: if you want to carry any supplies in your vehicle, I recommend keeping it fairly simple. Especially if you're traveling in most of the country where EMS response times are decent. Mine has mostly first aid level- dressings, wraps, Sam splints, ice packs, tourniquets, OPAs, trauma shears, etc. I do have a spring-loaded center punch to break car windows, lots of gloves, Purell wipes, and camping type headlight. A yellow reflective vest is right on top. The only advanced item is decompression needle and chest seal. You might want z-fold gauze and multiple tourniquets if you want to be ready for a shooting situation. For me, I consider that the car gets hot, so lots of things don't last long. Other things expire in a way that matters. I can't afford to replace expensive clotting products, for example, but would probably keep those if I could.
Can you recommend minimalist items to carry for someone who is not an EMT? For example I don't carry ice packs or splints because they are for non life threatening injuries and I would rather an EMT deal with it when they get there and do a much better job. But I do carry a tourniquet.
@@noodlesthe1st Combat medic here, minimalstic would be: -Gloves, -Tourniquet, -Gauze, -Elastic dressing for pressure bandage, -Emergency blanket -Maybe a heatpack. This allows you to stop or at least slow massive hemmorhages and prolong the survival of the patient until professionals arrive. The emergency blanket and heatpack can absolutely save a life. If the body loses too much heat, coagulation stops. So don't forget to pack them with you.
@@con5577 I'd like to ask your advice on this matter. I'm carrying some kind of emergency pack in my backpack. There is not only medical stuff, but also stuff like charging cables, duct tape, multitool, wipes, etc., In terms of equimpent I have 4 our 5 things you mentioned, and I'd like to ask your opition on drugs. I got antiseptic, ibuprofen, antacid, nitro, sorbents, antihistamine, dexpanthenol, adrenalin, insulin and prednisolone. Is there anything else you think should be there? I'm not the US, and I have basic emergency medicine trainig, if that matters
I don't know if it was omitted or not carried, but the first thing on my list would be a BP kit then probably a pulse-ox. Unless you're in an area likely to have life threatening injuries, I'd put assessing their condition as high priority. Would you really give that nitro without knowing their BP?
Out of the "3 dos" mentioned, telling someone directly to call for emergency services is easily the most important. So often people will just assume that someone else has done it already, potentially causing a life threatening delay in getting that patient getting to the care they need
A similar problem: you see an emergency happening in the distance, do you call it in, or has it already been done? A rail fan, here on RUclips, spotted a fire, off in the distance, somewhere most people tend to ignore, in this case a piece of radio communication equipment on top of a skyscraper was burning. He ran to a nearby fire station to let them know, and just as he was doing that the call came in.
The way I was told to do it is point at someone specifically and shout "YOU, call 911" and make sure they understand. If you just yell "call 911" it might not do anything.
As a retired EMT I believe it is important to note that while we appreciate MDs being on scene, it's also important to note that we are under a medical control from a nearby hospital so any on scene doctor should be aware that if they want to assert full control over the case they must continue with us to the hospital. We will gladly mention their presence to our medical control and what has been done but unless they (the on scene doctor) are willing to assume full control and express as much to medical control, have their consent and come with us to the hospital we will only accept orders from our medical control.
Very true. When I ran rescue as a firefighter, sometimes I would get the look and the nod from the paramedics to get this doctor out of here. I was always willing to take the heat because I didn't have to work with them whereas the paramedics were sometimes less inclined to anger one of them.
Nice video, great to hear advice from a MD/JD. I've had 2 situations where I assisted on a plane flight. I am internal medicine trained and specialized in oncology, with prior experience as a hospitalist. I will say, helping on a plane is an extremely stressful job. You are limited in equipment/meds, have the stress of someone's life in your hands, and may be alone to triage until the plane lands. Both flights were very exhausting as I was by the patient's side the entire flight. Did not expect any compensation. Anytime there's a call for a doctor on a plane, I pray an ED doctor is onboard. They can handle most situations much better than other specialties.
I'm from Norway, and in Europe you generally have a legal obligation to help, whether you're a lay person or professional. Just the notion that helping will have legal implications for you is frightening for me. If I see a person slumped over in the street, no matter how much I think he's a drug addict and don't want to go near him, if I don't do anything, I can serve actual jailtime.
It’s the same in the Kingdom of Denmark. I’m appalled by the fact that there are States in the US where you can just ignore someone who is in danger and needs help. It’s crazy that you can get sued for assisting someone in need.
Same in Poland (and also if you are proffesional and don't help you can be sued in civil case or in job-related (I don't know english word for „prawo dyscyplinarne”) case (for example your medical licence can be revoked))
In the USA, some people don't help because many times these patients or oftentimes their families can turn around and sue the good Samaritan/ Healthcare professional. Even if nothing happens to the doctor, it's still stressful and expensive to fight a nuisance lawsuit. The law should protect the doctors not jeopardize them. That's why some don't help.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.+
One of the police officers I work with saved the life of somebody in Waterloo station (London, UK). I did not know anything about it until a week later when another officer told me that they knew the person who had the heart attack and was saved by my colleague's CPR. That is what I call modesty/humility. That is the kind of stuff that London's Metropolitan Police should be proud-of.
I always love the videos where you have a guest on. They always bring an interesting perspective on things just a little outside the topic of anesthesia, but that still apply to it indirectly. This is the perfect example of that. Thank you!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂+.+.+.+
@@prtygrl5077I think "philosophy doctor" should be reserve for those actually studied philosophy. All other degree holders should be referred to by their profession, like MathD or EngD or PhyD. there's no rational behind calling everyone a "philosophy doctor"
Loved it Max. As a paramedic, the only thing I would add to what this highly informative video was saying is remember folks, Good Samaritan law covers you only if you are working within your scope of practice. Don’t go beyond what you are trained to do, if you are trained at all. Great video Max. I learned a lot like usual
It’s insane in some places in the US. I’m a doctor as well and very happy that in our country it’s mandatory for me to help those in medical need, even if it’s in the streets when I have the day off. I’m actually bound by law to stop other activities. I’m all for that. I didn’t take an oath to please attorneys.
And I'd just like to reinforce what he said about having someone call 911. Tell one person specifically to do it; if you just say for someone to call 911, everyone will assume someone else will do it and the call won't be made.
The Good Samaritan law protects any citizen trying to help as long as they don’t intentional harm the person. An average civilian has zero scope of practice yet they are completely protected even if they kill the person while genuinely trying to help. 🤔
As a critical care nurse, I would not hesitate to help on in flight emergency. However, stopping at an car accident scene is a tough call. You can get hit by other vehicles while helping. Calling 911 is often the best thing to do. I carry reflective triangles to redirect traffic.
Number one rule I learned (the hard way) is to never stick around after you hand them off to a professional. A neighbor from two streets down, that I didn't know one bit, fell asleep with a cig and caught his house on fire. I smelled it and called for fire to come out while I was running to the house. I ended up getting there before the fire dept and ambulances. So I pulled him, his wife, and their dog out of the house. Luckily, I'm fairly fire resistant... but they weren't as their skin looked like it was staring to melt (dog was fine though). Responders come along, do their thing, I talk with them and give them the story, then they send those two out to the hospital (another neighbor took the dog for them). About a week later I get a call from the police with claims from the guy that I was the one who must have set the fire since I was there so quickly and it was two in the morning. So we do a little back and forth for a couple weeks while the fire investigator does his things (they were backed up at the time). Once he was done, and found out it was a lit cig in his recliner, I didn't have to worry about anything. But there was talk from his camp that he was going to sue the hell out of me and get me thrown in jail for my (cough) "heinous" actions. So yeah, never going through that kind of stress again and I've never stuck around to give anyone any info since. Upon hand off its simply: this is what happened, this is what I did, and, in medically related cases, what i think is going on... then I'm out. Bye!
The sad thing is the following. One thinks "Good Samaritan Law", well, I recall reading Florida's version. It says : "medical professionals are held to the standard of their profession". I HAVE driven past accidents that JUST HAPPENED and simply say "Someone will call 911, they will be in a hospital within the golden hour" and carry on. It is awful, but I am not willing to risk myself. The problem is that "negligence" is the loosest term on Earth.
And if you do stop to help and get sued you're probably on your own as far as legal representation or insurance is concerned because the incident took place on your own time.
I am a MD and psychiatrist, so not exactly my speciality - I was once asked to make a psychiatric evaluation in Arlanda aerodrome in Stockholm - but that is another story. In Finland everybody is obliged by the law to help anybody in emergency situations. Whatever your competence is, you are to do all you can. Especially a medical person could face a severe reprimand and even a prison sentence, if you would just walk away. But of course we have no culture of sueing physicians...
I encourage anyone to read the story about the Paramedic that assisted in a cardiac arrest either at the airport or during a flight, that paramedic had ACLS training and knew the change in defibrillation guidelines per AHA, that included no longer giving stacked defibrillator shocks, with single defibrillation delivered followed by two minutes of CPR and then a rhythm check, followed by another defibrillation if needed...etc. The AED provided by the airline or airport had not yet been reprogrammed, so it instructed the paramedic and bystanders to continue shocking in a stacked fashion up to three shocks, per old ACLS guidelines. The paramedic followed the new guidelines as trained, and not the prompts from the AED. He was sued by the window of the man who died, and she won. She sent him a gift of flowers or something else so that the Good Samaritan law would no longer be in effect, so be aware. After reading this story I am very hesitant to assist anyone, especially if others are already assisting. This happened at least a decade ago, and a year or two after the AHA changes involving defibrillation. I would strongly caution against carrying any advanced equipment, such as intubation equipment and AEDs etc, as you then become responsible if they malfunction and are not usable on the call, and honestly as a paramedic I can tell you the chances of you being able to intubate someone not in cardiac arrest, on a scene, without medications is almost zero, and as a medic if someone claiming to be a physician just shows up to my scene telling me they are going to intubate my patient, I am gonna respond with a no, because I don't know you, and intubation is within my scope of practice and RSI (depending on the area) are also within my scope of practice . If it's a cardiac arrest, the last priority is intubation, unless they arrested because of choking or airway obstruction, the focus should be on quality CPR and early defibrillation, as long as effective ventilations can be given using an oral airway and BVM! If you are a physician wanting to continue care alongside EMS, you would have to discuss that via radio or cellphone with our medical control physician, who would then decide, in conjunction with EMS personal as to whether that was warranted or needed. As usual, thanks for the video Max Anesthesia.
Old RN here. Did home health in islands area with makeshift vessels coming ashore containing all sorts of health emergencies. (This was before cell phones.) Many times along the single road performed various Good Samaritan acts hoping another driver would arrive for me to ask help to call 911…which occurred. Another time at school waiting on my son, a terminal patient collapsed next to me where the spouse begged for help. Assist arrived to help get person from vehicle to ground and I did CPR. A deputy who did school duty arrived, called for ambulance, then assisted CPR. EMTs arrived and took charge. The patient‘a child came with me and my child to the ER, where we waited for the spouse. The patient lived and was admitted to the unit. The spouse took the child. And my child and I went home. Your videos are watched with anticipation of excellence. This one was most beneficial and the remembrance of my events over 30 years ago came to fore in mind. (A note, I have required 15 surgeries and am grateful for my past anesthesiologists.)
In Australia anyone who assist someone unconscious or in need of help you are completely protected from the law lay person or dr. But I’m pretty sure it’s illegal to drive past if your a healthcare professional and required to stop and help. I carry pretty well stocked first aid kid that includes a bag valve mask both child and adult but gloves and cause are most important. Getting others to protect you from getting hurt (hit by a car etc) is really important. I pulled up to a car accident and the pt was seizing and there were two truckers there and one other guy pulled up and I asked them to protect me leaning non the car and the other guy to help hold the head up to keep the airway save and neck safe. They also were helpful in shutting down the car as it was jammed and the keys couldn’t turn off.
Same in Norway. You have a duty to help/assist a person in a "helpless situation" - and you may end up in court if you do not. This even applies to animals. I.e. if you hit a deer while driving and it runs away wounded - or you see a wounded animal lying on the side of the road - you must notify the wildlife service.
