HSE Madness

[Mark James]

Yes they are mostly urban myths, my wife's a nurse in A&E and even some of are colleagues come away with statements regarding not helping people as you could be left accountable. It is utter tripe and mostly started in a bar with local expert after 10 pints.

If my wife didn't help someone in the street if they collapsed surely that has to be worse!

 

 

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[scotspine1]

yes but sadly not known to you the victim had a broken neck , the sudden pulling motion on the way up resulted in the victim passing away before reaching the surfce .

 

The woman in this case died of a heart attack on the way up whilst being rescued by mountain rescue specialists.

 

There's very little time to think about possible outcomes in a real life rescue situation, she needed medical help urgently. Anyone going down that hole would have some basic knowledge regarding movement of victim and possible spinal injuries. You'd assess the situation as it happened. In the case in Ayrshire the woman didn't have a broken neck.

[combined tree services]

Please give a link to documentary evidence of such a real case.

 

These accounts are often urban myths.

 

this may help explain what i am trying to say -

 

Duty of Care & The Law

 

 

Disclaimer: because of the generalisations made in this article, it should be taken only as guidance. For further information, consult the United Kingdom Resuscitation Council document “The legal status of those who attempt resuscitation.” or a legal expert.

 

One of the most common questions we receive is "Will I get sued if I give first aid to a casualty?"

 

This is a reasonable question given the increasingly litigious world we live in. The following article provides some of the important factors that must be considered to protect both yourself and the casualty.

 

This article is not intended to frighten or deter a potential First Aider, rather inform potential rescuers of the current legal situation where examples exist.

 

The most important thing to remember is that to date, no one in the UK has ever been sued for administering life-saving First Aid. The reasons – and how you protect yourself from litigation – are explained below.

 

 

 

Terminology

Duty of Care

 

A duty of care is a legal obligation set on an individual requiring that they confirm to a standard of reasonable care while performing any acts that could foreseeably harm others. It is the first element that must be established to proceed with an action in negligence.

 

Reasonable care – or the actions of a reasonable person - is a legal basis of Common Law representing an objective standard against which any individual's conduct can be measured. It is used to determine if a breach of the standard of care has occurred, provided a duty of care can be proven.

 

What is important to remember is that ones actions would be judged against those of a reasonable person of the same standing in a similar situation; the actions of a First Aider would therefore only be judged against those of someone of similar training and experience, not against the actions or decisions of a paramedic or doctor.

 

 

 

Negligence

 

Negligence exists when a person breaches their duty of care owed to another through an act or omission which results in an injury or a loss. This is not the same as carelessness because someone might be exercising as much care as they are capable of, yet still fall below the level of competence expected of them.

 

 

 

Common Law

 

Also known as case law or precedent, is law developed through previous cases by judges and through decisions of courts and similar tribunals rather than through legislative statutes.

 

 

 

Statutory Law

 

Statute law is written law set down by a legislature, as opposed to Common Law.

 

 

 

Duty of Care and the First Aider

The situation may be different for those who are not mere bystanders, and who have some kind of connection with the victim (such as a teacher-student situation or a First Aider in the workplace who has assumed a heightened duty of care).

 

Under the Health and Safety at Work Act 1974 and the subsequent Health and Safety (First Aid) Regulations 1981, an employer is under a statutory duty to provide first-aiders in the workplace for the benefit of their employees. These first-aiders must undergo training to an approved standard in a specified list of competencies. As such, an individual who takes on this role as part of his job description could be argued to owe a duty of care to his fellow employees to render first aid.

 

A person, whether a healthcare professional or a member of the lay public, who witnesses a situation ‘in the street’ where life-saving First Aid might be required is under no obligation to assist, provided the situation was not caused by him. However, if that person does choose voluntarily to intervene to render assistance they will assume a duty of care towards the individual concerned. By starting treatment you are accepting a responsibility to the care of that person.

 

Rule 1: Only treat if you are willing and able to do so.

 

 

 

Can I choose to do nothing?

 

Whilst there is no law that forces anyone to treat a casualty this does not mean that one can simply leave a casualty who you know is in danger. To do so may make you liable through your omission to act. If you are not happy to provide First Aid treatment in the 'classic' sense there are several things you can and should do including (but not limited to):

 

Inform someone else, such as 999 if it is an emergency.

Make the area around the casualty safe for yourself, others and the casualty.

Monitor the casualty and/or find out what happened.

Comfort the casualty.

These are examples of simple but important actions that can be done without 'getting your hands dirty'.

 

 

 

What if I injure the casualty?

 

A person who administers First Aid will only be liable for damages if negligent intervention directly causes injury which would not otherwise have occurred, or if it exacerbates an injury.

 

If First Aid is administered inappropriately or negligently and a consequential injury can be proved to have arisen from that procedure, a First Aider may be held liable for substantial damages if the standard of care he employed fell below that which could be expected of him in the given circumstances. This applies whether they are a healthcare professional, a non-professional volunteer first-aider, or simply an unskilled member of the general public.

