FIRST AID DUTY OF CARE AND THE GOOD SAMARITAN (Part 1)

FIRST AID DUTY OF CARE AND THE GOOD SAMARITAN  

Part 1

1

My First Aid students often ask me the question:

‘Can someone sue me, if I offer First Aid and do something wrong or cause the victim to take umbrage against me?’

Well, that is a good question, because I tell them that being a First Aider not only falls under the heading ‘Duty of Care’ but also the Bible story titled ‘The Good Samaritan Law’. (See picture above).

I think that this question is reasonable for learners of First Aid to ask, given the increasingly litigious world that we live in. Although it must be pointed out that, in the USA, I am sure that the rules are very different from the stories we read about people suing their First Aider for breaking their ribs when they were performing life-saving CPR in the form of Chest Thrusts!

The most important thing to remember is that up to now, no one in the UK has ever been sued for administering life-saving First Aid on a casualty.

The reasons are as follows; ‘A Duty of Care’ is a legal obligation set on an individual requiring that they confirm to a standard of ‘Reasonable Care’, whilst performing any acts that could foreseeably harm others.  It is the first element that must be established to proceed with an action in negligence.

It is essential to remember that one’s 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, Health Care Professional or Doctor.

What do we mean by the word ‘Negligence’?

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

For a First Aider nominated in the workplace, the situation may be different from those who are simply bystanders, because it could be argued that they have assumed a ‘heightened’ duty of care.  Also, the First Aider in the work place would have completed Emergency First Aid at Work (EFAW) course (certificated and valid for 3 years).

Under the Health & 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/her job description, could be argued to owe a ‘Duty of Care’ to his fellow employees to give First Aid where and when it is needed.

A person, whether a Healthcare Professional or a member of the 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). An example of this might be if the First Aider felt that he/she was in danger.

However, if that person does choose voluntarily to intervene to provide assistance to the casualty, 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. I always say to my learners on my First Aid courses to only approach and treat someone, if you are willing and able to do so and you are not risking your own life (or the lives of others) in doing so.

You can refuse to offer treatment to the victim of an injury, especially if you or others around you, are in danger of being harmed.

I say to them: If you are not happy to provide First Aid treatment in the ‘classic’ sense, there are several things that you can and should do:

  1. Make the area around the casualty is safe for yourself, others and the casualty (known as the ‘Primary Survey’)
  2. Shout for help or inform someone else (a Second Aider to call 999/112, if it is an emergency)
  3. Get a response from the casualty by shouting at them and tapping their shoulders
  4. Check that the casualty has an airway and is breathing
  5. Provide CPR, if they are not breathing
  6. Position the casualty safely on their side (Recovery Position)
  7. Cover them in a blanket or coat, if possible
  8. Monitor the casualty and/or find out what happened
  9. Comfort the casualty, even if it is talking to them or reassuring them that they will be ok using a calm voice

10.If necessary, write-up what occurred in an Accident Report Book

The next big question my learners often ask is

‘What happens to me if I injure the victim or casualty?’

A person, who administers First Aid to a victim of an incident, will only be liable for damages, if negligent intervention directly causes injury to the casualty, which would not otherwise have occurred. This may also be the case, if it worsens an injury e.g. pulling a knife out of a casualty’s chest causing them to bleed to death.

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/she used, fell below that which could be expected of him/her 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.  This is the reason why filling in an Accident report Book is essential in all cases of injury.

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 interference be leaving them in a worse position.

If, however, CPR is performed on a casualty who is in Cardiac Arrest, It is difficult to see how a person’s intervention could leave the casualty worse off, since a victim would, without immediate resuscitation almost certainly die.  In addition to this, if an AED (Automated External Defibrillator) is being used, it will only permit the administration of a defibrillator shock, when it detects a shockable rhythm and since the victim is in this state, they are clinically dead. It is unlikely therefore that any intervention with this device, could make the situation worse.

Attending an accredited First Aid training course (EFAW) not only provides you with lifesaving skills but also aids you in the knowledge and understanding of current best practice.

A First Aid certificate is not a ‘Licence to Treat’, however, 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. You are also being a ‘Good Samaritan’. This comes from the bible story of the same name in the Old Testament LUKE 10:30-37, where a man had been robbed and harmed and left to die in the road. A priest came past him and ignored the poor man, and then a lawyer avoided him, until a man from a different faith to the victim became the Good Samaritan because he helped the man, by giving him food and clothes, so that he could get home. It is a very important bible story, because it illustrates man’s kindness and charity to his fellow man and our duty of care to our friends, family and neighbours alike.

Anyone can be a Good Samaritan, even you!