Every EMS call begins with scene safety. In fact, it starts long before you ever respond to your first call. It starts with your training. Any EMS provider who has ever taken an EMS course or certification exam knows the term “BSI, Scene Safe”. If that little phrase is not verbalized before performing the patient assessment, it’s an automatic fail. That is because scene safety is the very first priority when responding to any emergency and it's extremely vital in your role as an EMS provider. Although EMS providers have an obligation to treat sick or injured patients in a timely manner, they are of no use if they become a patient as well, because they did not ensure that the scene was safe before entering.
The first order in managing any scene is to gather as much information as possible. This can be initially accomplished by the dispatcher, who tries to obtain as much vital information as they can from the reporting caller. Train yourself to scrutinize any information that you receive, and keep yourself on alert about the information that makes you feel unsafe. Beware of calls that have the potential to be threatening such as stabbings, shootings, domestic disturbances, or person down calls. If you are suspicious about a call or the information you receive from dispatch, you have the right to ask for a police response if you believe it might be a risk to enter the scene first. Do not feel like you are less of an emergency provider if you wait for the police to show up on scene first. Most agencies have policies where EMS crews must stage in safe areas away from the scene in cases involving overdose, violence, or behavioral issues. In these cases, EMS crews are not permitted to enter the scene until police have declared it safe to enter. We always recommend that you follow your local protocols.
Regardless of whether the police are on scene or not, EMS providers should always approach an emergency scene with a high level of suspicion and pay close attention to obvious or subtle indications of threats to the safety of the scene.
Standard safety procedures, such as the use of personal protective equipment (PPE), high-visibility apparel, and vehicle placement are all important factors in scene safety. However, it is not enough to just ensure the scene is safe once as if checking off something on a list and forgetting about it. Emergency scenes are dynamic. While the scene might be safe one moment, it could change in a matter of seconds. It is important to continually assess possible hazards to maintain a safe operating environment. Where initial scene safety leaves off, situational awareness has to take over. Situational awareness requires you to be attentive to what is going on around you 100% of the time.
We have a limited ability to control what occurs on the scene. The only controllable factor is yourself. Be aware of what you say, where you stand, and what you touch, and never put your guard down.