 

For example, if a person inappropriately administered chest compressions where a casualty was not in cardiac arrest, which caused damage to the chest wall or underlying organs, they would be causing damage which would not otherwise have been suffered and, given that the casualty was not in need of emergency resuscitation, would by his intervention be leaving them in a worse position.

 

If, however, CPR is performed on a casualty in cardiac arrest, It is difficult to see how a persons intervention could leave someone worse off since a victim would, without immediate resuscitation, certainly die. Furthermore, if an AED is being used, it will only permit the administration of a defibrillatory shock when it detects a shockable rhythm and, since patients in this state are clinically dead, it is unlikely that any intervention with this device could make the situation worse.

 

Attending an accredited First Aid training course not only provides you with life saving skills but skills, knowledge and understanding of current best practice. A First Aid certificate is not a 'licence to treat' but it demonstrates that the candidate, at the time of the course, was able to perform tasks to a nationally recognised standard. By treating a casualty to these standards you are protecting yourself against a claim of negligence.

 

To treat a casualty in a way that goes against the training you have received or to treat a casualty using techniques you have not been trained in but have 'seen it on the telly' exposes you to a claim for negligence.

 

Rule 2 – Only treat in the manner you have been trained.

 

 

 

But what if the casualty does not want to be treated?

 

This situation is not as strange as it may seem; there are several reasons why a casualty, even with serious injuries may not want you to treat them.

 

It may be that they don't want you to treat them, but they might want someone else.

Is there personal history between you and the casualty?

Is there a gender issue?

Is the casualty suffering with a personal or embarrassing issue?

Is there a lack of trust? Could this be how you presented yourself?

Is the injury or condition self-inflicted and the casualty is refusing treatment from anyone?

 

please see second post

[combined tree services]

Under UK law any form of physical touch without consent could be interpreted as common assault. (although is more accurately described as 'battery' in England and Wales or 'wrongful interference with the person' in Scotland). Practically this is unlikely to lead to a conviction if - for example - a First Aider were to hold the hand of a casualty to reassure them, without first gaining consent. A conviction could be made if the First Aider were to use any form of force against the casualty to administer treatment.

 

Under the Mental Capacities Act (2005) a person is presumed to have the mental capacity to make their own decisions unless proved otherwise. On the basis that the casualty has the capacity to choose to refuse treatment this must be respected. It is important that the casualty is not coerced or pressured into accepting treatment, rather they are helped to make an informed decision:

 

Can the casualty self-treat? Do you need to be involved in the treatment?

If the casualty does not want you to treat them, will the casualty accept treatment from someone else?

Is the casualty aware of the seriousness of their injury or condition?

 

 

How do I know if they have the mental capacity to make a decision?

 

The criteria set out by the Act for a casualty to consent / reuse treatment is that they can:

 

Understand the information relevant to the decision

Retain the information long enough to make a decision

Weigh the information and make a decision

Communicate the decision

 

 

In an emergency situation it could be argued that the First Aider could not be in a position to ascertain this information and make a decision and should therefore not be held liable provided all other actions were in line with those of this article.

 

 

 

What if they are unconscious?

 

If a casualty is unconscious and therefore unable to consent – or indeed they had refused consent and then became unconscious – you are permitted to undertake treatment that is only required for the purpose of saving life. You are not permitted to undertake non-life threatening treatment, such as treating minor injuries.

 

Section 5 of the Act applies in connection with the care or treatment of another person. If a casualty is found unconscious - and therefore their mental capacity cannot be assessed nor can the casualty express refusal of treatment - it is suggested that a First Aider who administers life saving actions should not incur any liability in relation to their actions (that he would not have incurred if the casualty had capacity to consent and had consented to treatment) providing that:

 

before performing a procedure the First Aider takes reasonable steps to establish whether the casualty lacks capacity in relation to the matter in question and

 

when performing the act reasonably believes that the casualty lacks capacity in relation to the matter and

 

that it will be in the casualty’s best interests for the act to be performed

 

The best interest of the casualty is usually doing as little as you need to, rather than as much as you can. This is true whether the casualty accepts or refuses your treatment.

 

Rule 3 – Act in the best interest of the casualty.

 

 

 

Can someone refuse treatment on behalf of someone else?

 

No one can refuse Life-Saving treatment on behalf of a capable adult or child over 16.

[combined tree services]

The woman in this case died of a heart attack on the way up whilst being rescued by mountain rescue specialists.

 

There's very little time to think about possible outcomes in a real life rescue situation, she needed medical help urgently. Anyone going down that hole would have some basic knowledge regarding movement of victim and possible spinal injuries. You'd assess the situation as it happened. In the case in Ayrshire the woman didn't have a broken neck.