I’m not a physician, but ever since the opening scene of “The Good Doctor” (which many have reasonably questioned), I’ve found the question of benevolent emergency care law to be very interesting and complex. Fantastic discussion guys! I found it incredibly engaging.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+..+
I'm an EMT in Los Angeles. My teachers told me that while the good Samaritan exists and applies to us off duty. We are held to the same standards as an on duty EMT. A (minor) mistake that a normal good Samaritan could make, would not be acceptable as an EMT, even off duty. As I understand it, If it ever went to court, the judge would look at my protocols as an EMT in LA county, and if I did not act within them, it would qualify as gross negligence. We talked about a very interesting area of this as well when it comes to Narcan. Narcan is over the counter so anyone can carry it, however our protocols state you must be on duty to administer and that it cannot be on your person. Now that I'm trained to administer Narcan, it is illegal for me to do so off duty, when a non-EMT can do it with no problem. My teachers told me they had to have someone else press the shock button on an AED in the past, and that this type of legal quirk is not new.
It is sad that in US, doctors may hesitate to help someone in an emergency because they worry about getting sued. I hope this changes in America one day.
I have attented to few inflight medical emergency. One time the flight attendent refused to open the medical kit siting she has to do long paper work afterwards and the other time an air hostess asked me if im a real doctor, i had to show her my licence.
In Belgium, everyone has a legal obligation to help the person who is sick, if all you know is calling the emergency this is good too. I'm a trained first aid helper (not EMT). If I don't help someone in need, I risk more legally than someone who isn't trained. The fear of being sued after helping someone is not really a thing here.
@@demoniack81 same in germany: you have to do full day (9 hours of lesson) and get a first aid certificate to apply for a driving license (and a lot of driving lessons in theory and practice of course)
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.++...+
Video like this, remind me how much I love being from Europe. Germany has a duty to help and it is mandatory to carry a first aid kit, gloves and masks in your car. It is also mandatory to do a first aid course as part of your driving licence.
One slight correction (at least in NY)... you can turn the patient over to another provider consistent with any interventions you have performed are in their scope of practice. So if you have dropped an OPA and are simply ventilating a patient with a BVM, you can pass that off to an EMT, but if you have intubated the patient or performed a surgical airway you must transfer care to a paramedic or ride along.
@@froggybug Nope, EMT is shorthand for EMT-Basic which are limited to BLS interventions so no definitive airways. Have to be at the EMT-Advanced or Paramedic levels to intubate.
lmao. in what fucking world are you intubating a patient outside of your work. and no. you transfer care to the first arriving EMS unit. If some doctor tried refusing to let me work on my patient because they tubed them while out grocery shopping, they'd be leaving in handcuffs.
@@danielmorgan5401 only happened once to me. Working a code at a golf course and our trauma medical director walks up. Was happy for the help. You're absolutely right, wouldn't accept it in any other circumstance.
As a retired Paramedic/FF I have assisted on flight emergencies before. First and foremost stay within your standard of care. Relinquish authority to the higher certification (Nurses, doctors and PA’s). Most of which always ask me to assist. And the flight attendants are always very appreciative of your help. And yes I have received miles and plane tickets for helping. I don’t ever expect it but it’s a nice gesture.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.+
This reminds me of the Winter Camp I attended while in the Sixth Grade (January 1969), My mother, who was a registered nurse, signed on as assistant cook. While we were there, a kid injured his hand. Naturally my mother volunteered to help, and they took him into town, so that a doctor could attend to him. He begged them not to call his parents, because he was sure they would want him to come home, and he did not want to leave. They explained they had to call them, but when they did, they told the parents that he seemed to be okay, and there was no medical reason for him to leave. The parents consented to him staying.
Shortly after, write down what you did - this is good advice for lots of situations. I make notes after witnessing an accident, or anything else of consequence that might become a legal issue in the future. This has come in handy when I've been a witness in court - I think the term is "present recollection recorded" - and I can describe the details that led me to an opinion. The rest of this is a long description of two cases where this came in handy. TLDR: Notes are a good idea. In one case, I noted a car behind me using a following distance that was consistently less than 1 second _and_ a tendency to pull hard right when braking. I had seen that for about 7 miles before that car braked hard and veered into a pedestrian - who was thrown about 20 feet. (The pedestrian lived, but had an unstable pelvic fracture.) The court case was months later, and the prosecutor said that she had the better evidence than she could ever imagine for that case. (It wasn't just me - at the time of the crash, a power company worker was on a nearby pole, and a sheriff's deputy was on-site for traffic.) In another case, after witnessing a crash, the officer that interviewed me at the scene failed to write some details in his report. When an Asst. DA interviewed me by phone, I went to my notes, and she ended up being able to add charges of assault & battery and vehicular assault. The officer who had interviewed me ignored that I saw the passenger swing nunchucks (sp?) at pedestrians on the sidewalk, and hit a couple of kids who ran off, and that I saw the vehicle repeatedly aimed at peds - and the pedestrian that was hit was probably not just because the driver lost control. That ADA started some investigation that found the kids who had been hit and ran away, and some pedestrians that had seen the driver aiming at them. (Those guys took guilty pleas - no trial.) There have also been times that my notes have defended me from accusations, but those examples are uninteresting.
I think that if someone assists another in an emergency, it's just in a to receive a good will gesture. It's nice to be appreciated, this does not require a continuous gift but a small token of appreciation is nice treat. Everyone like to feel appreciated. Working in a hospital, some patients give a bouquet of flowers to the unit. They're not paying us but it's so appreciated. In an emergency, no one expects anything but a token is just a small way of saying "thank you, and I appreciate what you did".
Great vid, I’ve had several situations here in nyc where I took control of a scene until EMS arrived and have been meaning to look up all this legal stuff 😅. Thank you!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩.+.+
@@prtygrl5077 there is actually a word, it’s “physician” there are also a ton of social and etiquette issues around the term “doctor” it can be quite a rabbit hole of information.
In the UK at least, you will never be prosecuted for trying to perform first aid. The courts will never, ever convict anyone because it would discourage further people from helping in other situations.
I believe the UK also has a version of Good Samaritan law (at least It says so on the first-aid page of the NHS website) so you shouldn't be prosecuted for providing assistance.
The concept of a country or state where you can legally just ignore a person in need of assistance is bleak to someone from developed countries with duty to assist and good samaritan laws. These are usually super forgiving and sane, too. Like, just calling 911 equivalents is enough to be in the clear, and your obligation is waived if you'd put yourself in danger, are pregnant etc. I'm not trying to virtue signal or boast, but even as a regular guy who took a few first responder courses and only had to assist someone like, twice, the thought of ignoring a hurt person in need of help is really distressing.
Most of those countries also don't allow frivolous lawsuits and don't have a culture that encourages ghetto lotteries aka finding any excuse to sue to get a big payout whether its warranted or not. Its exacerbated by insurers that deal with so many suits just deciding to settle because it cheaper than actually fighting. As long as the complaintent has a half plausible case it's usually settled for a not insignificant sum out of court rather than risk a jury awarding them Alex Jones levels of stupid verdicts. So you can do everything right and still get sued simply because the opportunity to sue opened up and it they have nothing to lose by doing so
As austrian its kinda surprising to hear the state of laws for us/NY. In Austria also Germany (not sure if it applies to all EU countries), you have to attend a first aid curse before getting a driver license. Things like checking cardiac arrest, performing CPR are trained here and it is expected you could perform this in case of emergency. You could even face high fees/jail if you do not perform first aid. Of course you could not face trial if you did mistakes..
I'm not sure about driving license, I got it 15 years ago. But in Poland helping people in emergency is also required by law. And even from logic perspective... everybody should at least call the darn emergency services, that one thing will increase chance of survival of that person significantly. Which I one time failed to do, because of the shock from seeing this. Fortunately that driver did not hit anybody and the car was stopped relatively safely by a tram station. I think visualising such situation in advance can help to prepare. I didn't make the same mistake later.
If I'm not mistaken, here in Luxembourg if you are part of any medical field and you see an emergency that is not yet taken care of by emergency services, you have to stop by and at least ask if they need help. If someone saw you just drive by or run away then they can sue you if they know that you are working in the medical field. That is at least what my mom told me when I was a child of 8 maybe 12 years so it might be different but it's an overall generally good way to approach it.
Not sure about Luxembourg, but in Serbia (which pretty much copied EU laws and regulations in that field), if I drive and come to a scene of an accident, I am *required* by law to try to help. The law only does not specify if I must do it only if I am the first responder and what "trying to help" exactly means.
in Germany, before getting the drivers license you need to take a first aid course. When witnessing an accident or something similar it's your duty to help, at least as good as you can. In the car there also must be a little first aid kit, with bandages and stuff. You might get up to 1 year of jail time if you didn't help.
I am a doctor too and it's sad that in this age of being "civilized" people have a choice of not helping someone in need, or that I have to worry about legal implications before helping someone out...
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩.+.++.+.++
There were some interesting episodes of Bondi Rescue (an Australian show following life guards on Bondi Beach), wherein it wasn’t unusual for off duty doctors/medical professionals doctors to attempt to help with serious incidents. More often than not, the life guards would ask them to take a step back; these life guards were trained to deal with these very specific types of incidents, and trained to work well together in high stress environments. Often the doctor , whilst well intended , was ultimately a hindrance.
I would also leave contact information with the police or call them afterwards. As too many times working as a firefighter, we get on scene, we focus on the incident first, but the witnesses are gone before we realize. A simple business card with "Blue car hit Red Car" or what you did, and the police can follow up.
Definitely an interesting note on the "hand off to someone with higher training" advice, that probably assumes that it's mostly going to be a lay person handing a patient off to an ambulance crew and then to an emergency room, but not always
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+++.+.
Super interesting video Max!! I found myself in a similar situation with a random pedestrian trauma in Manhattan not too long ago. This is all great to know if that ever happens again!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.++.
I'm a paramedic and my understanding is that the rule of handing off patients to providers of equal or higher level only applies when the providers are on the clock getting paid. so when I am on the clock I can transfer care of my patients to another paramedic or a nurse, NP, PA, or doctor as long as any of those people are also on the clock. I can never hand over patients to an EMT or bystander, even if the bystander is also a healthcare provider but they are off duty. but if I arrive on scene and the patient is being cared for by an off duty doctor, it is perfectly legal to take over care of the patient even though I am a less advanced provider. I guess what it boils down to is the fact that the off duty doctor has extremely limited resources at their disposal in that moment, whereas I have an entire ambulance full of ALS equipment so in that situation, I am better equipped to help the patient. if we were in the hospital however and the doctor was on duty they could not hand the patient over to me.
My take away was that if you aren't being paid and choose help someone, you are acting as good samaritan and you just need to avoid doing something grossly negligent.
Wow- this dude is great! The fact this dude has full degrees in both legal and medical is impressive! He is able to sum things up better than really anyone else. There is so much nuance and semantics with these bystander laws and rather than bogging down in well this could and maybe well if then... it sums up the points that are most important. And since it is not advice in ether feild- it is a great crash course.
In Poland we have lawe that says you have to rescue if its is safe for you. If I remember correctly if you don't rescue you can go to jail for 2 years. But if you rescue you have protection from any damages you do
A physician and an attorney? Good lord man, doctor, Man-doctor, esquire. On a scale of Single payer system to 100% anarchy - how much do you love school? Love your content, Dr. Feinstein - you've really opened my eyes to some of the complexities faced by the good men & women who've kept me from dying while surgeons were doing whatever it is surgeons do (I'm kidding, the surgeons and nurses are awesome, also) At the very least, they've resisted the urge to take me out. Hell, none have even knicked my recurrent laryngeal nerve in the hope of a minute's peace when I awaken. Good people, all. Doing a job I can't comprehend in a needlessly complex and bafflingly money-centric environment. Have a thumbs-up while knowing I think you deserve much more Cheers!
somehow the advice is the same as for laypeople, if a computer scientist steps forwards and a swiming instructor comes in, the swimming instructor is probably more current on their emergency training. And the general rule is to stay with the person until the emergency vehicle arrives and someone relieves you. I think the difference between a good samaritan doctor and the emergency vehicle is also that however appropriatethe training of the doctor is beforehand (on the emergency care to psychiatry spectrum), the vehicle has gear and a trained team in the appropriate gear, reaharsed procedures and the mindeset to do the job.
Being trained in first aid, doesn’t make one a dr. Just like staying overnight in motel six doesn’t either. I did save a life using first aid training using the hemlich maneuver when a guy had a hot dog stuck in his throat. I asked are you choking and do you want me to do the maneuver which he shook his head. It was a lot harder than training. In my mind, I was going to try twice then tell them to call 911. It worked. Amazing how many people were standing around.
