Bystanders...Get out of my way!

I have observed and recently experienced the plight of the Good Samaritan.  As emergency responders we arrive on a scene with what appears to be a strike team, an engine and a medic unit with a combined crew of six. We perform a rapid assault assessing the patient, mitigating any life threatening concerns, and then rapidly remove the victim from the surrounding area in an efficient and coordinated manner.  It is poetry in motion. What I think we miss out on at times is paying attention to the bystanders and what occurred prior to our arrival. We tend to discount any persons input if they are not wearing a fire department uniform. 

Recently I was off duty and witnessed someone have a syncopal episode. I was dressed in civilian clothing and had no indicators that I was trained in emergency medicine at all.  I performed an initial assessment, garnered the patient’s history, and had what I considered a very good run down of what could have been the underlying cause and what treatment would be required.  When the responders arrived they weren't really interested in anything I had to say. The first part of the strike team to arrive was an engine. I attempted to help them with their assessment and suggested acquiring a 12-Lead EKG.  I was told that the medic unit would take care of that and was brushed aside.  When the medic unit arrived the crew wasn't very interested in anything I had to say either. They repeated some of my assessment questions and never wrote down or appeared interested in anything I had done prior to their arrival. They then took the patient away to their unit.  I later found out the medic unit obtained a patient refusal and the patient was never seen by a physician.  WTF...I was beside myself.  I saw the patient later in the day and he said that everything was checking out fine so he didn't go to the hospital. 

Who were these people that came to check him out...WTF...of course it checked out fine...he was conscious now...anyone with any iota of medical training should know that a syncopal episode could be a medical time bomb waiting to explode...whatever caused them to go unconscious and then wake up just didn't last long enough to kill them...definitely a medical condition requiring further testing and follow-up. Not every syncopal episode denotes a dangerous life threatening underlying condition but it's possible and should be taken seriously.

I think it's very important to not only treat the patient as a human being but also all the other human beings in your immediate area at any given moment.  Don't discount the value of the bystanders or allied healthcare worker on the scene of any emergency. They can be a valuable asset.  The time you spend gaining information from them can possibly  save you time later on. Not a sermon...just a sermon.