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seanw146

            This past spring break (2016), on a Monday night while at home, I responded to a motor vehicle accident as a Good Samaritan. The accident happened at approximately 19:00 hours on my street in Blackstone, Massachusetts. My father was on our front porch when he heard a car barreling down our back country road which has a long straight away before taking a sharp turn. Before the impact he knew that the driver would not anticipate the curve fast enough at the speed he was traveling. Sure enough, there was a loud bang and the sound of a car rolling over, which I could hear from inside the house (approximately ¼ mile from crash).

I grabbed both of my personal first aid kits and a flashlight while my father called emergency services. I walked to scene with my father and younger brother. I sped walked and arrived at the crash site first.

The vehicle was a ‘90s sedan that went straight into a telephone pole, which broke like a toothpick, and rebounded backwards and flipped 90 degrees on its left side. Parts of the car, tools, and glass were on ground, airbags deployed. There was a car seat in back, and for a moment I thought a child but it was just clothing. Front right tire was up inside front passenger compartment. Hazards flashing. Driver window was rolled down. No people in the car.

My brother and father directed traffic on either end of the crash site. They almost certainly prevented at another crash by a car who didn’t see the accident but saw my brother flag them down with his light.

I saw man standing 20’ from crash site, talking to people in a gold SUV. When I arrived I start asking medical questions and the people in the SUV leave – they were by standards who pulled up but left after I started taking over. The man in question appeared to be a lower/middle class white/Hispanic, male in his 30s. He was driving an older car with lots of tools in the back which were now all over the road. Our neighborhood is a small country community and I know he was not from our neighborhood. I assumed he was some kind of mechanic, bases on tools in car. He was wearing dirty jeans and stained hoodie. He was definitely a blue-collar worker. He may have been from downtown Blackstone which is largely lower middle class and blue collar, or he may have been from Woonsocket, Rhode Island, which is known as “the Detroit of Rhode Island”.

As I tried to obtain basic medical information from the patient, it was apparent he had an altered mental status, and did not appear to understand fully what was going on. I am not certain if it was alcohol and/or drugs as for safety reasons I did not get close enough to the patient/suspect to tell. He was ambulatory and verbal. The interesting part of our conversation was to the best of my ability as follows:

“Are you sure you’re okay? Umm yeah. Are you hurt anywhere? I’m fine. [I did visual inspection of patient using flashlight which revealed no major injuries other than minor cuts from airbag]. [He starts to edge away from scene]. You should wait for ems to check you out. Wait, you’re right! I might die?! You appear to be okay externally but things like internal bleeding, and a full assessment could reveal other problems. Naaaa [turns and starts to walk away down street]”

I attempted to convince the patient to wait on scene but he was going through several mode swings during my interactions with him from fear, anxiety, agitation, and anger. While I was talking to the patient, the first officer from the neighboring town arrived on a motor cycle. I informed the officer at the scene of the situation about the patient/suspect fleeing the scene. The officer took note of it and continued to work to secure the crash site. Another officer arrive from my town from the west. I informed the same and he stated that he would need me to make a witness statement and proceeded to the crash site. A third and fourth officer arrived together the same time as two ambulances (indicated because of rollover) from the east. One of them told me again that they would need a witness statement.

I met back up with my dad and brother who were no longer needed to control traffic with law enforcement on scene. Neighbors had started coming out to see the commotion. We were all talking near the scene while waiting for officers. Finally one of the officers asked another officer if he should go look for the suspect. He left approximately 20 minutes after my last contact. I never spoke with the arriving EMS as they came from the east and I was on the west of the accident but officers told them that the patient was missing. Eventually multiple officers and cars were out looking for patient/suspect but was not found as far as I am aware. I finally was given the chance to give my testimony which, to the best of my knowledge, mirrors this report. After reading out loud in front of the officer and my father and brother to confirm accuracy, the officer asked me something very strange. First, he asked me to add what the suspect was wearing (which I had forget to include), but then he also asked me to state that I saw the suspect drive into the telephone pole and that I smelled alcohol on the patients breath. Neither of these things were what I told any of the officers and ran counter to my testimony as written. I include the suspect’s clothing description but I did not add the second mention and stated that I had not witnessed those things. After my report I left the scene with my brother and father.