I feel like even as someone who doesn’t live in the US. It’s food for thought. I’m not a physician but he speaks quite equally on both sides. I always like to say “give with caution”. I think that also applies when someone is having a medical emergency. We have to consider things we do not know. Society needs to heed to contacting 911. A lot of people talk poorly about reality tv but once I heard on one of their shows. That if a person is laying down, you must be carful of their neck. Depending on the situation. As you don’t know if they broke their neck or strained it. A lot of people don’t think of legal ramifications when it comes to medical emergencies as a Samaritan. Which I believe people need to be more careful of paying attention too.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.+
There was case law in Australia where a doctor was asked to attend a boy who was never his patient and was having a fit 1-2 blocks away. He did not attend and was sued (and lost). So therefore whenever asked to attend an emergency I run out. Case 1: 7pm dark and cold, with a few patients in the clinic still waiting, was requested to attend an accident where pedestrian was hit by car. Arrived, ensure safety and assessed level of consciousness and checked for spinal injury etc. Helicopter landed nearby to take patient to the hospital. Prepared the incident report straight away as police asked for statement few weeks later. Outcome the girl did have head injury but recovered. Case 2: lunch time and a young guy outside got knocked down crossing the road. Ensured his safety before ambulance arrived. He broke a femur and definitely needed help. Case 3: 8am clinic just opened someone ran in and said a girl in her 20s found in street gutter unconscious. Lucky for her that my senior partner was on and he used to do helicopter rescue. She was intubated and brought back to life. It was not an overdose case (unlikely in our area), but a rare cardiac arrhythmia. I got to talk to her some months later and realised that she was "the one" that survived.
"you're going to be trapped in that situation once you start"-- this is the important part. You don't have to help, but once you start helping, if you are a medical professional, you are obligated to continue until you hand off to another (more senior?) caregiver.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+..+
Here in Denmark we have defibrillators hanging everywhere. They are never far away. As a respiratory carer I am trained in CPR and other things. I would always step in when needed, but anyone here can be become a Heart Runner (as they are called) and use these defibrillators following CPR. There have very easy to follow step by step guides on them. Do you have them in the US? I think they are a good idea. They've save many lives.
Yeah, there are defibrillators in many public places. They are Automatic External Defibrillators (AEDs) that are designed for a lay person to use. They have a voice that guides the user and it has some electronics to assess the patient to determine if defibrillation is indicated.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.+.+
Part of the problem with AEDs is that they don't actually "save many lives". They save MORE lives than the 1% that CPR alone saves, but success is still highly dependent on medical circumstances and time to intervention. AEDs in hospital are wonderful because you can give them a trained nurse to keep around otherwise-healthy patients with a history or risk of throwing arrhythmias. Most people who have arrests on the sidewalk are already terminally ill with heart disease, and most of them aren't even fibrillating, they're just asystolic and clearly DRT.
Yeah, just recently found a guy who was OD on Fentanyl and I was as close as one can get to performing CPR. Thankfully he started breathing (1 breath every 30-45 seconds), and I didn't have to start chest compressions. Called 911. Paramedics got there and delivered Narcan. I was wearing an N95, but no face shield and no gloves. PPE is def something I will carry from now on. At least an N95 and face shield in the day of COVID.
Well done but 1 breath every 30-45 seconds is not effective breathing, so CPR would still be needed. Sometimes patients may present as breathing where their actually breathing agonally. When we’re looking for effective breathing it should be at least one breath every ten seconds and a regular rising and falling of the chest or breaths. You did amazing regardless and we all are learning.
@@harismohammad2005 Appreciate the input and encouragement. Guy had a strong pulse and his color was surprisingly good, despite not visually breathing. I'm guessing he had just OD'd, and I had made the call to emergency services, immediately. Would have started chest compressions if I did not see him breathe or noticed his heart wasn't beating. Instead I made sure his airway was open and unobstructed, which it was. Paramedics arrived and bagged him while giving him narcan. In this case, no CPR and a quick response time with the narcan saved a life. Paramedics did not perform CPR either.
The "Good Samaritan" Laws were largely the results of legislatures acting after a famous "Dr. Kildare" episode on TV. Most of those states which had governors who were lawyers did not enact such laws. The reason was that removing liability creates an additional obligation to act. However, I think that the legal advice offered here was good. To date, I believe that there have been no successful suits against physicians who acted appropriately in good faith during an out of hospital emergency. Personally, I once stopped at the site of a severe auto accident late at night, identified myself to one of the police officers who told me that a pregnant woman was the victim but he was sure she was dead. I grabbed a small surgical kit from my car and rushed down the hill to the vehicle prepared to perform a C-section (not my area of expertise). Unfortunately, she had been dead for a long time and there was no possibility of fetal survival.even if the pregnancy had been more advanced. I realize that a suit would be very unlikely but I would never consign the care of a complex, at risk pt. to paramedics in an ambulance. In one such situation, I once rode with an electrically unstable pt to a major med. center and resuscitated/cardioverted/defibrillated her at least 20 times to get her on the table for cath. and then surgery. She survived and did well.
In the UK I can't imagine anyone could or would sue a doctor or random bystander who performed cpr whilst waiting for paramedics to arrive. Even imperfect CPR and a couple of cracked ribs are preferable to the alternative. Likewise I found someone who'd passed out. Breathing was OK and heart rate was fine, so I put this person in the recovery position whilst calling an ambulance. Turned out they were epileptic and had had a seizure. I know some epileptics in the US don't want ambulances called due to the bills, but in the UK that's not a concern. In the position I was in, I acted in the best way I could. It turned out I had done the recovery position slightly wrong, but of course I didn't face legal consequences. The police aren't wasting their time on a well intentioned civilian doing adequate but imperfect first aid whilst waiting for an ambulance.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩...+.+
This is really interesting. Also alarming that you don't have the duty to help over there. I thought that was something that existed everywhere. Although I must admit people rarely get prosecuted under that, at least where I live.
Thought I'd share a half-care story. Some years ago as an EMT we were called to an old age home. The call was for CPR in progress. When we entered the room as a BLS unit we saw nurses very badly performing CPR and we're told that the previous shift had essentially begun CPR left, and they had "rediscovered" the patient. In my country, any death scene outside of a hospital must be cleared by a police lieutenant as accidental or natural. Usually this is a routine question and if we are asked we give our honest opinion usually yes we think this was natural / accidental. This one we answered the very surprised officer, we think this one requires further investigation and told them what we saw and heard
With all the respect, I’m a respiratory therapist and had received intubated patients in the ER from EMTs where the tube was found in the esophagus or in the right main stem, the outcome was to educate and not to point fingers of who killed the patient.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩++.+.
@@prtygrl5077if they are doctors, than they should be called doctors. And by no means is an MD or many of the other titles and specialties low level degrees, unlike your Masters in copy/paste.
"Doctor" is a very broad category, "Medical Doctor" is much more specific, though still a broad category. There are many types of Medical Doctors as well. Most of the problem is when people ask for a doctor, they really mean an MD (Medical Doctor), not just someone with a PhD.
Great idea. I would make an emergency kit. THANK YOU for this video. This will make many ppl informed. BTW kudos to going through law school AND med school but having a sense of humor is key (which he has). I hope both of you have many children..we need as many intelligent people as we can get in this world.
Pretty crazy over there in the US... Here in Germany, you have to take a day of first aid lessons to get a drivers licence. The first thing we where told there: "don't be afraid to do something wrong. What do you you think could happen? The patient dying twice?". If you do not try to help or at least call the rescue (who will instruct you on what to do) when you see someone needing help, you can get pretty hefty fines or even up to a year in prison for "failure to provide assistance".
@@John_Smith_86 Well if you are not a trained professional you do not have any legal liability apart from beeing obligated to help them in the best way you know. If you do nothing, then you are probably liable. Might be a different mindset in diffrent societies.
Thank you for providing us with such detailed and enjoyable content Dr. Feinstein! Special thanks to Dr. Appel for his insight in this video & on this topic too!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.++++
Good Samaritan laws don’t keep people from suing you. Even if it’s ultimately thrown out of court, you still hired an attorney, were deposed, ran up legal fees with your attorney and missed work. And I’d say that your malpractice rates would increase. When people see “rich” doctors they don’t think they have anything to lose and good luck recovering the money you spent.
This is true of anything; nothing stops people from filing frivolous lawsuits except in the most egregious cases of abuse. However, such a lawsuit would likely be dismissed summarily before any real discovery, and malpractice insurance covers legal fees.
@@morbo3000 Typically retired physicians don't carry malpractice. I recently looked into it in order to volunteer and the rates were unsustainable. Tail coverage isn't the same as current.
@@morbo3000 Still talking $20 to $40k to hire a competent attorney for such a conclusion. If it went to trial because of a corrupt judge (lots of them), you're screwed.
A few years back I was in the US with a friend and we witnessed a cyclist get hit by an SUV… We helped, nothing huge, basic first aid, recovery position and whatnot. I was amazed by how folks just stood around staring. No one called emergency service and no one offered to help. One of the onlookers asked my friend if he was an EMT / paramedic. He was rather busy and replied with ‘no. I’m British’ Was a very strange day. It worked out okay in the end and the cyclist was able to recover.
I love Max's posts and I particularly liked this one. I'm 79 ½ and have always been interested in medicine so when I learned to drive aged 17 I used to carry 6 x 1ml ¼ gr ampules of morphine sulphate (lets go with 15 mg if you find that easier). I had a glass and metal syringe in an old Alka Seltzer glass tube submerged in methylated spirit. I never got to use them. Remnants of my father's last days of stroke treatment. Oddly enough the local bobby knew I had them in my car but it was Wales and it was the late 1950s.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩.++.+++
I'm a retired internist now living in Florida, and I do not have a Florida medical license. Before medical school, I was a volunteer EMT on a rescue squad in New Jersey. I have considered volunteering again but worry that I might be held to a higher standard than an average EMT, even though I have not practiced medicine in several years.
@@lanaofficiel4042 For a variety of reasons, not least of which is the weather. 😃 While it was cold this last week, into the low 20's F, we did NOT get any of the horrid white stuff falling from the sky.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.++.
00:40 in Germany that's a state law. It's called "unterlassene Hilfeleistung" (Failure to provide assistance) and it's punished with up to 1 year in prison or a hefty fine. The idea is that when someone is about to die you can't make it worse. (of cause it only applies if you do not need to endanger yourself while rescuing)
If you're on a plane assisting, most airlines call Medlink where doctors are on the line and will assist (they know what's in the airline-specific medical kits) and the airline's licensed dispatcher is on the call in most cases too, and that's the person with the authority (shared with the captain) to send the flight to a diversion city, in coordination with Medlink doctors (where they may assess the best options not just for weather, airport services, approach capability, legal authority to operate at the airport, etc, but also conferring with Medlink on proximity to hospitals or special units--like cardiac). If Medlink recommends something, I'd defer to them. By taking the call, they're accepting medical liability and thus the airline isn't on the hook for medical decisions including whether or not to divert. I assume they'd take liability from onboard physicians as well.
Medlink takes full liability and is primary decision maker. If on board Doc says “we need to land” and Medlink doc over radio says “keep flying”, according to SOP for liability protection I have to listen to Medlink. Same thing if I’m on the ground after pushback. Blows my mind someone could clearly be having a heart attack but pilots have to wait 10-15min for Medlink to get linked in, given the passengers info and then a decision made allowing pilots to divert.
@@Sports-Jorge I know what you mean, but it's probably for the sole reason that by using MedLink and following their advice, your carrier is mostly free of liability in medical decisions. An onboard doctor (or nurse, medic, EMT, etc) may or may not have specialty in the field and also doesn't have access to tools and information MedLink does. Like if Tyler, TX is in your op specs, it may make more sense to drop in there rather than the Dallas metroplex for a cardiac emergency because they have good cardiac units, less traffic, etc. Do we divert to an offline airport (and/or closest suitable) or wait until the next major airport, one with service, etc? Those are largely MedLink and dispatch decisions and factors to consider. Not that the PIC doesn't have a role of course, but dispatch handles more medical situations and has more resources to consider, including weather, NOTAMs, services, etc.
There is always a doctor,nurse medic,on a plane. Have had many medical emergencies on my aircraft.(retired fa). Eager to help, so thankful of medical people. We listen if they say to land. We make an emergency landing at closest airport.
