Scene assessment and first impressions are key when arriving to an emergency scene. As the first person on scene providing care, you must always assess the scene for safety hazards before taking any further action. This includes looking for signs of danger, such as a fire or exposed wires. Once you have determined it is safe to approach, you can then begin to size up the scene and victim. This involves quickly assessing the situation and determining the best course of action.
Author Steven Grella is a veteran police detective, trained EMT, and American Red Cross lifesaving skills trainer.
You may only have a few seconds to make these decisions, so it is important to be aware of your surroundings and always err on the side of caution. If in doubt, do not hesitate to call for backup or additional help. Remember, your safety is always paramount.
Use Your 5 Senses
As you approach the victim you should be using your 5 senses to determine what could have possibly caused the victim to be in the emergency situation they are currently in. Remember, the scene size-up is extremely important for your safety. As much as we want to jump in and help right away, we need to take a brief step back and make sure we don’t become a victim ourselves. Just like on an airplane when they go over safety protocols, you put your oxygen mask on before helping the person next to you. Don’t put yourself in a situation where you can’t physically help the victim. If you are confronted by an unsafe scene, there's a few things you can do:
Size Up The Scene
Make sure the scene safe yourself, such as by putting out a fire. Assess the situation and identify any potential hazards. This will help you to create a plan of action and make sure that you are taking all the necessary precautions. Once you have made the scene safe, you can then focus on providing assistance to those who need it.
This might involve administering first aid or working with other emergency services to evacuate the area. By taking these steps, you can help to ensure that a potentially dangerous situation is brought under control.
Personal Protective Equipment (PPE): Ensuring Safety During Scene Size-Up
In emergency response situations, personal protective equipment (PPE) plays a vital role in ensuring the safety of responders during a scene size-up. PPE serves as a barrier between responders and potential hazards, minimizing the risk of injury and the spread of infections. Let's explore the importance of using appropriate PPE, discuss different types of PPE, and understand when to use them based on potential hazards present in an emergency scenario.
Importance of Using Appropriate PPE:
Using appropriate PPE is essential for several reasons:
Personal Safety: PPE protects responders from physical and biological hazards, including chemicals, sharp objects, airborne particles, and bodily fluids. It helps minimize the risk of injuries, such as cuts, burns, respiratory issues, and exposure to infectious diseases.
Infection Control: PPE acts as a barrier against the transmission of infectious agents, reducing the risk of cross-contamination between responders, victims, and bystanders. It prevents the spread of infections and promotes a safer working environment.
Confidence and Focus: By wearing proper PPE, responders can enhance their confidence levels, allowing them to focus on their tasks without compromising their personal safety.
Types of PPE and Their Usage: Different types of PPE are designed to protect specific areas of the body and provide varying levels of protection. The following are commonly used types of PPE during a scene size-up:
Purpose: Protect hands from contact with blood, bodily fluids, sharp objects, and chemicals.
Usage: Wear disposable latex, nitrile, or vinyl gloves when there is a potential for exposure to fluids or contact with contaminated surfaces. Ensure proper glove removal and disposal after use.
Recommended Product: Disposable Nitrile Gloves
Purpose: Protect the respiratory system from inhaling harmful particles, dust, chemicals, and airborne pathogens.
Usage: Use masks, such as N95 respirators or surgical masks, in situations where there is a risk of inhalation of hazardous substances or airborne contaminants.
Recommended Product: N95 Respirator Mask
3. Eye Protection:
Purpose: Protect the eyes from impact, splashes, chemical exposure, and airborne particles.
Usage: Wear safety goggles or face shields to safeguard the eyes from hazards such as debris, chemicals, or bloodborne pathogens.
Recommended Product: Safety Goggles
4. Protective Clothing:
Purpose: Cover the body to protect against contact with hazardous substances, heat, or flames.
Usage: Wear protective clothing, such as coveralls or gowns, when there is a risk of exposure to chemicals, infectious materials, or extreme temperatures.
Recommended Product: Disposable Coveralls
It is important to choose PPE that meets the appropriate safety standards and is suitable for the specific hazards encountered during a scene size-up. Consider factors such as material durability, comfort, and the level of protection provided when selecting PPE.
Move The Victim To Safety
If the victim is not in immediate danger, you may be able to help by moving them to a safe location. An example of this is if you are outdoors during a thunderstorm, you would want to move to a dry location away from any trees. If possible, try to get the victim to a safe area where they can receive medical attention. Remember, your safety should always be your top priority.
The third option is to back out of the scene. If the scene is too dangerous to approach, back out of the scene and wait for emergency medical care to arrive. Once the scene is safe, you can provide any assistance that may be needed. Keep in mind that even if the scene appears to be safe, there may still be potential hazards that you are not aware of. It is always best to err on the side of caution and let trained professionals take care of the situation.
Scene First Impressions
Your first impressions will give you an idea of what may have happened and the type of emergency care needed. By taking a few moments to assess the situation, you can ensure that the appropriate level of care is provided. In some cases, first impressions can be misleading, but in many cases they can give you a good idea of the severity of an accident and the type of care that will be required. This occurs the moment you recognize the victim is in an emergency situation.
