Scene Security BSI. (BSI is physique substance isolation). That’s what we’re taught to say at the beginning of any sensible state of affairs. You don’t observe Scene Security BSI, you fail the station.
Two fascinating articles not too long ago on Jems.com about EMS security.
The primary, Security is Third, Not First, and We All Know It Ought to Be. (The authors put security behind 1. Getting the job completed and a couple of. Having enjoyable.
The second, Security First or Security Third: Contemplating Practitioner Security in EMS, is a rebuttal.
I discover the primary article provocative in questioning a basic tenet of EMS. It argues that EMS needs to be about threat evaluation versus absolutes. I’ll allow you to learn the articles and decipher their arguments. A few of their distinction is simply semantics. They each clearly need EMS responders to be secure. The authors of the primary article assume they are going to be safer if they aren’t blanketed with the Security First Motto, which might simply free its significance. They like you consider it when it issues most.
I like the road within the first article “It relies upon.” My boss, the EMS medical director at our hospital, does a whole lecture on “It Relies upon.” I agree in EMS, the place issues usually aren’t black and white. “It relies upon,” is usually the very best reply.
If security actually was first always, EMS wouldn’t exist. What we do –drive lights and sirens in autos with much less security requirements than cattle automobiles, reply to scenes that may turn into hostile with out warning, cope with sufferers with infectious illness and others with histories of violence, always of day and in all kinds of climate, is basically unsafe. The bodily and psychological well being dangers of our occupation are identified to all. Our job requires that somebody reply to traumatic occasions and that somebody is us. We reply regardless of the identified hazard. We will and may do our greatest to mitigate our threat. We will accomplish that higher with widespread sense and threat evaluation primarily based on the particulars of a scene than with the generic Security First motto.
Once I started in EMS, we have been the one responders within the metropolis. The fireplace division got here out if requested for motorcar extrication and the police have been there may be lively violence was reported beforehand. Aside from that it simply me and my accomplice. We gauged the dangers of every encounter. Some we by no means entered, some we backed out of, however by no means routinely sat within the ambulance ready for another person to evaluate the scenario. I keep in mind a few years later, I used to be precepting a brand new paramedic and once we bought despatched to a psychiatric name, he wouldn’t get out of the ambulance till the police had arrived. He stated we needed to stage. This was a brand new time period for me. “Staging” is commonplace right this moment. We’re informed to stage on many calls. This usually ends with us ready on scene for thirty or minutes whereas the police examine. There have been many instances I’ve been on scene, staging a block away, solely to search out the police got here and went. I do know some crews like to make the most of these notification lapses to get a break. I’ve additionally been informed to stage for an overdose, and waited on the scene for fifteen minutes for the police to reach just for them to scream for a medic. An individual who might have been revived fifteen minutes earlier than, is now in cardiac arrest.
Not too long ago, in “The Door” I mentioned the dilemma of instantly placing defib pads on a cardiac arrest sufferer or ready to correctly apparel myself in all my PPE.
I’m not calling for us to all turn into lifeless heroes within the title of glory. I merely saying acknowledge that what we do is inherently unsafe and we must always use our greatest judgement in every particular person state of affairs to make every scene as secure as we will with out turning our backs on the job now we have chosen.