As 911 Paramedic I had run into all levels of medical providers who were "unintended" first responders. And, a few times we recognized the MD or PA-C/NP. And, if we did not recognize them we had a card we carried that had printed instructions by our Medical Director. Which in the readers digest version stated if the unintended provider wished to issue orders that they would have to accompany the patient to the ER and relay information to the ER Doc (our Medical Control Doc). That usually had them backing off. But if it was someone we recognized we embraced their input. The problem with unintended first responders....is that they are out of their element. I have witnessed "Clinic" nurses doing CPR Compressions so fast that well. Best cluster in motion was call to an allergy clinic. A patient being tested had full blown anaphylactic reaction. We go into the clinic and well there was a Crash Cart present with several physicians in the room doing a whole lot of nothing.....and RN/LPN staff...trying to prompt the docs into action...NO EPI NO Benadryl, etc. worst of off al her lips were BLUE. Like my first paramedic partner said....What is paramedic without ALS Supplies Equipment? = you become Basic EMT without equipment so you have to improvise. Rolled up magazines make great splints. Take a door off the hinges and add towels and duct tape...Back board!.
@@opusthe2nd Don't you know it. I once had Nursing Professor from a College west of St. Cloud MN try to tell my partner that is not how you give drugs.....she probably had not touched a patient in years. The funniest one was a gentleman attending the local hospital fund raising event suffered an event. Once of the ICU nurses from the local hospital ripped her skirt purposely so she could get down and do compressions. She just smiled and kept on going.......and when we left with the patient we gave her one of the blankets off the cot to wrap up in. God Bless those that try to help. But, sometimes you have to know your limitations!
When I helped someone on United, worrying about a PE, suggested that he go directly to the ER, I got 0 compensation. I got the guy's phone number and called to check that he was ok and found that he had pneumonia which surprised me.
I'm a Paramedic. For all the doctors and nurses out there: Yes, please help the patient. Yes, please identify yourself to us. Please don't try to give us orders, they may conflict with our agency's Standard Operating Guidelines or Protocols.
No shade on you, @JohnSwanson, but paramedics- please recognize *us.* The worst time for me was when I was with a motorcycle rider victim (full disclosure: against my 'instructions,' my partner opened the front passenger door while we were stopped at a light and the lane-splitting biker ran into it. Thankfully she hadn't exited yet). I identified myself as trauma center PA to the patient, brief assessment without removing helmet, determined fractured clavicle (pretty obvious) and indeterminate injury to a couple of fingers. When EMS arrived I was ignored, and yep - to backboard him they rolled him onto his fractured clavicle. That was they only time he screamed on scene. -- I get it, not all providers are similarly competent, especially not out in the streets. Doesn't take long to hear them out - seconds to determine if they have any useful info.
@@spartlow8872 Oh absolutely. As EMS we need to listen to bystanders or witnesses, often while doing other things. A hand off report from a Healthcare provider on scene is always welcome. Bossing me around -not that you were bossing anyone around- never is, that's all I mean. Just as an example: I wouldn't backboard a motorcycle accident today because of the risk of aggrevating other injuries and it's not required by my protocols. I'd use a scoop stretcher so we don't have to roll the patient at all.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩.+.+..
I mean...If we were there first and have assumed care then idk what you are hung up about. It is our role in medicine to coordinate roles and make medical decisions. I understand this may come from some nuanced scenario you have in mind, but it's coming across like you don't want a doctor telling you medically what to do. Sorry, but it's kind of our job to give medical orders.
@@kjhart91 again a hand off including the results of an assessment and treatments preformed is always welcome. But regarding orders; we have orders. That's what we have protocols and medical control physicians for.
Enjoyed the discussion. It clarified a few contentious situations and medical responses. The book looks like interesting reading. Look forward to reading it.
Great vid! I’m in school now for a DNP and Bioethics certificate and these ethical situations are always interesting to mull over but we have to remember the legal ramifications in real life situations. And just bought Dr Appel’s book - looking forward to reading it!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.
Regarding your scenario about plane emergency: That happened on a winter flight, when I was a professor. Nobody on board had any medical training. But many assumed I did. "Sorry. I'm a doctor. But not that kind of doctor." We ended up doing an emergency landing in Memphis.
The general theme is that Good Samaritan laws mean all of that about licensing, certification, etc. isn't relevant and that anyone who helps is protected as long as they act in good faith and don't do something grossly negligent.
Thats interesting. I thought anyone in the medical field doctor or below has to help someone IF they have the training to help. Example literally everyone who works in the medical field has cpr training, there for has to do that. Or another example a CNA can help stop/slow the bleeding until EMT arrives or someone who has more education. Now i have to look up the laws in my state lol. Definitely a great topic you brought up.
In Europe that is the case. You can get jail time If you DONT help as trained professional in an emergency. The average citzen fullfills their duty to "help" by calling 911 (112). If you have training (btw for your driver license you have to get CPR/ first aid certified but that doesnt count as training in a legal context) you have to do the best you can according to your training, the resources available and without putting yourself at risk.
Once got a handful of chocolates. Very hard turbulence on approach to our destination, overhead compartment door above me opening suddenly, unbuckled quickly, slammed the door, sat back down and fastened the seat belt again. If I did not act right there and then, the person on the other side of the aisle could get seriously injured of something fell out and it was really safe for the attendant to walk and close it. She saw what I did, smiled and later on handed me a handful of chocolates with "Sir, I think you forgot this" :)
Emergency physician with 35 yrs experience here. Contrary to “what everyone knows” it is very rare to be offered any freebies or compensation when you step in during an in-flight emergency. I got vomited on during one such episode and Delta wouldn’t even let me into the Club Lounge to clean myself up after deplaning. It was gross. No upgrades No free drinks and certainly no free miles.
Try Lufthansa next time, totally different experience. Helping someone on a flight or assisting the crew in any medical case once they call for a doctor definitely won't stay unnoticed!
Good to know...I'm a cardiologist, and I've helped on a plane thrice so far... no Miles, no upgrades no free drink...good to know that I'm not alone here!
I understand to want to clean up. But for the rest you shouldn't be a doctor if you expect those things for helping
@@jeihka1you shouldn’t be a Person
Oh...sorry to see this happened to you...
My mom is an anesthesiologist or was for more than 40 years and had saved a woman on the plane from choking on some food. Was given nothing in return by the airline and the woman she saved never once thanked her or contacted her after the incident. The daughter of the woman did find and call my mom but only to try and have my mom verify untruths about the airline's food in an attempt to sue the airline. Some people are just ridiculous....
Yea, your mum really did a bad deed there
Some people are not worth saving
This world is ridiculous!
@@acmhfmggru nope, she isn't obliged to help, and she deserves the recognition fro saving that woman's life. Don't be stupid here. Give recognition where it is due.
@@acmhfmggru people with “expensive degrees” are people as capable as everyone that decided to invest more than 10 years in training, sacrificing youth, time, family time and opportunity cost to study a degree that made them able to do what they did. You don’t have to give praise or a thank you to anyone, but it’s very entitled to feel like giving a “thank you” or any kind of praise to someone else that helped you doesn’t matter because they are “wealthy and with expensive degrees”. They are people just like you
Former flight attendant here. I've been in several situations where a physician (or anyone with healthcare knowledge, really) was needed during a flight. Usually, it's not a problem to find someone. The only times we had trouble getting ANYONE to come help was on flights to or from the US, likely because people are so unsure of the legal situation. And we even carried legal papers explaining that there would be no consequences to anyone offering help, even in the case of injury or a fatality of the patient. Coming from Germany, where it is illegal to NOT help, this is just absolutely ridiculous. It makes me sad to think that a qualified person might not offer to help someone experiencing an acute health issue because there's the possible threat of legal action should they fail to save the person.
Edited to add the following: "Helping" in this case means at the very least calling emergency services, similar to how another person in the comments described it being in Switzerland. Technically though, one might be required to help more than this. And everyone should be able to do so anyway, as any person with a driver's license acquired in Germany has to have taken a day-long first aid and CPR course and is required by law to carry a fully-stocked, non-expired first aid kit in their car at all times. I really wish the US, or rather its states, would loosen the legal barriers to providing aid in the case of an emergency, and require people with drivers licenses to obtain a minimum qualification in first aid.
Well in CDL schools (at least some in PA) they make you take a CPR course and they get you certified. Anything else after that 🤷♀️. But, it would be nice if the states did the CPR stuff regardless of the type of license. That's useful for multiple reasons.
Yep, I’m a doctor as well and very happy that in our country it’s also mandatory for me to help those in medical need, even if it’s in the streets when I have the day off.
I’m actually bound by law to stop other activities. I’m all for that. I didn’t take an oath to please attorneys.
To add another aspect: "Helping" = bare minimum calling an ambulance refers to the general public. A doctor in Germany is by law bound to do more; if they don't endanger themselves of course, and if they're in a condition to help (so not intoxicated etc).
I disagree. No one should be required to take first aid classes and carry a firs aid kit. That all should be by choice only. No damn government forcing more requirements on people...
Instead of first-aid, I’d appreciate it if states would condition drivers’ licensing on just knowing how to drive!
Very good answers. Not only did he answer what's legal, he answered what's ethical and what's practical. I am majorly impressed.
"None of this is legal advice"
I was on a flight from Atlanta to Seattle and a flight attendant asked for anyone with medical training. A young man next to me pushed his call button and was asked to go to the back of the plane. He returned moments later complaining that he had never before been required to show his medical license, but retrieved it and rendered aid. It was just someone having a panic attack, but when we were all on the escalator in Seattle going to baggage claim, a couple of guys said "If he's a doctor, what's he doing riding in coach?", so I informed them that he was one of those poorly-paid residents just returning from a medical conference. Sheesh - the expectations of the uninformed public! Not every physician is a multimillionaire with his own plane!! Great video, thanks.
a resident is a student doctor bruh...ofc they arent rich...some people don't understand the amount of training it takes.
@@gaditproductionssome people overestimate the amount of education and training required for certain specialties, such as psychiatry. Why would you do 8 years of school when you could do 6 instead and make more money right off the bat doing the same thing as a np
@@reddbendd for many people, their work in medicine is a passion which just happens to pay. Np could pay more in some world, but if someone's passion is psychiatry, it's not worth leaving it.
And in medicine, many times passion is very personal; ignited from personal tragedy or experience.
As a paramedic of 25 years, I can tell you that, when on an aircraft, if you decide to provide medical care, the airline has physicians on call and available to consult. As a paramedic that works under the license of an MD at home, this allows me to provide much more care than I could legally without that resource. it also takes the liability off an MD, Nurse, or Paramedic on the flight that decides to assist.
Dear Max, you should be proud of what you did! I am not a doctor, I encountered a drowning of a 16-year old this summer - when he was pulled out of the pond by the heroic people who rescued him, he was unconscious, blue in the face and his red eyes were not responsive. I was not a certified lifeguard back then (which I am now), so I called my doctor, put him on loudspeakers and did what he said until the ambulance arrived. Thankfully, the boy is alive and well
what a good idea , calling a doctor for instructions while you wait!! I will try to remember this!
@@sciencewithcats2274 when a person’s life is at stake the best you can do is call a specialist and do exactly as he says instead of guessing what to do and probably hurting him more if I did the wrong thing. The boy is alive which is what matters. Doing as the doctor said until the ambulance arrived is what mattered to keep him alive until professionals could take over. Now that I became a certified lifeguard I know exactly what to do in a situation like that. You might want to get certified yourself (the most important skills can be learnt in less than a day) and be more pre for if you ever witness someone drowning
His parents LOVE you, too.
@@TerryReedMiss I’m afraid I don’t think so. He doesn’t have a father. When I found his profile in social media and wrote to him wondering how he was, he just blocked me. But that doesn’t matter, the main thing is he is alive and well. And Irina, the woman who saw he was drowning and was first to leap into the water to save him and raise commotion, as well as the people who followed her, my doctor who was on the line and the ambulance crew are true heroes of that day
Some people simply know what the right thing to do is. You earned that pat on the back.
Awesome video, thanks! Having a dual MD/JD is amazing. You quite literally picked the most qualified person to help answer this question. Thanks for all the great content too! 25 years ago I narrowed my career choices down to either wanting to be an anesthesiologist or my current career. So now I get my "dose" of anesthesia from watching yours and other anesthesiologist's RUclips videos!
