Paramedic Scene Safety – “The number one priority for me when I start a shift… is to be able to finish my job for the day and go home to my family… that’s why my first thought is to scene safety… and ONLY then… all other issues… ” Australian Paramedic (And just about every other Paramedic in the world).
Scene safety for paramedics requires the paramedics to think 2-3 steps ahead of themselves at all time and consider all the possible “what if” scenarios and their possibly solutions. For example, when I arrive at a scene, I park the Ambulance in such a way that I know that if things go bad at the scene, I can drive out forwards and easily if I have to make a quick “get away.” When I walk into a house, I’m constantly assessing where I could move, or what I could do if the patient became violent, or if someone else came into the house. I try to always stick together with my paramedic partner – often it takes more than one pair of eyes to pick up a problem.
For example, one day I was called to a 40 year old who had had a query cardiac arrest. With the hightened nerves, I rapidly approached the patients bedroom and was just about to commence CPR, when my partner stopped me. He had noticed a power cord running for the wall power plug to the patient. We switched the power off and then removed the wire – the patient had intentionally killed himself with high power electricity and I was just about to follow him to his death by touching him. Early lesson for me on scene safety and its importance.
All scenes can turn bad
More often than not, we are allowed to do our job primarily unhindered, and I don’t go around to every job paranoid that I’m going to be attacked. But, as you build up experience, and skills in the area of risk managment, you develop an ability to have a sub-conscious thought process in the back of your mind that constantly assesses and reasesses the scene for safety problems, so that you don’t end up caught out unaware. This way, when only subtle changes are made, something triggers in your mind, to make you realise when the scene is going down hill.
For example, I once was treating an 88 year old lady with chest pain – we attached the ECG and she had increased ST elevation (not a good sign on the monitor). Anyway, her 21 year old grandson was there, and my partner (who recognised the need to get going to hospital) went outside to get the stretcher. By the time he had returned, the patient’s grandson had attacked me with a knife because he wanted drugs.