Relay The Information
If you know the victim, you may have an idea of their medical history, such as allergies, diabetic history or past cardiac episodes. This will give you the upper hand in determining the type of emergency care needed when you are taking action and is crucial information to pass along to emergency medical providers upon their arrival.
Scene Size-Up Examples
1. Motor Vehicle Accident:
Example: You arrive at the scene of a motor vehicle accident. Multiple cars are involved, and there are injured individuals.
Hazards to Look Out For:
Traffic congestion and moving vehicles
Fuel spills or leaking hazardous materials
Broken glass, sharp objects, or debris
Potential fire hazards from damaged vehicles
Steps to Ensure Scene Safety:
Park your vehicle at a safe distance, ensuring it does not obstruct traffic or create additional hazards.
Assess the overall scene to identify potential hazards and ensure your safety.
Communicate with other responders and bystanders to coordinate efforts and establish a safe working zone.
Stabilize any immediate hazards, such as turning off vehicle ignitions or extinguishing small fires if safe to do so.
Ensure the safety of the victims and bystanders by directing them away from the immediate scene.
Appropriate Course of Action:
Assess the severity of injuries and prioritize medical attention based on triage principles.
Initiate appropriate medical interventions for victims based on their conditions, such as CPR or controlling bleeding.
Collaborate with other emergency services, such as firefighters or paramedics, for extrication and transportation of injured individuals.
Anecdotal Example: During a motor vehicle accident response, a scene size-up revealed an overturned vehicle with a strong smell of gasoline. Recognizing the potential fire hazard, responders quickly evacuated nearby individuals to a safe distance and requested additional resources for a hazardous materials response. They secured the scene, initiated medical care, and coordinated with firefighters to address the fuel spill.
2. Residential Fire:
Example: You arrive at a residential structure fire. Smoke is billowing from the windows, and there are reports of people trapped inside.
Hazards to Look Out For:
Intense heat and smoke
Structural instability or collapse
Toxic fumes from burning materials
Potential entrapment or rapid fire spread
Steps to Ensure Scene Safety:
Establish a command center away from the immediate danger zone to coordinate efforts effectively.
Evaluate the stability of the structure, ensuring it is safe for responders to enter.
Identify potential escape routes and establish control zones to prevent unauthorized access.
Communicate with fire department personnel to ensure a coordinated approach to fire suppression and victim rescue.
Appropriate Course of Action:
Confirm the presence of trapped individuals and their locations, if possible.
Initiate fire suppression and rescue efforts based on established protocols and available resources.
Ensure the safety of responders by using proper personal protective equipment and following established firefighting strategies.
Coordinate with additional resources, such as medical personnel, to provide necessary medical care to victims.
Anecdotal Example: During a residential fire response, a scene size-up revealed a weakened structural integrity of the building. Responders quickly recognized the danger and established a collapse zone, preventing further injuries. They focused on evacuating nearby residents, initiated fire suppression, and conducted a systematic search for trapped individuals. By promptly identifying hazards and implementing appropriate safety measures, they successfully controlled the fire and ensured the safety of all involved.
These examples demonstrate how scene size-up is crucial for different emergency scenarios. By assessing potential hazards, ensuring scene safety, and taking appropriate action, responders can effectively manage emergencies and protect lives. Remember, every emergency situation is unique, and the ability to adapt and make informed decisions based on scene size-up is vital for a successful response.
Frequently Asked Questions
(Regarding Scene Size Up and Initial Impressions)
At what point is the scene size-up complete?
When responding to an emergency, it's important to size up the scene as quickly as possible. Unfortunately, there is no definitive answer for when the size-up is complete. In some cases, it may only take a few seconds to assess the situation and determine a course of action. However, in other cases, the size-up may be ongoing throughout the response. For example, if you are responding to a multi-vehicle accident, you may need to constantly reassess the scene as new information comes in. In general, though, you should err on the side of caution and assume that the size-up is not complete until you have all the information you need to safely and effectively respond to the emergency.
What are the components of scene size up for lifeguards?
When arriving at the scene of an emergency, the first thing a lifeguard does is take in the situation and size up the potential risks. They look for things like hazardous weather conditions, bodies of water, and the number of people involved. They also assess the extent of the emergency and whether or not immediate action is required. By taking a few moments to size up the situation, lifeguards can better determine how to best respond to an emergency.
What are the five senses used to size up a scene?
Our five senses consist of sight, sound, smell, taste, and touch. Each sense provides us with information that helps us navigate our environments and make decisions. For example, we use sight to identify objects and determine where we are going. Sound allows us to communicate with others and alerts us to dangers. Smell helps us to identify smoke or fire. Taste allows us to avoid poisonous substances. And touch provides us with a sense of texture and temperature. Together, these senses provide us with a wealth of information about our environment and help us to assess the situation.
During scene size-up, what hazard most likely involves thinking about standard precautions?
If there is a potential for exposure to blood or other bodily fluids, standard precautions must be taken to avoid contact. This includes wearing gloves, masks, and other personal protective equipment as needed.
It is my mission to help educate as many people as I possibly can in CPR, first aid and other lifesaving skills. I hope this article helped you to understand how to size up a scene and form an initial impression. Join my email list where I highlight lifesaving skills tips and keep you up to date with the latest safety trends.