Are we taking "Scene Safety" too far?

ffemt8978

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Some comments recently got me wondering if we are taking the "scene safe, BSI" mantra we're all taught from day one too far.

I'm not talking about immediately dangerous to life and health hazards, but lower risk hazards. Every job has risks, and EMS is no exception. However, recent posts have highlighted that some EMS personnel refuse to accept any level of risk.

Where do you draw the line? Do you try to mitigate those risks in any way, or do you wait for someone else to mitigate the risks and bring the patient to you?

Just a reminder to keep it civil please.
 

DrParasite

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I believe this topic was in EMS World last month.....

EMS has risks. some that are manageable and mitigatable, while others less than so. EMS personnel get hurt all the time. they do die (thankfully, not all the time). and certain careers (and certain areas of the country) are more willing to take risk based on a solid risk assessment than others.

teaching ems students to say "Scene safety and BSI" before every practical in in class is, quite honestly, a waste of time. it gives people a false sense of security, and leads to providers who don't know how to do a risk assessment, or how to minimize risk (other than by passing it off onto someone else).

As for my personal beliefs, I want to go home at the end of every shift. but I also know that I will risk a lot to save a lot; the corollary is I am not going to throw my life away for no reason, nor am I going to risk it unnecessarily. If I end up in a situation where there is a high probability that I won't be coming home from, I have no problem grabbing my crew and saying "we are out of here until this situation is under control."

Mitigate risk within your control, and when they are beyond your ability, call someone who can mitigate them. But remember Chief Brunacini's words: Risk a lot to save a lot, risk a little to save a little, and risk nothing to save nothing.
 
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mgr22

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Some comments recently got me wondering if we are taking the "scene safe, BSI" mantra we're all taught from day one too far.
I agree. During practical exercises, stating "the scene is safe" as a hedge against automatic failure is meaningless.
 

VFlutter

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This is a topic that frequently comes up in HEMS as well. Although there is a generally established norm of what is assumed risk the actual line is a very personal decision. It is a spectrum with outliers on each side and most people somewhere in the middle. Lately I feel the culture has shifted so far to one side that it is counterproductive.

I am of the mentality of "If not you, than who?". Evaluate the situation, find a solution, and mitigate risk as able. Clearly do not push situations that are clearly unsafe or unachievable but I will not find a reason to say no, when i am capable, and have someone else go instead.
 

SandpitMedic

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You have to consider that, by design, everything taught in an EMT class is dumbed down to the most common denominator. They have made it as simple as possible, and they’ve gotten the information across, and have then tested the knowledge of the students to demonstrate the lowest possible competency.

Don’t mistake what I’m saying as a jab- it’s just reality. I was an EMT also, just like everyone else. I took an 8 weeks class. If one would take a good look of the new pool of freshly minted EMTs around your AO, one could probably see that it’s pretty good to still teach scene safety at entry level. Is it a “save all?” Of course not, but it is a starting point for people with near-zero life or work experience (which is the lions share of new EMTs).
 
OP
ffemt8978

ffemt8978

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You have to consider that, by design, everything taught in an EMT class is dumbed down to the most common denominator. They have made it as simple as possible, and they’ve gotten the information across, and have then tested the knowledge of the students to demonstrate the lowest possible competency.

Don’t mistake what I’m saying as a jab- it’s just reality. I was an EMT also, just like everyone else. I took an 8 weeks class. If one would take a good look of the new pool of freshly minted EMTs around your AO, one could probably see that it’s pretty good to still teach scene safety at entry level. Is it a “save all?” Of course not, but it is a starting point for people with near-zero life or work experience (which is the lions share of new EMTs).
Agreed...but it's become apparent that some people are unwilling or unable to accept that risk mitigation exists, so they fall back onto their most basic training and the first thing they've learned as an EMT.
 

Carlos Danger

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I wouldn't say we've taken "scene safety" too far. EMS courses don't allow for the teaching of much nuance and judgment, and that's probably for the best. There's a lot to learn in a short period, and just not enough time to teach critical thinking to a group of students with varied educational backgrounds, experience and maturity levels, and willingness or ability to learn higher order thinking. With that in mind, I think teaching "all the PPE and all the safety, all the time" is a reasonable and usually effective approach. There will always be some situations and some individuals who that approach doesn't work for.
 

VentMonkey

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I’ve found that over the years, people who have trouble reading between the lines, or take everything so literal, struggle in many aspects of general daily life.

If anything, we’ve come to the point in society where questioning such common sense in attempts to curb the effects it might have on someone who struggles with such simple reasoning is now something worth asking ourselves.

Does it make me an insensitive dolt for asking?...//shrugging// depends who you ask.
 

SandpitMedic

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I can agree with that. People forget the gray.
 

NomadicMedic

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I wouldn't say we've taken "scene safety" too far. EMS courses don't allow for the teaching of much nuance and judgment, and that's probably for the best. There's a lot to learn in a short period, and just not enough time to teach critical thinking to a group of students with varied educational backgrounds, experience and maturity levels, and willingness or ability to learn higher order thinking. With that in mind, I think teaching "all the PPE and all the safety, all the time" is a reasonable and usually effective approach. There will always be some situations and some individuals who that approach doesn't work for.
I agree with this. The EMT course isn't really structured to teach more than a rudimentary analysis of scene safety. And you can't teach anecdotal experience or "spidey sense". You literally have to structure it as, "before you go in, look and see if anything is going to hurt or kill you or your partner". And that doesn't allow for any gray area.
 

SandpitMedic

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I think what you just described is situational awareness. Some people have it naturally, some are taught, and some would walk right into a pole in front of their face.
 

NomadicMedic

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It more than situational awareness. Most new EMTs can recognize obvious danger. It’s the calls where something doesn’t feel quite right. That’s where things seem to go off the rails.
 

Kevinf

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It more than situational awareness. Most new EMTs can recognize obvious danger. It’s the calls where something doesn’t feel quite right. That’s where things seem to go off the rails.
I think this is something that can't really be taught. A person either has street-smarts or they do not. We all know someone that blunders into things that most people should see coming over and over and they never seem to learn from it.
 

DrParasite

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Well. One partner said he'd refuse any COVID call because he has a family and it's not safe etc etc.

But he loved to go on and on about his experiences with firefighting and EMS and how he been doing it longer than I've been alive blah blah.
your partner was an ignorant hypocritical idiot.
 

DragonClaw

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your partner was an ignorant hypocritical idiot.
Yeah. And I didn't even bother explaining that to him. No point. He was too "experience"d to be taught.

He just wanted his hours how he wanted them. Nothing more nothing less.
 

Monday

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It more than situational awareness.

It’s the calls where something doesn’t feel quite right. That’s where things seem to go off the rails.
Ime this can be if not taught, then improved on though.

As in if something feels off, go through just a feeling to reasons why, communicate the feeling to your partner, don't ignore it as unimportant, compare what you take in before walking into it.

Tldr; Taking subtleties as valid information instead of dismissing, sharing tabs mid go, reevaluating on go.

Two sets of eyes can be quite valuable, we all notice different things differently. But a lot of it boils down to communication and respect which yah. Ain't really for granted.
 

Phillyrube

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We used to do an EMT practical exercise where you went into a room to find an unconscious person. You start your assessment, then a guy in the next room started to leak in that banana flavored stuff we used to fit test N95s. Very rare to have a team call out somethings wrong and back out. One team did and dragged the patient out with them. They passed.
 

DragonClaw

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Anyone have any IRL experiences of an unsafe scene that would otherwise have gone unnoticed and been dangerous?
 

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