How many years did that take 😭
there was a documentary about this dude. he has other degrees as well. it was something like the person who has the most degrees on earth. he is not just any old person.
I believe he's a psychiatrist and not a medical doctor.
@@jojomakesare psychiatrists not medical doctors? genuine question
@@jamesparr7036 Yes, they are! I just found that out. I actually had no idea they had to go to medical school.
Different in every state and every country. In Switzerland, the laws says anyone should help someone in need, and try to save the person with all the capabilities and knowledge they have. If you don't stop, even if the only thing you know what to do is call emergency services, you go to jail. At the same time, the good samaritan rule protect the helper.
Yes, it means that an EMT, doctor or nurse, etc. should stop and provide help to the best of their training
That's nice but scary
Same in Italy, if you don't stop you commit the crime of "omitting rescue".
In America, it's the individual's right to NOT do anything and go on about their own business that comes first.
"stop to help" would be a clearer way to put it (not "stop helping")
'I am both an attorney and a physician' 😬 Yep MD/JD is very, very impressive! Informative video, thanks Max! In France, we can be prosecuted for non assistance to a person who is in danger. Ugh. It's complicated.
I believe he's a psychiatrist and not a medical doctor.
@@jojomakes they are medical doctors :) college+ 4 yrs of Medical School + 3 years of residency
This guy is a loon with 10 degrees
@@jojomakes I think you are mistaking psychiatrist as psychologist. psychiatrist are a real doctor, unlike psychologist.
@@jojomakes psychiatrists are M.D.'s
Former EMT, now long time ED/trauma PA putting in my two cents: if you want to carry any supplies in your vehicle, I recommend keeping it fairly simple. Especially if you're traveling in most of the country where EMS response times are decent. Mine has mostly first aid level- dressings, wraps, Sam splints, ice packs, tourniquets, OPAs, trauma shears, etc. I do have a spring-loaded center punch to break car windows, lots of gloves, Purell wipes, and camping type headlight. A yellow reflective vest is right on top. The only advanced item is decompression needle and chest seal. You might want z-fold gauze and multiple tourniquets if you want to be ready for a shooting situation. For me, I consider that the car gets hot, so lots of things don't last long. Other things expire in a way that matters. I can't afford to replace expensive clotting products, for example, but would probably keep those if I could.
Can you recommend minimalist items to carry for someone who is not an EMT? For example I don't carry ice packs or splints because they are for non life threatening injuries and I would rather an EMT deal with it when they get there and do a much better job. But I do carry a tourniquet.
It seems very risky id u so cpr . U dont know what disease they have will give u
@@noodlesthe1st Combat medic here, minimalstic would be: -Gloves, -Tourniquet, -Gauze, -Elastic dressing for pressure bandage, -Emergency blanket -Maybe a heatpack. This allows you to stop or at least slow massive hemmorhages and prolong the survival of the patient until professionals arrive. The emergency blanket and heatpack can absolutely save a life. If the body loses too much heat, coagulation stops. So don't forget to pack them with you.
@@con5577 I'd like to ask your advice on this matter. I'm carrying some kind of emergency pack in my backpack. There is not only medical stuff, but also stuff like charging cables, duct tape, multitool, wipes, etc.,
In terms of equimpent I have 4 our 5 things you mentioned, and I'd like to ask your opition on drugs. I got antiseptic, ibuprofen, antacid, nitro, sorbents, antihistamine, dexpanthenol, adrenalin, insulin and prednisolone. Is there anything else you think should be there?
I'm not the US, and I have basic emergency medicine trainig, if that matters
I don't know if it was omitted or not carried, but the first thing on my list would be a BP kit then probably a pulse-ox. Unless you're in an area likely to have life threatening injuries, I'd put assessing their condition as high priority. Would you really give that nitro without knowing their BP?
Out of the "3 dos" mentioned, telling someone directly to call for emergency services is easily the most important. So often people will just assume that someone else has done it already, potentially causing a life threatening delay in getting that patient getting to the care they need
A similar problem: you see an emergency happening in the distance, do you call it in, or has it already been done? A rail fan, here on RUclips, spotted a fire, off in the distance, somewhere most people tend to ignore, in this case a piece of radio communication equipment on top of a skyscraper was burning. He ran to a nearby fire station to let them know, and just as he was doing that the call came in.
The way I was told to do it is point at someone specifically and shout "YOU, call 911" and make sure they understand. If you just yell "call 911" it might not do anything.
@@JV-pu8kx call it in. Because unless you do, you would never know that it was called it and if it wasn't, you could save someone's life
As a retired EMT I believe it is important to note that while we appreciate MDs being on scene, it's also important to note that we are under a medical control from a nearby hospital so any on scene doctor should be aware that if they want to assert full control over the case they must continue with us to the hospital. We will gladly mention their presence to our medical control and what has been done but unless they (the on scene doctor) are willing to assume full control and express as much to medical control, have their consent and come with us to the hospital we will only accept orders from our medical control.
Very true. When I ran rescue as a firefighter, sometimes I would get the look and the nod from the paramedics to get this doctor out of here. I was always willing to take the heat because I didn't have to work with them whereas the paramedics were sometimes less inclined to anger one of them.
Nice video, great to hear advice from a MD/JD. I've had 2 situations where I assisted on a plane flight. I am internal medicine trained and specialized in oncology, with prior experience as a hospitalist. I will say, helping on a plane is an extremely stressful job. You are limited in equipment/meds, have the stress of someone's life in your hands, and may be alone to triage until the plane lands. Both flights were very exhausting as I was by the patient's side the entire flight. Did not expect any compensation. Anytime there's a call for a doctor on a plane, I pray an ED doctor is onboard. They can handle most situations much better than other specialties.
I'm from Norway, and in Europe you generally have a legal obligation to help, whether you're a lay person or professional. Just the notion that helping will have legal implications for you is frightening for me. If I see a person slumped over in the street, no matter how much I think he's a drug addict and don't want to go near him, if I don't do anything, I can serve actual jailtime.
It’s the same in the Kingdom of Denmark. I’m appalled by the fact that there are States in the US where you can just ignore someone who is in danger and needs help. It’s crazy that you can get sued for assisting someone in need.
Same in Belgium
Same in Poland (and also if you are proffesional and don't help you can be sued in civil case or in job-related (I don't know english word for „prawo dyscyplinarne”) case (for example your medical licence can be revoked))
In the USA, some people don't help because many times these patients or oftentimes their families can turn around and sue the good Samaritan/ Healthcare professional. Even if nothing happens to the doctor, it's still stressful and expensive to fight a nuisance lawsuit. The law should protect the doctors not jeopardize them. That's why some don't help.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.+
One of the police officers I work with saved the life of somebody in Waterloo station (London, UK). I did not know anything about it until a week later when another officer told me that they knew the person who had the heart attack and was saved by my colleague's CPR. That is what I call modesty/humility. That is the kind of stuff that London's Metropolitan Police should be proud-of.
I always love the videos where you have a guest on. They always bring an interesting perspective on things just a little outside the topic of anesthesia, but that still apply to it indirectly. This is the perfect example of that. Thank you!
Being a medical doctor and a lawyer is a parent's dream come true!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂+.+.+.+
@@prtygrl5077 I say only call medical doctors doctors. A medical doctor with a PhD should be called a super-doctor.
@@messyties nop, there's no rational behind that naming convention 💩 "body engineers" are more suitable than calling "medical doctors" 😂
@@prtygrl5077I think "philosophy doctor" should be reserve for those actually studied philosophy. All other degree holders should be referred to by their profession, like MathD or EngD or PhyD. there's no rational behind calling everyone a "philosophy doctor"
@@prtygrl5077 that’s a retarded over-engineered take on something very base.
Loved it Max. As a paramedic, the only thing I would add to what this highly informative video was saying is remember folks, Good Samaritan law covers you only if you are working within your scope of practice. Don’t go beyond what you are trained to do, if you are trained at all. Great video Max. I learned a lot like usual
It’s insane in some places in the US.
I’m a doctor as well and very happy that in our country it’s mandatory for me to help those in medical need, even if it’s in the streets when I have the day off.
I’m actually bound by law to stop other activities. I’m all for that. I didn’t take an oath to please attorneys.
In NYC, it protects any citizen.
And I'd just like to reinforce what he said about having someone call 911. Tell one person specifically to do it; if you just say for someone to call 911, everyone will assume someone else will do it and the call won't be made.
The Good Samaritan law protects any citizen trying to help as long as they don’t intentional harm the person. An average civilian has zero scope of practice yet they are completely protected even if they kill the person while genuinely trying to help. 🤔
@@doctordantedds oddly, killing a patient is less legal headache then doing live long damage.
As a critical care nurse, I would not hesitate to help on in flight emergency. However, stopping at an car accident scene is a tough call. You can get hit by other vehicles while helping. Calling 911 is often the best thing to do. I carry reflective triangles to redirect traffic.
Number one rule I learned (the hard way) is to never stick around after you hand them off to a professional. A neighbor from two streets down, that I didn't know one bit, fell asleep with a cig and caught his house on fire. I smelled it and called for fire to come out while I was running to the house. I ended up getting there before the fire dept and ambulances. So I pulled him, his wife, and their dog out of the house. Luckily, I'm fairly fire resistant... but they weren't as their skin looked like it was staring to melt (dog was fine though). Responders come along, do their thing, I talk with them and give them the story, then they send those two out to the hospital (another neighbor took the dog for them). About a week later I get a call from the police with claims from the guy that I was the one who must have set the fire since I was there so quickly and it was two in the morning. So we do a little back and forth for a couple weeks while the fire investigator does his things (they were backed up at the time). Once he was done, and found out it was a lit cig in his recliner, I didn't have to worry about anything. But there was talk from his camp that he was going to sue the hell out of me and get me thrown in jail for my (cough) "heinous" actions. So yeah, never going through that kind of stress again and I've never stuck around to give anyone any info since. Upon hand off its simply: this is what happened, this is what I did, and, in medically related cases, what i think is going on... then I'm out. Bye!
No more bad deeds for you!
The sad thing is the following. One thinks "Good Samaritan Law", well, I recall reading Florida's version. It says : "medical professionals are held to the standard of their profession". I HAVE driven past accidents that JUST HAPPENED and simply say "Someone will call 911, they will be in a hospital within the golden hour" and carry on. It is awful, but I am not willing to risk myself. The problem is that "negligence" is the loosest term on Earth.
And if you do stop to help and get sued you're probably on your own as far as legal representation or insurance is concerned because the incident took place on your own time.
I am a MD and psychiatrist, so not exactly my speciality - I was once asked to make a psychiatric evaluation in Arlanda aerodrome in Stockholm - but that is another story. In Finland everybody is obliged by the law to help anybody in emergency situations. Whatever your competence is, you are to do all you can. Especially a medical person could face a severe reprimand and even a prison sentence, if you would just walk away. But of course we have no culture of sueing physicians...
Those are questions we would never wonder about in Europe... Seems terrible that you would refrain from helping to avoid a lawsuit!
"consult an attorney or marry one" lol
and remember- "no good deed goes unpunished"
Attorney and physician is truly an impressive accomplishment. Thank you for the video!
I encourage anyone to read the story about the Paramedic that assisted in a cardiac arrest either at the airport or during a flight, that paramedic had ACLS training and knew the change in defibrillation guidelines per AHA, that included no longer giving stacked defibrillator shocks, with single defibrillation delivered followed by two minutes of CPR and then a rhythm check, followed by another defibrillation if needed...etc. The AED provided by the airline or airport had not yet been reprogrammed, so it instructed the paramedic and bystanders to continue shocking in a stacked fashion up to three shocks, per old ACLS guidelines. The paramedic followed the new guidelines as trained, and not the prompts from the AED. He was sued by the window of the man who died, and she won. She sent him a gift of flowers or something else so that the Good Samaritan law would no longer be in effect, so be aware. After reading this story I am very hesitant to assist anyone, especially if others are already assisting. This happened at least a decade ago, and a year or two after the AHA changes involving defibrillation. I would strongly caution against carrying any advanced equipment, such as intubation equipment and AEDs etc, as you then become responsible if they malfunction and are not usable on the call, and honestly as a paramedic I can tell you the chances of you being able to intubate someone not in cardiac arrest, on a scene, without medications is almost zero, and as a medic if someone claiming to be a physician just shows up to my scene telling me they are going to intubate my patient, I am gonna respond with a no, because I don't know you, and intubation is within my scope of practice and RSI (depending on the area) are also within my scope of practice . If it's a cardiac arrest, the last priority is intubation, unless they arrested because of choking or airway obstruction, the focus should be on quality CPR and early defibrillation, as long as effective ventilations can be given using an oral airway and BVM! If you are a physician wanting to continue care alongside EMS, you would have to discuss that via radio or cellphone with our medical control physician, who would then decide, in conjunction with EMS personal as to whether that was warranted or needed. As usual, thanks for the video Max Anesthesia.
