Chapter 12 Scene Size Up

Front 1

Scene size up

Back 1

An Assessment of the scene for safety hazards and to determine the nature of the patient's problem and the number of patients

Front 2

3 basic goals during scene size up

Back 2

1. Identify possible hazards at the scene and ensure your safety and the safety of other members of your EMS crew the patient and the bystanders.

2. Identify what led to your being called to the scene -either an I jury or a medical problem. This identification will determine the steps you need to follow to assess the patient and provide emergency care.

3. Determine whether any factors, such as the number of patients or unusual characteristics of the scene, might require a call for additional assistance.

Front 3

How to proceed with a scene size up in a step wide manner.

Back 3

1. Take necessary standard precautions to protect yourself and put on any necessary personal protective equipment.

2. Evaluate the scene for safety hazards.

3. Determine the mechanism of injury or the nature of illness.

4. Determine the number if patients at the scene.

5. Determine the need for additional resources to effectively manage the scene or the patient.

Front 4

Does the scene size up end after you contact the patient T/F?

Back 4

False, scene size up is a continuous process, use your intuition throughout the assessment.

Front 5

Is staying vigilant on a scene imperative to your safety? Why is it imperative?

Back 5

Yes, its is imperative that the emt remain vigilant, violence towards ems personnel is common in an uncontrolled/out of hospital environment.

Front 6

Dispatch information can be incomplete or inaccurate. What can you do when you arrive on scene?

Back 6

Make your own assessment of the scene and of the need for additional protection.

Front 7

Ant type of equipment that you put on to reduce your risk of personal injury or illness is referred to as

Back 7

Personal protective equipment (ppe)

Front 8

Scene Safety

Back 8

Steps taken to ensure the safety and well being of the EMT, his partners, patients, and bystanders.

Front 9

The process of ensuring scene safety.

Back 9

The process of ensuring scene safety is dynamic and ongoing, it is not done quickly upon arrival at the scene and then forgotten.

Front 10

Considering the need for additional or specialized resources.

Back 10

It may be necessary to recognize your own limitations and call for additional resources or specially trained personnel for situations or rescues beyond your training.

Front 11

Personal protection of the emt is a primary importance because

Back 11

An injured or helpless EMT cannot provide care. You also lead attention and resources away from the patient to the injured ent risking patient compromise.

Front 12

Keep these overriding principals in mind when determining scene safety.

Back 12

Do not enter unstable car crashes

Managing patients at crash scenes

Take extra caution at crime scenes/ scenes involving volatile crowds, wait for police.

Bring your portable radio with you.

Call for help from the appropriate agencies

Remove yourself if a scene turns hazardous.

Front 13

General rules to reduce the incidence of being struck by a car

Back 13

Wear an ANSI reflective vest

Limit time near traffic

Shut down traffic

Place flares or cones far enough away from crash scene.

Place ems vehicles and apparatus strategically to protect the scene.

Do as.much work possible away from the scene.

Dont turn back to moving traffic.

Dont jump highway dividers

Reduce any unnecessary lighting.

Tuen the wheels of parked emergency vehicles so they are pointed away from scene.

Avoid stopping or standing between vehicles.

Front 14

Arriving at the scene

Back 14

Turn off the siren several blocks from the scene, by arriving discreetly you draw less attention to the scene from bystanders

Front 15

When arriving at the scene why should you park two or three houses away from the scene

Back 15

It affords you more opportunity to study the scene before becoming involved in it. During a scene involving firearms parking in such a position will usually put you outside the killing zone.

Front 16

Killing zone

Back 16

Area controlled by hostile fire.

Front 17

If someone has a gun inside the house what area in front of the house is controlled by hostile fire.

Back 17

120 degrees in front of the house is atleast partially exposed to hostile fire.

Front 18

Studying the crowd

Back 18

Be aware the size of the crowd is less important than the mood of the crowd.

Front 19

Approaching the Scene procedures

Back 19

Walk on the grass, its quieter.

If you have flashlight hold it beside you.

If walking with partner walk single file.

Only first person in line should carry a flashlight.

Make a mental map of possible places of concealment and cover.

Take a moment to look at windows and corners.

As soon as the door is open asses situation before you make call to retreat or have partner move the ambulance up to front of building.

Front 20

Even when you at the patients side your first priority is to

Back 20

Protect yourself and your partner

Front 21

When you are assisting a patient at a properly secured crime scene you should follow these procedures

Back 21

Limit number of responders to number required to care for each patient.

Do not allow bystanders to interact with patient or immediate surroundings

Introduce yourself and say you are to help them.

Be alert that on a crime scene your patient may be a perp.

If able have one emt do crowd control

Be considerate of police requests

Assist police in collecting and recording anything on the patient

Take care to not disturb any evidence.

Never touch or move suspected weapons unless necessary.

Wear gloves

If patient was strangled cut at the knot instead of untying it.

Document everything.

Front 22

Approaching Car passengers

Back 22

Park the ambulance at least one car length behind the vehicle

Align your headlights in the middle of the trunk of the vehicle and turn them into high beam

While still in the ambulance write down the license plate number on the vehicle and leave it at the radio

Note how many people are in the vehicle their positions and the drivers of parent condition

As you approached the vehicle and be alert to the possibility of other unseen occupants check to see whether the trunk is locked and look on their rear seat and the floor as you pass

Have your partner open the passenger door a split 2nd before you open the driver's door if you are alone wait for help to arrive

Keep behind the center post carry an object set as report book or bag that you can throw at the occupants face if he becomes violent

If you must retreat in mediately get into your vehicle and back of rapidly move 100 are a 150 yd to clear the killing zone

Front 23

Control the Scene

Back 23

Provide light

Consider moving furniture

Consider moving patient

Maintain and escape route and keep it open when a scene is tense or danger exists

Pay attention to bystanders

Control the scene or the scene will control you

Stay calm

Use tact and diplomacy

Be flexible

Be open minded about the situations, circumstances, and conditions you encounter on the job.

Be alert

Be compassionate toward the people you have been called on to serve.

Front 24

Maintaining Situation Awarness

Back 24

Dont leave anything to chance be alert and investigate things that appear out of place.

Front 25

A mistake EMS personnel often make after performing an initial scene survey

Back 25

They Focus completely on the patient. Always maintain situational awareness

Front 26

Multisystem Trauma

Back 26

Trauma. In which more than one major body system is involved.

Front 27

Mechanism of injury (MOI)

Back 27

Factors and forces that cause traumatic injury.

Front 28

Index of suspicion

Back 28

Is the degree of your anticipation that the patient has been injured or has been injured in a specific way based on your knowledge that certain mechanisms usually produce certain types of injuries.

Front 29

Nature of illness

Back 29

The type of medical condition or complaint a patient suffers from