The document discusses key considerations for safely assessing and securing a scene of injury or illness. It emphasizes determining personal protective equipment needs, evaluating potential environmental hazards, understanding the mechanism of injury or nature of illness, and requesting additional resources if needed before making contact with any patients. Reassessment of safety is important throughout care.

1. Scene Size-Up

2. Scene Size-Up Body Substance Isolation BSI Gloves Eye protection Gowns Masks Protective Gear Head gear Eye protection Respiratory protection Gloves Boots Coat

3. Scene Size-Up “ An assessment of the scene and its surroundings” Constant reassessment Includes: Personal protection “ Is it safe to approach the scene” Crash/rescue scenes Toxic substances Crime scenes – Potential Violence Unstable surfaces- Slopes, Ice, Water, etc. Safety of the scene Nature of illness – Medical Mechanism of injury- Trauma # of pts Need for additional help Need for spinal immobilization Protection of the pt and bystanders

4. Scene Size-Up BSI Is the scene safe??? If not make it safe If you cant DON’T enter!!! Nature of illness Mechanism of injury Number of patients Request additional help if needed Rule in/out spinal stabilization

5. Motor Vehicle Accident Scenes STOP Ideally 100 ft Look and listen How many cars? How many pts? Assess resources Do you have what you need Can you get it? Windshield survey Are the pts moving? Do you see any starbursts? Steering wheel deformity? Stability Is the car stable and safe to enter? Lug Nut principle….

10. Starburst

11. Steering wheel deformity

12. WHATS WRONG WITH THIS PICTURE???

14. Crime Scenes NEVER enter a crime/violent scene without police If you arrive and signs/indications of violence are made- Retreat! DOCUMENT!!!!!!! Don’t cut through bullet/knife wounds If you’re inadvertently in area with a violent person: Don’t block their escape Don’t challenge them Identify yourself as a medical provider Acknowledge they seem upset and emphasize you’re there to help Explain exactly what you are doing Keep distance Avoid making quick moves

15. Environmental Hazards “ Is it safe to approach the pt?” Water rescues Ice Rain Slopes

16. Mechanism of Injury Trauma Mechanism of Injury (MOI) “Manner in which an injury occurred during a trauma” Type Strength Direction

17. Mechanism of Injury Trauma Patients MOI Pt, family, bystanders, inspection of scene Allows you to anticipate injuries Fall with landing on feet Unrestrained driver Side collision passenger Stab wound/location/depth Did medical event precede trauma? If more pt than units on scene can handle initiate MCI Obtain help prior to pt contact Less likely to call during care Begin triage

18. Hidden Injuries Safety devices cant prevent everything If they had one on it does not exclude all injury Deceleration = Sheering Forces Loose lap belt Compression of abd Shoulder belt minus lap belt Neck injury Airbag deployment Pt could still have hit the wheel “ Lift and Look” Inspect steering wheel Steering Wheel deformity= SERIOUS injury

19. Nature of Illness Medical patients “ Why EMS was activated” Determine from pt, family, bystanders Obtain # of pt Call for assistance if need be (ALS, fire, etc) Begin triage

20. Remember… Scene safety FIRST!!