Last week the area that I work in suffered a horrific tragedy: we had a line of duty death of one of our city’s police officers. The impact of this has been far reaching and very difficult on many of us. One of the questions that I have heard over the last couple of days has been about scene safety. The “what if” scenarios are being played out left and right. ”What if we were there?” “What if it was for a medical call and not a domestic?” While I too have asked myself these questions, the thing that I keep reminding myself and that I think we all need to remind ourselves is scene safety is not an absolute. I am not going to talk about specifics of this call however I feel that this is an important topic to reinforce.
Kyle David Bates of First Few Moments and Pedi-U fame teaches a class called “Scene Safety Stinks” and I could not agree more with him. The words “scene safety” and the declaration that the “scene is safe” might give us a piece of mind, but all it truly represents is a false sense of security that we all hold near and dear to our hearts. We should not “practice scene safety” or even worry about. What needs to be important is “scene awareness.”
Every scene that we are on evolves and changes moment by moment. Something as simple as the introduction of another family member or a patient uttering the word “ow” in the presence of the family dog could change things in a second, and the number of police officers, fire fighters, or national guard that you have there with you will not be able to prevent whatever happens next. When responding to any scene, keep the following in mind:
1. Always have a way to call for help – Cell phones are great, but I’d rather have a radio. No dialing required, no identifying yourself or asking for anything. All any of us should need to do is announce our unit number and declare that we need help. My radio now lives on my hip all the time so I do not forget it when I get out of the truck, and I recommend that everyone do the same.
2. Know your exits – Always remember how you got into a residence or apartment and always know the way out. Some people that I work with go as far as to carry a wooden door stop with them to prop a door if they need to. That way, help can get in. It is not always a popular choice with some apartment complexes, but if it is a matter of safety for you, I say do what you have to do.
Also, do your best to not allow anyone, especially the patient, to get between you and that exit.
3. Don’t put yourself at a disadvantage - Always be aware of how you are positioned in relation to your patient. Also, keep your hands out of your pockets, and do your best not to overburden yourself with gear. Don’t turn your back on the patient, and if all else fails, leave that Lifepak 15 sitting on the floor if you need to go. It is replaceable. You are not.
4. Politely request that pets be put away – Even the sweetest golden retriever will revert back to their instincts if they feel that their owner is injured. I was bit on the leg one night at a scene by a boxer that was initially described to me as a sweet dog that would never hurt a fly. I made the wrong decision of letting it remain in the room while I cared for the dog’s owner who was experiencing severe flank pain. When I started to assist her to the stretcher and she started to cry and say “ow” repeatedly, the dog took it as a sign and grabbed a hold of my thigh. Thankfully, he did not hold on long, and the tetinis shot that I got at the ER hurt more than the bite did, but I think you get the point.
5. Always be aware of your surroundings – Do not get tunnel vision. Be aware of what is going on around you and do not tunnel in on the patient. If your partner is the one dealing with the patient this goes double for you. Keep an eye on doorways, family members and everything else that may be going on in the room. Your partner’s focus is on the patient. Your focus should be on the surroundings.
I remember early in my career when I was still a cadet, I was at a call for an intoxicated female in police custody. She was strapped into a chair in the police station, and the tech that was kneeling in front of her (who coincidentally is also my father) had turned around to get something out of his BLS bag. She started reaching towards the wall and the power cord for the clock that was dangling a few feet away. For some reason, I could not get the words out of my mouth to tell him to move, but thankfully someone else did. My dad came up and backed away from her. As he did, she grabbed the clock and began slamming it on the floor right around where he was kneeling. It was a close call, and despite the fact that we were in a police station, with the police there, the scene turned violent and unsafe faster than any of us could act.
I am sure that some of these steps seem like a bit much for a routine call, but many of them are just subconscious steps that can be taken and as each of them are done repeatedly, they will become second nature. Most of all, we each need to be aware of our surroundings, and always be looking out for each other.
Remember: do not take the declaration of “the scene is safe” as an absolute. Always be vigilant and aware that a monkey wrench might be thrown into things right around the next corner.