If, in moving through your life, you find yourself lost...go back to the last place where you knew who you were, and what you were doing, and start from there. Bernice Johnson Reagon.

16 July 2013

Scene safe, PPE...NOT!

We’ve all heard it for years. The first thing we do and say when we are testing or going through a scenario for any EMS class is raise our hands and recite “Scene safe, PPE”. We’ve fooled ourselves into thinking we work in a ‘safe environment’. We’ve fooled ourselves into believing that maybe the presence of a law enforcement officer will provide a ‘safe environment’. We’ve fooled ourselves into thinking that since we are the ‘good guys’ no one is going to try and hurt us.

Guess what? We were wrong.

It is getting to be a common occurrence to read about another incident that has happened somewhere in our country where a member of an EMS crew has been attacked or assaulted, either with a knife, a firearm, or just a physical attack. Here are two links that I have seen in the past few days-


And over at EMS1.com, author Steve Whitehead has a pretty good take on the whole thing of "scene safe, PPE". I like his idea of teaching risk assessment and management. Like he says, it is not enough to 'acknowledge' that many of our scenes are not safe- we have to prepare for it. We have to realize that just because the scene was safe in the first 10 seconds, that does not mean it is safe in thsecond, third, or fourth 10 seconds.

It reminds me of something Sergeant First Class Bruce Grimes once said to me and the other members of my basic training platoon- "Stay alert and stay alive".

But anyway, in getting into the debate about unsafe scenes and assaults on EMS, the first thing someone is going to say is “let’s arm EMS”. The biggest flaw with that idea is that who is going to pay for the training necessary to be familiar with a firearm, let alone proficient with that same firearm? And then who is going to pay for the firearms? I can go on, but let’s just say that there are a bunch of hurdles to that one. Plus, I have worked with a lot of people that I really don’t trust with a firearm.

There are various courses out there that seek to educate and prepare EMS folks in how to evade or escape these encounters as well as how to defend themselves when escape or evasion is not an option. DT4EMS comes to mind.

But then, who pays for these classes?

I don’t know about some of the other states, but in my home state we are required to get 24 hours of continuing education each year of a four year cycle, with mandatory requirements in certain categories. There’s not a whole lot of leeway within the requirements, unless hours are added for something like DT4EMS.

So what are we to do?

First, we have to get out of the mindset that we work in a safe environment. We don’t and we never have. Think otherwise? Ask those five firefighters in Gwinett County, GA. Ask the EMS crew in Omaha or the EMT in Jersey City, NJ. Hell, you can ask one of my coworkers here with my current employer.

Every single scene we are on has the potential, the very real potential, to go very badly very quickly. And quite frankly, many of the folks I have worked with over the years are woefully unprepared to deal with it.

Second, we have to provide training and education to our people in how to deal with these situations. Simply saying “well, maybe it can happen to us” is not enough. We’ve got to prepare. I’ve done some research on the course and I like the concept of DT4EMS. I think it (or something like it) should be mandatory for every EMS responder in the country. It should be a part of the national curriculum, every state curriculum, and the National Registry requirements. Period. If it takes extra time, then so be it.

It has to be geared to our environment. I am not talking about martial arts training or some modified version of law enforcement or corrections training. What we have to have is some sort of training that is geared to us and to our environment. But is that all there is to it? Is taking a course that prepares us to evade a hostile encounter or defend ourselves really enough?

Well, no, it is not.

Thirdly, we have to develop plans, procedures, and protocols that cover how we deal with these situations. We have to have the equivalent of the fire service’s “MAYDAY” or law enforcement’s “SIGNAL 25” (maybe we can use one of their terms, but it has to be one or the other- I prefer MAYDAY since, well, I just do.).

And we have to train with it. More than “once in a while”.

We also have to change the way we train and re-train.

Sure, wear your gloves. Use your PPE. But don’t assume you are working in a safe environment. You’re not.

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