 

 

In this case the casualty did not but im quite happy to admit that i have not had the training to make that call and as much as i would want to get the casuaty out i would also be aware that i do not have a spinall injuries approved stretcher so would not run the risk of potentially killing someone by moving them in an attempt to help

[Mark James]

Under UK law any form of physical touch without consent could be interpreted as common assault. (although is more accurately described as 'battery' in England and Wales or 'wrongful interference with the person' in Scotland). Practically this is unlikely to lead to a conviction if - for example - a First Aider were to hold the hand of a casualty to reassure them, without first gaining consent. A conviction could be made if the First Aider were to use any form of force against the casualty to administer treatment.

 

Under the Mental Capacities Act (2005) a person is presumed to have the mental capacity to make their own decisions unless proved otherwise. On the basis that the casualty has the capacity to choose to refuse treatment this must be respected. It is important that the casualty is not coerced or pressured into accepting treatment, rather they are helped to make an informed decision:

 

Can the casualty self-treat? Do you need to be involved in the treatment?

If the casualty does not want you to treat them, will the casualty accept treatment from someone else?

Is the casualty aware of the seriousness of their injury or condition?

 

 

How do I know if they have the mental capacity to make a decision?

 

The criteria set out by the Act for a casualty to consent / reuse treatment is that they can:

 

Understand the information relevant to the decision

Retain the information long enough to make a decision

Weigh the information and make a decision

Communicate the decision

 

 

In an emergency situation it could be argued that the First Aider could not be in a position to ascertain this information and make a decision and should therefore not be held liable provided all other actions were in line with those of this article.

 

 

 

What if they are unconscious?

 

If a casualty is unconscious and therefore unable to consent – or indeed they had refused consent and then became unconscious – you are permitted to undertake treatment that is only required for the purpose of saving life. You are not permitted to undertake non-life threatening treatment, such as treating minor injuries.

 

Section 5 of the Act applies in connection with the care or treatment of another person. If a casualty is found unconscious - and therefore their mental capacity cannot be assessed nor can the casualty express refusal of treatment - it is suggested that a First Aider who administers life saving actions should not incur any liability in relation to their actions (that he would not have incurred if the casualty had capacity to consent and had consented to treatment) providing that:

 

before performing a procedure the First Aider takes reasonable steps to establish whether the casualty lacks capacity in relation to the matter in question and

 

when performing the act reasonably believes that the casualty lacks capacity in relation to the matter and

 

that it will be in the casualty’s best interests for the act to be performed

 

The best interest of the casualty is usually doing as little as you need to, rather than as much as you can. This is true whether the casualty accepts or refuses your treatment.

 

Rule 3 – Act in the best interest of the casualty.

 

 

 

Can someone refuse treatment on behalf of someone else?

 

No one can refuse Life-Saving treatment on behalf of a capable adult or child over 16.

 

More rule making nonsense, that's whats wrong where does it mention use common sense. That's the thing you should have been born with.

And if you have no common sense then you wouldn't realise that anyone needs any help in the 1st place.

 

 

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[combined tree services]

More rule making nonsense, that's whats wrong where does it mention use common sense. That's the thing you should have been born with.

And if you have no common sense then you wouldn't realise that anyone needs any help in the 1st place.

 

 

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ahhh i see thats where im going wrong !! so should i end up in a situation of going to the aid of a victim with possible neck and spinal trauma i should move them even though i do not have the correct equipment , if they end up i a wheel chair or worse still the victim ends up dead i will still be ok in the knowlege that i was only trying to help . Right ???????

 

now what was that about common sense ?

[born2trot]

How the emergency services could stand there and listen to that womans screams and not do something is beyond me.

 

I didn't realise until tonight that two kids jumped into the river clyde and saved someone drowning as the police looked on.

 

Something has gone wrong somewhere.

[combined tree services]

How the emergency services could stand there and listen to that womans screams and not do something is beyond me.

 

I didn't realise until tonight that two kids jumped into the river clyde and saved someone drowning as the police looked on.

 

Something has gone wrong somewhere.

 

What has gone wrong is that nasty stuff called red tape , why is it still required that all applicants to the police force must be capable of swimmins arround 100 meters ??? it would appear that its not for the purposes of saving a life . good on the two children for doind what they did Real heroes

[Mark James]

ahhh i see thats where im going wrong !! so should i end up in a situation of going to the aid of a victim with possible neck and spinal trauma i should move them even though i do not have the correct equipment , if they end up i a wheel chair or worse still the victim ends up dead i will still be ok in the knowlege that i was only trying to help . Right ???????

 

now what was that about common sense ?

 

Well surely if you use common sense from the start you would know not to move the person unless he or she was in more danger by being there.

Reading and quoting things from the HSE is all well and good, but when the sh*t hits the fan I rely on instinct, sense and damage limitation.

I will leave the questioning wither its right or wrong for other people, I would take my chances in a bad situation end of.

 

 

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