Some of the policies and procedures relevant to this case were: scene safety, dealing with aggressive/combative patients, and HIPPA did not apply to me as a bystander so I gave full testimony including medical status to the officers.

After reflecting on the education I received and didn't receive, there are a few things that would have allowed me to be better prepared for this incident. How do I convince patients to stay on scene? When do you give up? I wish my EMT class was a little better scene on safety training. Being distracted by the emergency at hand, I did not truly take into account the fact that the power lines were live and drooping with half of the telephone poll pulling on them. Only supported by the next and previous poll but not drooping more than 3’ from normal, more than 15’ from ground, and 10’ above vehicle. Reflecting on it, I did not really consider the threat as I should have, and neither did the officers on scene. I don’t understand why it took so long for police to search for the suspect who could have had major medical issues. Should I have followed suspect/patient alone? When is a citizen arrest allowed/appropriate? Should I have asked for the badge number of the officer who asked me to misrepresent the truth on an eye witness testimony? What is the process to do that anyway? If I had the answers to these questions I feel I may have been able to provide better assistance, but then again perhaps not.

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erin_tuttle
Annotation of

The system was built to serve organizations and individuals with humanitarian goals. The system gathers data from report, reviews, and users and compiles it into comprehensible information to help inform decision-making for humanitarian concerns. Portions of the app also focus on education and technical support for field researchers looking to collect large quantities of data.

pece_annotation_1475020279

erin_tuttle
Annotation of

The system is primarily used by researchers, scholars, and organizations with humanitarian interests. The app also has functions which would attract users that are beginning research and do not have established connections within the field as the app provides a support system.

pece_annotation_1475020310

erin_tuttle
Annotation of

Twine provides information and software to set up compatible data collection systems that pool information into the larger system, which the app then makes available to its users. The system also includes a publishing and collaboration aspect which allows groups of people from all over the globe to access the same data and report on the findings together.

pece_annotation_1475020326

erin_tuttle
Annotation of
In response to

Data visualization is primarily determined by the type of data being gathered and the system for data collection being used. The app integrates data in order to both make large quantities of data easily viewable and understood, as well as compare studies with existing data stored on the system.

pece_annotation_1475020351

erin_tuttle
Annotation of

Users must be registered with the site to access any of the available features, and the registration is free. Once registered, users can immediately begin gathering their own data, analyzing the existing information, publishing reports or reviewing existing publications. The system also has several active data collection locations that are only available to registered users.

pece_annotation_1475020454

erin_tuttle
Annotation of

The technical aspects of the site are quite complex, as the system has over 1,000 active data sites to compile in addition to the reports and reviews stored. The data collection software is the main function that the software supports as it relieves the users from needing their own data bank to work off of.  The publication functions are also supported by the storage system of the app allowing all users to access all publications.

pece_annotation_1475020477

erin_tuttle
Annotation of

The system has partners including UNAIDS, a branch of UNISEF, International Medical Corps, Medecins Du Monde, AAHI, and other humanitarian organizations. The support of these groups both financially and with the user community is important to maintain the app as an active site for research and development. The technical aspects of the site also heavily rely on the data storage method, which is not mentioned but would require massive amounts of memory as well as safeguards to prevent data loss on the app servers.

pece_annotation_1475020496

erin_tuttle
Annotation of

There are thousands of data collection apps that use similar technical system as Twine, one more popular app is Fulcrum which uses the same real time collection ideas and integration between existing data and new data. Fulcrum however is aimed towards medium businesses that need to coordinate between employees. There also exists several open source options that also allow for independent data collection.