Scene Safety

1

What is scene safety and how does it affect emergency medical service (EMS) providers?

Scene safety is the general principle of keeping safe from all hazards while working as an EMS provider. Scene safety is critical to all emergency responders and starts the moment they receive a call. Providers face risks, including traffic accidents, infectious disease exposures, and violence. While some events cannot be avoided, having a better understanding of your surroundings is paramount to staying safe while on scene as well as during patient transport.

EMS providers need to know their surroundings, plan a route of egress, and understand the emotional atmosphere of their environment. Throughout every call, they must continuously reassess the scene around them and try to predict active threats. They must see the big picture and avoid the tendency to have tunnel vision while providing direct patient care. Providers are wholly responsible for their own well-being, and the principle of scene safety must be taken into account on every call, no matter the circumstances or situation.

2

Is scene safety something that will affect day-to-day activities?

Scene safety affects all EMS providers. EMS providers have higher-than-average rates of workplace-related fatalities than all other professions, and the majority of EMS providers will experience violence in the workplace. Roadway accidents are a leading cause of fatalities among EMS providers, with ambulance crashes being responsible for the majority of these fatalities. Even during the most well-controlled call, EMS providers are at risk of injury and must constantly be alert.

3

What can EMS providers do to keep safe on scene?

When first arriving to an emergency scene, responders must take a moment to review the area around them, identifying any clear threats. This may include things such as fuel spills, fires, fast moving traffic, armed people, unruly crowds, or any other situations that may provide a direct threat. They should use this time to call for backup, discuss the potential threats with their partner, plan their approach, and identify an egress route. An extra few moments before exiting their vehicle can help formulate a plan to keep them safe. If there is an immediate threat, EMS providers should not get out of their vehicle but instead call for backup and retreat to a staging area. Even when police are present, it is never safe to assume that a scene is clear. They must communicate with the local authorities and use their own judgment regarding the safety and stability of a scene.

4

How should hazardous material (HAZMAT) calls be handled?

When encountering a HAZMAT scene, EMS providers should always park upwind and uphill while maintaining clear communication with incident command. The Emergency Response Guidebook, a reference developed by the Department of Transportation, is a resource that provides first responders with a go-to manual to help deal with HAZMAT transportation accidents during the critical first 30 minutes.

5

What are the greatest threats to prehospital personnel?

EMS providers are most vulnerable to infectious diseases, including blood-borne pathogens like hepatitis B or infections spread by respiratory droplets such as COVID-19, influenza, or meningitis. Standard precautions are the best defense against the spread of potentially contagious diseases. Disease-specific precautions, including contact, airborne, and droplet, should also be considered based on patient history and presentation.