You are 1000 percent correct. I agree with everything that you said and I am a Nurse Practitioner also.
Why did the Good Samaritan Act no longer apply due to the flowers?
@@ejoydv That was considered compensation, which voids the good Samaritan act.
@@bettysmith4527 That's absurd. wtf
Old RN here. Did home health in islands area with makeshift vessels coming ashore containing all sorts of health emergencies. (This was before cell phones.)
Many times along the single road performed various Good Samaritan acts hoping another driver would arrive for me to ask help to call 911…which occurred.
Another time at school waiting on my son, a terminal patient collapsed next to me where the spouse begged for help. Assist arrived to help get person from vehicle to ground and I did CPR. A deputy who did school duty arrived, called for ambulance, then assisted CPR. EMTs arrived and took charge. The patient‘a child came with me and my child to the ER, where we waited for the spouse. The patient lived and was admitted to the unit. The spouse took the child. And my child and I went home.
Your videos are watched with anticipation of excellence. This one was most beneficial and the remembrance of my events over 30 years ago came to fore in mind.
(A note, I have required 15 surgeries and am grateful for my past anesthesiologists.)
This is so SAD, most places in the world you would never risk a lawsuit for attempting to help, and you would never expect composation.
I cant be begin to express how much i appreciate how concisely Jacob speaks
In Australia anyone who assist someone unconscious or in need of help you are completely protected from the law lay person or dr. But I’m pretty sure it’s illegal to drive past if your a healthcare professional and required to stop and help. I carry pretty well stocked first aid kid that includes a bag valve mask both child and adult but gloves and cause are most important. Getting others to protect you from getting hurt (hit by a car etc) is really important. I pulled up to a car accident and the pt was seizing and there were two truckers there and one other guy pulled up and I asked them to protect me leaning non the car and the other guy to help hold the head up to keep the airway save and neck safe. They also were helpful in shutting down the car as it was jammed and the keys couldn’t turn off.
Same in Norway. You have a duty to help/assist a person in a "helpless situation" - and you may end up in court if you do not.
This even applies to animals. I.e. if you hit a deer while driving and it runs away wounded - or you see a wounded animal lying on the side of the road - you must notify the wildlife service.
watching this intently despite having zero medical education
I’m not a physician, but ever since the opening scene of “The Good Doctor” (which many have reasonably questioned), I’ve found the question of benevolent emergency care law to be very interesting and complex. Fantastic discussion guys! I found it incredibly engaging.
Dumbest show ever
@@robert039 I stopped watching it after I realized it wasn’t going anywhere
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+..+
I'm an EMT in Los Angeles. My teachers told me that while the good Samaritan exists and applies to us off duty. We are held to the same standards as an on duty EMT. A (minor) mistake that a normal good Samaritan could make, would not be acceptable as an EMT, even off duty. As I understand it, If it ever went to court, the judge would look at my protocols as an EMT in LA county, and if I did not act within them, it would qualify as gross negligence.
We talked about a very interesting area of this as well when it comes to Narcan. Narcan is over the counter so anyone can carry it, however our protocols state you must be on duty to administer and that it cannot be on your person. Now that I'm trained to administer Narcan, it is illegal for me to do so off duty, when a non-EMT can do it with no problem. My teachers told me they had to have someone else press the shock button on an AED in the past, and that this type of legal quirk is not new.
It is sad that in US, doctors may hesitate to help someone in an emergency because they worry about getting sued. I hope this changes in America one day.
One day it may change...
When that hesitation becomes an all out refusal
I have attented to few inflight medical emergency. One time the flight attendent refused to open the medical kit siting she has to do long paper work afterwards and the other time an air hostess asked me if im a real doctor, i had to show her my licence.
In Belgium, everyone has a legal obligation to help the person who is sick, if all you know is calling the emergency this is good too. I'm a trained first aid helper (not EMT). If I don't help someone in need, I risk more legally than someone who isn't trained. The fear of being sued after helping someone is not really a thing here.
Same here in Italy, and the driving license course includes some basic first aid training.
@@demoniack81 this has
recently been implemented in Belgium too.
@@demoniack81 same in germany: you have to do full day (9 hours of lesson) and get a first aid certificate to apply for a driving license (and a lot of driving lessons in theory and practice of course)
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.++...+
Video like this, remind me how much I love being from Europe.
Germany has a duty to help and it is mandatory to carry a first aid kit, gloves and masks in your car. It is also mandatory to do a first aid course as part of your driving licence.
One slight correction (at least in NY)... you can turn the patient over to another provider consistent with any interventions you have performed are in their scope of practice. So if you have dropped an OPA and are simply ventilating a patient with a BVM, you can pass that off to an EMT, but if you have intubated the patient or performed a surgical airway you must transfer care to a paramedic or ride along.
Makes sense. Good to know.
If you intubate you can’t pass it off to the EMT…but transfer it to a paramedic? Those are the same thing right?
@@froggybug Nope, EMT is shorthand for EMT-Basic which are limited to BLS interventions so no definitive airways. Have to be at the EMT-Advanced or Paramedic levels to intubate.
lmao. in what fucking world are you intubating a patient outside of your work. and no. you transfer care to the first arriving EMS unit. If some doctor tried refusing to let me work on my patient because they tubed them while out grocery shopping, they'd be leaving in handcuffs.
@@danielmorgan5401 only happened once to me. Working a code at a golf course and our trauma medical director walks up. Was happy for the help. You're absolutely right, wouldn't accept it in any other circumstance.
Dr. Appel is so knowledgeable, his answers just flow right out. Great interview.
As a retired Paramedic/FF I have assisted on flight emergencies before. First and foremost stay within your standard of care. Relinquish authority to the higher certification (Nurses, doctors and PA’s). Most of which always ask me to assist. And the flight attendants are always very appreciative of your help. And yes I have received miles and plane tickets for helping. I don’t ever expect it but it’s a nice gesture.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.+
@@prtygrl5077 Did you know the word, "physician" exists?
@@prtygrl5077 Huh? We’re you high when you typed out all of that nonsense?
This reminds me of the Winter Camp I attended while in the Sixth Grade (January 1969), My mother, who was a registered nurse, signed on as assistant cook. While we were there, a kid injured his hand. Naturally my mother volunteered to help, and they took him into town, so that a doctor could attend to him. He begged them not to call his parents, because he was sure they would want him to come home, and he did not want to leave. They explained they had to call them, but when they did, they told the parents that he seemed to be okay, and there was no medical reason for him to leave. The parents consented to him staying.
Shortly after, write down what you did - this is good advice for lots of situations. I make notes after witnessing an accident, or anything else of consequence that might become a legal issue in the future. This has come in handy when I've been a witness in court - I think the term is "present recollection recorded" - and I can describe the details that led me to an opinion.
The rest of this is a long description of two cases where this came in handy. TLDR: Notes are a good idea.
In one case, I noted a car behind me using a following distance that was consistently less than 1 second _and_ a tendency to pull hard right when braking. I had seen that for about 7 miles before that car braked hard and veered into a pedestrian - who was thrown about 20 feet. (The pedestrian lived, but had an unstable pelvic fracture.) The court case was months later, and the prosecutor said that she had the better evidence than she could ever imagine for that case. (It wasn't just me - at the time of the crash, a power company worker was on a nearby pole, and a sheriff's deputy was on-site for traffic.)
In another case, after witnessing a crash, the officer that interviewed me at the scene failed to write some details in his report. When an Asst. DA interviewed me by phone, I went to my notes, and she ended up being able to add charges of assault & battery and vehicular assault. The officer who had interviewed me ignored that I saw the passenger swing nunchucks (sp?) at pedestrians on the sidewalk, and hit a couple of kids who ran off, and that I saw the vehicle repeatedly aimed at peds - and the pedestrian that was hit was probably not just because the driver lost control. That ADA started some investigation that found the kids who had been hit and ran away, and some pedestrians that had seen the driver aiming at them. (Those guys took guilty pleas - no trial.)
There have also been times that my notes have defended me from accusations, but those examples are uninteresting.
Writing basic contemporaneous notes, dated and timed is EXCELLENT advice.
I think that if someone assists another in an emergency, it's just in a to receive a good will gesture. It's nice to be appreciated, this does not require a continuous gift but a small token of appreciation is nice treat. Everyone like to feel appreciated.
Working in a hospital, some patients give a bouquet of flowers to the unit. They're not paying us but it's so appreciated. In an emergency, no one expects anything but a token is just a small way of saying "thank you, and I appreciate what you did".
Great vid, I’ve had several situations here in nyc where I took control of a scene until EMS arrived and have been meaning to look up all this legal stuff 😅. Thank you!
I have the feeling that these types of issues aren't typically addressed in medical school. I'd always been curious, too!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩.+.+
@@prtygrl5077 grl u prty!
@@prtygrl5077 there is actually a word, it’s “physician” there are also a ton of social and etiquette issues around the term “doctor” it can be quite a rabbit hole of information.
In the UK at least, you will never be prosecuted for trying to perform first aid. The courts will never, ever convict anyone because it would discourage further people from helping in other situations.
I believe the UK also has a version of Good Samaritan law (at least It says so on the first-aid page of the NHS website) so you shouldn't be prosecuted for providing assistance.
The concept of a country or state where you can legally just ignore a person in need of assistance is bleak to someone from developed countries with duty to assist and good samaritan laws. These are usually super forgiving and sane, too. Like, just calling 911 equivalents is enough to be in the clear, and your obligation is waived if you'd put yourself in danger, are pregnant etc. I'm not trying to virtue signal or boast, but even as a regular guy who took a few first responder courses and only had to assist someone like, twice, the thought of ignoring a hurt person in need of help is really distressing.
Most of those countries also don't allow frivolous lawsuits and don't have a culture that encourages ghetto lotteries aka finding any excuse to sue to get a big payout whether its warranted or not. Its exacerbated by insurers that deal with so many suits just deciding to settle because it cheaper than actually fighting. As long as the complaintent has a half plausible case it's usually settled for a not insignificant sum out of court rather than risk a jury awarding them Alex Jones levels of stupid verdicts. So you can do everything right and still get sued simply because the opportunity to sue opened up and it they have nothing to lose by doing so
As austrian its kinda surprising to hear the state of laws for us/NY.
In Austria also Germany (not sure if it applies to all EU countries), you have to attend a first aid curse before getting a driver license.
Things like checking cardiac arrest, performing CPR are trained here and it is expected you could perform this in case of emergency.
You could even face high fees/jail if you do not perform first aid.
Of course you could not face trial if you did mistakes..
I'm not sure about driving license, I got it 15 years ago. But in Poland helping people in emergency is also required by law.
And even from logic perspective... everybody should at least call the darn emergency services, that one thing will increase chance of survival of that person significantly.
Which I one time failed to do, because of the shock from seeing this. Fortunately that driver did not hit anybody and the car was stopped relatively safely by a tram station. I think visualising such situation in advance can help to prepare. I didn't make the same mistake later.
If I'm not mistaken, here in Luxembourg if you are part of any medical field and you see an emergency that is not yet taken care of by emergency services, you have to stop by and at least ask if they need help. If someone saw you just drive by or run away then they can sue you if they know that you are working in the medical field. That is at least what my mom told me when I was a child of 8 maybe 12 years so it might be different but it's an overall generally good way to approach it.
Not sure about Luxembourg, but in Serbia (which pretty much copied EU laws and regulations in that field), if I drive and come to a scene of an accident, I am *required* by law to try to help. The law only does not specify if I must do it only if I am the first responder and what "trying to help" exactly means.
in Germany, before getting the drivers license you need to take a first aid course. When witnessing an accident or something similar it's your duty to help, at least as good as you can. In the car there also must be a little first aid kit, with bandages and stuff. You might get up to 1 year of jail time if you didn't help.
