# Scene is safe or notify dispatcher first?



## PewPew (Nov 11, 2012)

Hello, I was wondering in case this is asked on the NREMT exam, what comes first? 

Once you arrive on scene what do you do first, do you notify dispatcher that you have arrived on scene or do you examine the area for safety(scene is safe)? And right after that you do BSI/standard precaution right


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## Chris07 (Nov 11, 2012)

PewPew said:


> Hello, I was wondering in case this is asked on the NREMT exam, what comes first?
> 
> Once you arrive on scene what do you do first, do you notify dispatcher that you have arrived on scene or do you examine the area for safety(scene is safe)? And right after that you do BSI/standard precaution right


Scene Safety is always first.  No matter what, Scene safety is your first priority. If you roll up somewhere and you find a LEO with his gun drawn and pointing at something...keep driving.

1. Scene Safety
2. BSI
I don't think they will mention notifying a dispatcher about your arriving on scene. If they do I'd answer Scene Safety, Notify Dispatch, BSI, General Impression/Initial Assessment.

EDIT: Also, Scene Safety is one of those things that can change without notice  so you must be constantly mindful of your surroundings from the moment  you pull up to the scene to the moment you pull away.


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## JPINFV (Nov 11, 2012)

...and the crime with this question is that "scene safety" and "BSI" are continuous processes that start at the time of dispatch, not a one off when you first get on scene.


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## Tigger (Nov 11, 2012)

If you don't tell dispatch you are on scene, how will they know if you get into trouble immediately?

Scene safety is not a step on a list. Assessing it happens throughout all aspects of the call.


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## JPINFV (Nov 11, 2012)

Tigger said:


> If you don't tell dispatch you are on scene, how will they know if you get into trouble immediately?




...because if I'm in trouble in the time period between me getting onto a property and calling "on scene," I'm going to be more concerned about getting the hell out of dodge. To steal a saying from aviation, in an emergency you aviate, navigate, communicate.


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## 9D4 (Nov 11, 2012)

Our instructors for EMT gave us the grading sheet that they use for skills on the NR. It starts off;
BSI/ Scene Safety on the same step, so honestly I don't think you have to specify which is first. The skills sheet says nothing about contact dispatch, either.


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## Achilles (Nov 11, 2012)

You're over thinking it.
scene saftey- is the scene safe yes or no if not, get to a safe place a notify dispatch/ pd.


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## MMiz (Nov 11, 2012)

There are few "always" answers in life. For the NREMT scene safety is always first.


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## PewPew (Nov 11, 2012)

Alright thanks for the quick responses.

I just got confused because in several case studies in the book (Brady), it showed the EMT notified dispatcher once they arrived on scene before scanning for scene safety. I'll stick what you guys and my EMT instructor said


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## medic417 (Nov 11, 2012)

MMiz said:


> There are few "always" answers in life. For the NREMT scene safety is always first.



Followed by BSI


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## Tigger (Nov 11, 2012)

JPINFV said:


> ...because if I'm in trouble in the time period between me getting onto a property and calling "on scene," I'm going to be more concerned about getting the hell out of dodge. To steal a saying from aviation, in an emergency you aviate, navigate, communicate.



Part of "scene safety" is calling dispatch, there is no reason it cannot happen simultaneously.


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## Achilles (Nov 11, 2012)

Tigger said:


> Part of "scene safety" is calling dispatch, there is no reason it cannot happen simultaneously.



You're not going to be able to call into dispatch if you're dead.


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## ATFDFF (Nov 11, 2012)

Achilles said:


> You're not going to be able to call into dispatch if you're dead.



You've never met me have you?  I could run a traumatic arrest ALONE while I'm dead.

But back to the OP.  I see where you're coming from with your thoughts, but don't go that far into it during testing.  As others have said, scene safety would be the correct answer.


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## Akulahawk (Nov 12, 2012)

It's been a long time since I've done NREMT skills stuff... that being said, with them, it's always SAFETY FIRST. Scene safety and BSI should be considered first and is an on-going thing. Think of the two as safety for you. If the scene isn't safe, you shouldn't be there. If you're not BSI safe, you shouldn't be there. Lose either while on scene, you shouldn't be there. When to advise dispatch that you're "on scene" is an operational judgment call. It should be when you're close enough to begin to assess scene safety. Some calls, you might find out on the way there, that it's too dangerous right then, so you find a place that is safe and advise dispatch what's going on and why you're not in a place where you could be soon making patient contact. 

Most of the time, I consider myself to be "on scene" from an operational standpoint when my ambulance is stopped and I'm ready to exit it to retrieve things necessary for patient care and make my way to the patient with said equipment at the ready. It's often one of the last things I do before I exit the ambulance.


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## med109 (Nov 12, 2012)

PewPew said:


> Hello, I was wondering in case this is asked on the NREMT exam, what comes first?
> 
> Once you arrive on scene what do you do first, do you notify dispatcher that you have arrived on scene or do you examine the area for safety(scene is safe)? And right after that you do BSI/standard precaution right



I don't recall this being a question, or part of a question on either of my tests (basic or intermediate, classroom test or final exam), so don't get hung up on it. Trying to memorize everything in order really messes me up on testing. You know A B C D E and F need to happen in order, but on the test they leave out B and D, so now your sitting there trying to refigure a new order because you know B and D are important also. 

It really is hard to answer your question, for me anyway. If you know your going to a unsafe scene, then you are talking with dispatch and officers long before you arrive, so when you arrive you know your scene is safe, cause if not you wouldn't be there yet. It is important to let dispatch know you are on scene incase things become unsafe again.

But you may be responding to a "normal" call where there is no reason to suspect an unsafe scene. Wife calls 911 cause husband has low blood sugar. No other info from dispatch because they had disconnected from the wife, PD isn't coming because they are busy and it isn't emergent. You pull in the drive, tell dispatch your on scene, and head inside. During the time of call and arrival husband has become combative, and is so altered he has grabbed a gun, NOW your scene is very unsafe. As your running to the rig, your calling dispatch for officers. Once in the rig your letting them know you are leaving the scene until PD arrives, and you call back onscene once officers have said it is safe.

Bottom line, makes sure your scene is safe from the moment you get the call until the moment you transfer care to the ER. Always let dispatch know where you are at, there may be times when they are the only ones that can help you.


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## Akulahawk (Nov 12, 2012)

And I also don't recall ever seeing any questions regarding notifying dispatch of "on scene" on any exam I've taken in the EMS world. It wasn't part of my EMT class nor was it part of my Paramedic class or the NREMT-P exam, as far as I can recall... the radio stuff (aka calling dispatch) is something that they all pretty much figure that you'd learn on the job anyway because each company/agency/system is different in how they address those operational, non-patient care, non-personal safety things.


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## Handsome Robb (Nov 12, 2012)

It's not something they will ask you about on the NREMT exam. 

Scene Safety and BSI are the first things that are to be done per NREMT. Like others have said, in real life, scene safety is dynamic and constantly changing. Keep your head on a swivel.


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