I am a doctor too and it's sad that in this age of being "civilized" people have a choice of not helping someone in need, or that I have to worry about legal implications before helping someone out...
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩.+.++.+.++
@@prtygrl5077 you are reported TROLL
@@prtygrl5077This person is so jelous & frustrated Lol
@@titanicexpert did your reporti!ng do anything? sa!ddist 😂
There were some interesting episodes of Bondi Rescue (an Australian show following life guards on Bondi Beach), wherein it wasn’t unusual for off duty doctors/medical professionals doctors to attempt to help with serious incidents.
More often than not, the life guards would ask them to take a step back; these life guards were trained to deal with these very specific types of incidents, and trained to work well together in high stress environments. Often the doctor , whilst well intended , was ultimately a hindrance.
"If you need legal advice, either consult an attorney or marry one" now THAT is a smart man
I would also leave contact information with the police or call them afterwards. As too many times working as a firefighter, we get on scene, we focus on the incident first, but the witnesses are gone before we realize. A simple business card with "Blue car hit Red Car" or what you did, and the police can follow up.
Definitely an interesting note on the "hand off to someone with higher training" advice, that probably assumes that it's mostly going to be a lay person handing a patient off to an ambulance crew and then to an emergency room, but not always
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+++.+.
Super interesting video Max!! I found myself in a similar situation with a random pedestrian trauma in Manhattan not too long ago. This is all great to know if that ever happens again!
What did you end up doing and what would you do different?
Shyam! You gotta tell me about that
@@MaxFeinsteinMD Off course you have to fight the invalid lawsuit when the create it! so it doesnt really matter when you win in the end!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.++.
I'm a paramedic and my understanding is that the rule of handing off patients to providers of equal or higher level only applies when the providers are on the clock getting paid. so when I am on the clock I can transfer care of my patients to another paramedic or a nurse, NP, PA, or doctor as long as any of those people are also on the clock. I can never hand over patients to an EMT or bystander, even if the bystander is also a healthcare provider but they are off duty. but if I arrive on scene and the patient is being cared for by an off duty doctor, it is perfectly legal to take over care of the patient even though I am a less advanced provider. I guess what it boils down to is the fact that the off duty doctor has extremely limited resources at their disposal in that moment, whereas I have an entire ambulance full of ALS equipment so in that situation, I am better equipped to help the patient. if we were in the hospital however and the doctor was on duty they could not hand the patient over to me.
My take away was that if you aren't being paid and choose help someone, you are acting as good samaritan and you just need to avoid doing something grossly negligent.
Wow- this dude is great! The fact this dude has full degrees in both legal and medical is impressive! He is able to sum things up better than really anyone else. There is so much nuance and semantics with these bystander laws and rather than bogging down in well this could and maybe well if then... it sums up the points that are most important. And since it is not advice in ether feild- it is a great crash course.
I loved the "I'm a psychiatrist, but I don't bring a couch with me," comment. Neat video!
Thank you Dr. Max and Dr. Jacob! Really appreciate the information that you both have provided!
In Poland we have lawe that says you have to rescue if its is safe for you. If I remember correctly if you don't rescue you can go to jail for 2 years. But if you rescue you have protection from any damages you do
A physician and an attorney? Good lord man, doctor, Man-doctor, esquire. On a scale of Single payer system to 100% anarchy - how much do you love school?
Love your content, Dr. Feinstein - you've really opened my eyes to some of the complexities faced by the good men & women who've kept me from dying while surgeons were doing whatever it is surgeons do (I'm kidding, the surgeons and nurses are awesome, also)
At the very least, they've resisted the urge to take me out. Hell, none have even knicked my recurrent laryngeal nerve in the hope of a minute's peace when I awaken.
Good people, all. Doing a job I can't comprehend in a needlessly complex and bafflingly money-centric environment. Have a thumbs-up while knowing I think you deserve much more
Cheers!
somehow the advice is the same as for laypeople, if a computer scientist steps forwards and a swiming instructor comes in, the swimming instructor is probably more current on their emergency training. And the general rule is to stay with the person until the emergency vehicle arrives and someone relieves you. I think the difference between a good samaritan doctor and the emergency vehicle is also that however appropriatethe training of the doctor is beforehand (on the emergency care to psychiatry spectrum), the vehicle has gear and a trained team in the appropriate gear, reaharsed procedures and the mindeset to do the job.
Being trained in first aid, doesn’t make one a dr. Just like staying overnight in motel six doesn’t either. I did save a life using first aid training using the hemlich maneuver when a guy had a hot dog stuck in his throat. I asked are you choking and do you want me to do the maneuver which he shook his head. It was a lot harder than training. In my mind, I was going to try twice then tell them to call 911. It worked. Amazing how many people were standing around.
I feel like even as someone who doesn’t live in the US. It’s food for thought. I’m not a physician but he speaks quite equally on both sides. I always like to say “give with caution”. I think that also applies when someone is having a medical emergency. We have to consider things we do not know. Society needs to heed to contacting 911. A lot of people talk poorly about reality tv but once I heard on one of their shows. That if a person is laying down, you must be carful of their neck. Depending on the situation. As you don’t know if they broke their neck or strained it. A lot of people don’t think of legal ramifications when it comes to medical emergencies as a Samaritan. Which I believe people need to be more careful of paying attention too.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.+
There was case law in Australia where a doctor was asked to attend a boy who was never his patient and was having a fit 1-2 blocks away. He did not attend and was sued (and lost). So therefore whenever asked to attend an emergency I run out.
Case 1: 7pm dark and cold, with a few patients in the clinic still waiting, was requested to attend an accident where pedestrian was hit by car. Arrived, ensure safety and assessed level of consciousness and checked for spinal injury etc. Helicopter landed nearby to take patient to the hospital. Prepared the incident report straight away as police asked for statement few weeks later. Outcome the girl did have head injury but recovered.
Case 2: lunch time and a young guy outside got knocked down crossing the road. Ensured his safety before ambulance arrived. He broke a femur and definitely needed help.
Case 3: 8am clinic just opened someone ran in and said a girl in her 20s found in street gutter unconscious. Lucky for her that my senior partner was on and he used to do helicopter rescue. She was intubated and brought back to life. It was not an overdose case (unlikely in our area), but a rare cardiac arrhythmia. I got to talk to her some months later and realised that she was "the one" that survived.
We were told on school help and leave fast!!! Give no info!!
"you're going to be trapped in that situation once you start"-- this is the important part. You don't have to help, but once you start helping, if you are a medical professional, you are obligated to continue until you hand off to another (more senior?) caregiver.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+..+
@@prtygrl5077 GFY
Here in Denmark we have defibrillators hanging everywhere. They are never far away. As a respiratory carer I am trained in CPR and other things. I would always step in when needed, but anyone here can be become a Heart Runner (as they are called) and use these defibrillators following CPR. There have very easy to follow step by step guides on them. Do you have them in the US? I think they are a good idea. They've save many lives.
Yeah, there are defibrillators in many public places. They are Automatic External Defibrillators (AEDs) that are designed for a lay person to use. They have a voice that guides the user and it has some electronics to assess the patient to determine if defibrillation is indicated.
@@DavidCiani 👍
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.+.+
Part of the problem with AEDs is that they don't actually "save many lives". They save MORE lives than the 1% that CPR alone saves, but success is still highly dependent on medical circumstances and time to intervention. AEDs in hospital are wonderful because you can give them a trained nurse to keep around otherwise-healthy patients with a history or risk of throwing arrhythmias. Most people who have arrests on the sidewalk are already terminally ill with heart disease, and most of them aren't even fibrillating, they're just asystolic and clearly DRT.
Yeah, just recently found a guy who was OD on Fentanyl and I was as close as one can get to performing CPR. Thankfully he started breathing (1 breath every 30-45 seconds), and I didn't have to start chest compressions. Called 911. Paramedics got there and delivered Narcan. I was wearing an N95, but no face shield and no gloves. PPE is def something I will carry from now on. At least an N95 and face shield in the day of COVID.
Well done but 1 breath every 30-45 seconds is not effective breathing, so CPR would still be needed. Sometimes patients may present as breathing where their actually breathing agonally. When we’re looking for effective breathing it should be at least one breath every ten seconds and a regular rising and falling of the chest or breaths. You did amazing regardless and we all are learning.
@@harismohammad2005 Appreciate the input and encouragement. Guy had a strong pulse and his color was surprisingly good, despite not visually breathing. I'm guessing he had just OD'd, and I had made the call to emergency services, immediately. Would have started chest compressions if I did not see him breathe or noticed his heart wasn't beating. Instead I made sure his airway was open and unobstructed, which it was. Paramedics arrived and bagged him while giving him narcan. In this case, no CPR and a quick response time with the narcan saved a life. Paramedics did not perform CPR either.
The "Good Samaritan" Laws were largely the results of legislatures acting after a famous "Dr. Kildare" episode on TV. Most of those states which had governors who were lawyers did not enact such laws. The reason was that removing liability creates an additional obligation to act. However, I think that the legal advice offered here was good. To date, I believe that there have been no successful suits against physicians who acted appropriately in good faith during an out of hospital emergency. Personally, I once stopped at the site of a severe auto accident late at night, identified myself to one of the police officers who told me that a pregnant woman was the victim but he was sure she was dead. I grabbed a small surgical kit from my car and rushed down the hill to the vehicle prepared to perform a C-section (not my area of expertise). Unfortunately, she had been dead for a long time and there was no possibility of fetal survival.even if the pregnancy had been more advanced. I realize that a suit would be very unlikely but I would never consign the care of a complex, at risk pt. to paramedics in an ambulance. In one such situation, I once rode with an electrically unstable pt to a major med. center and resuscitated/cardioverted/defibrillated her at least 20 times to get her on the table for cath. and then surgery. She survived and did well.
"The reason was that removing liability creates an additional obligation to act." How? Aren't those independent?
@SolomonUcko well if you're not going to get sued, you ought to act. But if there's a danger to yourself, it's reasonable to decline
Dude's a lawyer AND a physician... that's a lot of cred right there.
In the UK I can't imagine anyone could or would sue a doctor or random bystander who performed cpr whilst waiting for paramedics to arrive. Even imperfect CPR and a couple of cracked ribs are preferable to the alternative. Likewise I found someone who'd passed out. Breathing was OK and heart rate was fine, so I put this person in the recovery position whilst calling an ambulance. Turned out they were epileptic and had had a seizure.
I know some epileptics in the US don't want ambulances called due to the bills, but in the UK that's not a concern. In the position I was in, I acted in the best way I could. It turned out I had done the recovery position slightly wrong, but of course I didn't face legal consequences. The police aren't wasting their time on a well intentioned civilian doing adequate but imperfect first aid whilst waiting for an ambulance.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩...+.+
Disclaimer. Legal advice in the US only. In the UK you can loose your license to practice as a medic or a nurse for not helping in an emergency
This is really interesting. Also alarming that you don't have the duty to help over there. I thought that was something that existed everywhere. Although I must admit people rarely get prosecuted under that, at least where I live.
The difficulty of prosecution is probably a large part of why the law doesn't exist in most US states.
Thought I'd share a half-care story. Some years ago as an EMT we were called to an old age home. The call was for CPR in progress. When we entered the room as a BLS unit we saw nurses very badly performing CPR and we're told that the previous shift had essentially begun CPR left, and they had "rediscovered" the patient.
In my country, any death scene outside of a hospital must be cleared by a police lieutenant as accidental or natural. Usually this is a routine question and if we are asked we give our honest opinion usually yes we think this was natural / accidental. This one we answered the very surprised officer, we think this one requires further investigation and told them what we saw and heard
With all the respect, I’m a respiratory therapist and had received intubated patients in the ER from EMTs where the tube was found in the esophagus or in the right main stem, the outcome was to educate and not to point fingers of who killed the patient.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩++.+.
@@prtygrl5077if they are doctors, than they should be called doctors. And by no means is an MD or many of the other titles and specialties low level degrees, unlike your Masters in copy/paste.
@@darkeyeze You typed "than". It should be "then" you uneducated hil!billy j!unk 😂💩
"Doctor" is a very broad category, "Medical Doctor" is much more specific, though still a broad category. There are many types of Medical Doctors as well. Most of the problem is when people ask for a doctor, they really mean an MD (Medical Doctor), not just someone with a PhD.
Great idea. I would make an emergency kit. THANK YOU for this video. This will make many ppl informed.
BTW kudos to going through law school AND med school but having a sense of humor is key (which he has).
I hope both of you have many children..we need as many intelligent people as we can get in this world.
Pretty crazy over there in the US...
Here in Germany, you have to take a day of first aid lessons to get a drivers licence. The first thing we where told there: "don't be afraid to do something wrong. What do you you think could happen? The patient dying twice?".
If you do not try to help or at least call the rescue (who will instruct you on what to do) when you see someone needing help, you can get pretty hefty fines or even up to a year in prison for "failure to provide assistance".
The patient dying with you holding the legal liability. That is the answer
@@John_Smith_86 Well if you are not a trained professional you do not have any legal liability apart from beeing obligated to help them in the best way you know. If you do nothing, then you are probably liable. Might be a different mindset in diffrent societies.
@@simonexner6199 Only a few European countries implement such proactive laws. It is not the norm
@@John_Smith_86 Well, I am happy to live in a country where in fact it is the norm ;)
Thank you for providing us with such detailed and enjoyable content Dr. Feinstein!
Special thanks to Dr. Appel for his insight in this video & on this topic too!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.++++
A friend of mine a doctor never uses "Dr." out of the office and always prefers "Mr." outside. The legal pitfalls can be an issue.
The reality of "legal pitfalls" are much more imagined than real.
Good Samaritan laws don’t keep people from suing you. Even if it’s ultimately thrown out of court, you still hired an attorney, were deposed, ran up legal fees with your attorney and missed work. And I’d say that your malpractice rates would increase. When people see “rich” doctors they don’t think they have anything to lose and good luck recovering the money you spent.
This is true of anything; nothing stops people from filing frivolous lawsuits except in the most egregious cases of abuse. However, such a lawsuit would likely be dismissed summarily before any real discovery, and malpractice insurance covers legal fees.
@@morbo3000 Typically retired physicians don't carry malpractice. I recently looked into it in order to volunteer and the rates were unsustainable. Tail coverage isn't the same as current.
@@morbo3000 Still talking $20 to $40k to hire a competent attorney for such a conclusion. If it went to trial because of a corrupt judge (lots of them), you're screwed.
A few years back I was in the US with a friend and we witnessed a cyclist get hit by an SUV…
We helped, nothing huge, basic first aid, recovery position and whatnot.
I was amazed by how folks just stood around staring. No one called emergency service and no one offered to help.
One of the onlookers asked my friend if he was an EMT / paramedic. He was rather busy and replied with ‘no. I’m British’
Was a very strange day. It worked out okay in the end and the cyclist was able to recover.
"No, I'm a human being."
I love Max's posts and I particularly liked this one. I'm 79 ½ and have always been interested in medicine so when I learned to drive aged 17 I used to carry 6 x 1ml ¼ gr ampules of morphine sulphate (lets go with 15 mg if you find that easier). I had a glass and metal syringe in an old Alka Seltzer glass tube submerged in methylated spirit. I never got to use them. Remnants of my father's last days of stroke treatment. Oddly enough the local bobby knew I had them in my car but it was Wales and it was the late 1950s.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩.++.+++
I'm a retired internist now living in Florida, and I do not have a Florida medical license. Before medical school, I was a volunteer EMT on a rescue squad in New Jersey. I have considered volunteering again but worry that I might be held to a higher standard than an average EMT, even though I have not practiced medicine in several years.
Hi Dr. New Jersey is a hard state to practice medicine. You work like a dog 🐕 in NJ. I bet you don't miss NJ at all.
Doctor Kuntz. I am a Nurse Practitioner in NJ and it's rough work in the trenches here in NJ, especially Northern NJ.
@@lanaofficiel4042 For a variety of reasons, not least of which is the weather. 😃 While it was cold this last week, into the low 20's F, we did NOT get any of the horrid white stuff falling from the sky.
Nice job Max. I have been in these situation innumerable times. Good, practical presentation. Kudos.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.++.
00:40 in Germany that's a state law. It's called "unterlassene Hilfeleistung" (Failure to provide assistance) and it's punished with up to 1 year in prison or a hefty fine. The idea is that when someone is about to die you can't make it worse. (of cause it only applies if you do not need to endanger yourself while rescuing)
If you're on a plane assisting, most airlines call Medlink where doctors are on the line and will assist (they know what's in the airline-specific medical kits) and the airline's licensed dispatcher is on the call in most cases too, and that's the person with the authority (shared with the captain) to send the flight to a diversion city, in coordination with Medlink doctors (where they may assess the best options not just for weather, airport services, approach capability, legal authority to operate at the airport, etc, but also conferring with Medlink on proximity to hospitals or special units--like cardiac). If Medlink recommends something, I'd defer to them. By taking the call, they're accepting medical liability and thus the airline isn't on the hook for medical decisions including whether or not to divert. I assume they'd take liability from onboard physicians as well.
Medlink takes full liability and is primary decision maker. If on board Doc says “we need to land” and Medlink doc over radio says “keep flying”, according to SOP for liability protection I have to listen to Medlink. Same thing if I’m on the ground after pushback.
Blows my mind someone could clearly be having a heart attack but pilots have to wait 10-15min for Medlink to get linked in, given the passengers info and then a decision made allowing pilots to divert.
@@Sports-Jorge I know what you mean, but it's probably for the sole reason that by using MedLink and following their advice, your carrier is mostly free of liability in medical decisions. An onboard doctor (or nurse, medic, EMT, etc) may or may not have specialty in the field and also doesn't have access to tools and information MedLink does. Like if Tyler, TX is in your op specs, it may make more sense to drop in there rather than the Dallas metroplex for a cardiac emergency because they have good cardiac units, less traffic, etc. Do we divert to an offline airport (and/or closest suitable) or wait until the next major airport, one with service, etc? Those are largely MedLink and dispatch decisions and factors to consider. Not that the PIC doesn't have a role of course, but dispatch handles more medical situations and has more resources to consider, including weather, NOTAMs, services, etc.
There is always a doctor,nurse medic,on a plane. Have had many medical emergencies on my aircraft.(retired fa). Eager to help, so thankful of medical people. We listen if they say to land. We make an emergency landing at closest airport.
As 911 Paramedic I had run into all levels of medical providers who were "unintended" first responders. And, a few times we recognized the MD or PA-C/NP. And, if we did not recognize them we had a card we carried that had printed instructions by our Medical Director. Which in the readers digest version stated if the unintended provider wished to issue orders that they would have to accompany the patient to the ER and relay information to the ER Doc (our Medical Control Doc). That usually had them backing off. But if it was someone we recognized we embraced their input. The problem with unintended first responders....is that they are out of their element. I have witnessed "Clinic" nurses doing CPR Compressions so fast that well. Best cluster in motion was call to an allergy clinic. A patient being tested had full blown anaphylactic reaction. We go into the clinic and well there was a Crash Cart present with several physicians in the room doing a whole lot of nothing.....and RN/LPN staff...trying to prompt the docs into action...NO EPI NO Benadryl, etc. worst of off al her lips were BLUE.
Like my first paramedic partner said....What is paramedic without ALS Supplies Equipment? = you become Basic EMT without equipment so you have to improvise. Rolled up magazines make great splints. Take a door off the hinges and add towels and duct tape...Back board!.
Scariest thing to hear when on scene is; "Move over, I'm a nurse, I can help". :)
@@opusthe2nd Don't you know it. I once had Nursing Professor from a College west of St. Cloud MN try to tell my partner that is not how you give drugs.....she probably had not touched a patient in years. The funniest one was a gentleman attending the local hospital fund raising event suffered an event. Once of the ICU nurses from the local hospital ripped her skirt purposely so she could get down and do compressions. She just smiled and kept on going.......and when we left with the patient we gave her one of the blankets off the cot to wrap up in.
God Bless those that try to help. But, sometimes you have to know your limitations!
When I helped someone on United, worrying about a PE, suggested that he go directly to the ER, I got 0 compensation. I got the guy's phone number and called to check that he was ok and found that he had pneumonia which surprised me.
I'm a Paramedic. For all the doctors and nurses out there: Yes, please help the patient. Yes, please identify yourself to us. Please don't try to give us orders, they may conflict with our agency's Standard Operating Guidelines or Protocols.
No shade on you, @JohnSwanson, but paramedics- please recognize *us.* The worst time for me was when I was with a motorcycle rider victim (full disclosure: against my 'instructions,' my partner opened the front passenger door while we were stopped at a light and the lane-splitting biker ran into it. Thankfully she hadn't exited yet). I identified myself as trauma center PA to the patient, brief assessment without removing helmet, determined fractured clavicle (pretty obvious) and indeterminate injury to a couple of fingers. When EMS arrived I was ignored, and yep - to backboard him they rolled him onto his fractured clavicle. That was they only time he screamed on scene. -- I get it, not all providers are similarly competent, especially not out in the streets. Doesn't take long to hear them out - seconds to determine if they have any useful info.
@@spartlow8872 Oh absolutely. As EMS we need to listen to bystanders or witnesses, often while doing other things. A hand off report from a Healthcare provider on scene is always welcome. Bossing me around -not that you were bossing anyone around- never is, that's all I mean.
Just as an example: I wouldn't backboard a motorcycle accident today because of the risk of aggrevating other injuries and it's not required by my protocols. I'd use a scoop stretcher so we don't have to roll the patient at all.
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩.+.+..
I mean...If we were there first and have assumed care then idk what you are hung up about. It is our role in medicine to coordinate roles and make medical decisions. I understand this may come from some nuanced scenario you have in mind, but it's coming across like you don't want a doctor telling you medically what to do. Sorry, but it's kind of our job to give medical orders.
@@kjhart91 again a hand off including the results of an assessment and treatments preformed is always welcome. But regarding orders; we have orders. That's what we have protocols and medical control physicians for.
Enjoyed the discussion. It clarified a few contentious situations and medical responses. The book looks like interesting reading. Look forward to reading it.
Great vid! I’m in school now for a DNP and Bioethics certificate and these ethical situations are always interesting to mull over but we have to remember the legal ramifications in real life situations. And just bought Dr Appel’s book - looking forward to reading it!
I think "doctor" position only should provided to PhD holders. All the other low level degree holders should called by their profession. For example. Who fix mechanical things: Mechanical Engineer. Likewise, medical degree holders who fix body should be called " *Body Engineers* " or " *Body mechanics* ". There's no rational to call them "doctors". 😂💩+.+.
Regarding your scenario about plane emergency: That happened on a winter flight, when I was a professor. Nobody on board had any medical training. But many assumed I did. "Sorry. I'm a doctor. But not that kind of doctor." We ended up doing an emergency landing in Memphis.
What happens if a physician is not board certified in a country where they're offering help?
The general theme is that Good Samaritan laws mean all of that about licensing, certification, etc. isn't relevant and that anyone who helps is protected as long as they act in good faith and don't do something grossly negligent.
in germany duty to care is universal, although you can get away with calling emergency services (and waiting for their arrival) in almost any case
Thats interesting. I thought anyone in the medical field doctor or below has to help someone IF they have the training to help. Example literally everyone who works in the medical field has cpr training, there for has to do that. Or another example a CNA can help stop/slow the bleeding until EMT arrives or someone who has more education.
Now i have to look up the laws in my state lol.
Definitely a great topic you brought up.
@Bernie Sanders "Help" in the context of these laws means to call 911. No one is requiring car mechanics to perform emergency resuscitation.
In Europe that is the case. You can get jail time If you DONT help as trained professional in an emergency. The average citzen fullfills their duty to "help" by calling 911 (112). If you have training (btw for your driver license you have to get CPR/ first aid certified but that doesnt count as training in a legal context) you have to do the best you can according to your training, the resources available and without putting yourself at risk.
Once got a handful of chocolates. Very hard turbulence on approach to our destination, overhead compartment door above me opening suddenly, unbuckled quickly, slammed the door, sat back down and fastened the seat belt again. If I did not act right there and then, the person on the other side of the aisle could get seriously injured of something fell out and it was really safe for the attendant to walk and close it. She saw what I did, smiled and later on handed me a handful of chocolates with "Sir, I think you forgot this" :)
Dr Feinstein this video was interesting but when are you going to go back to the anesthesia videos? I enjoyed those videos the most
I have more anesthesiology videos planned!
@@MaxFeinsteinMD Thank you so much have an amazing weekend
Fantastic video, Max. Topics like this keep me coming back. Well, that and the perfect mix of information and humor!