The patient almost certainly needs further treatment and transport to definitive medical care, but a few extra minutes won't make much of a difference at this point. First Responders need to be close by which means we need a lot of them and available to respond fast when you call Using BLS first responders helps make it affordable.
Let me use the example of a cardiac arrest to illustrate how it works:. The first two steps happen before responders arrive. Steps five through seven require paramedics and must have ALS responders, a fire engine, or an ambulance.
Step eight needs an ambulance. Not always using paramedics might sound like a decrease in medical care, but in , USA Today published a five-part series illustrating that EMS systems with fewer paramedics actually had higher survival rates for cardiac arrest.
If you call for a medical emergency, don't panic if the person you were expecting doesn't show up at first. A first responder knows how to help. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Your Privacy Rights.
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Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. We quickly took action. Lastly, we communicated. Not only with each other but with the rest of our departments. That is what brought us law enforcement. The man was quickly arrested, and we all walked away unharmed.
Now apply the same 6 steps to a more common risk. Let us say you and your partner are going to a call for a sick person. As you begin to walk up to the home, you notice a large dog is in the yard. You have perceived the dog prior to entering the yard. You look at his body language and you process it as calm and unaggressive. You predict that he will not bite if you enter that yard. You decide it is safe to enter. He perceives him as a possible danger. He sees this large dog in the yard.
His experiences reminds him of the last time he encountered a large dog. He nearly got bit and animal control was called before he could get closer to the patient. So, he is more cautious. He decides you should wait. His action was pulling your arm and he communicated by telling you to wait.
Understand that how one perceives, processes, decides, predicts, reacts, and communicates will be based on previous experiences and knowledge. Other than actual experiences and a learning curve, training is a great way to safely gain experience and knowledge. The problem is that many providers state they have had very little to no training on situational awareness. Sure, we all had training in our EMT and paramedic courses.
Students learn quickly that they must state this before every skills lab, and it is a critical failure on the National Registry psychomotor testing. The student could do every single step right but forget to utter those 3 words and the student fails. Why is that? It is because, in real life, that is exactly what could happen. The scene not being safe could lead to further injury or even death. So how does one train and prepare? For instance, windows and doors can put a first responder at risk.
Remember the story about my crew being ambushed? The shooter was standing at his window. Understand that many times, a person can see out their window, but you cannot see in. The occupants have a clear view of you. They get to see everything, but you see a limited, if any, view. Doors pose a threat as well. Providers should always stand to the side, never straight in front of the door. Providers have been shot through doors.
Another important safety obstacle is how many people are on scene. Do you know where everyone is in the room? I warn trainees often about getting trapped inside a room with no exit and there being multiple people blocking your only exit. An irate family member can quickly turn into a dangerous situation. The first responder should do their best not to get in a situation where they have no clear exit. If one must flee a scene quickly like my partner and I in the ambush, a clear path is essential for a timely departure from the environment.
What room or environment one is standing in is also important. Kitchens have numerous weapons at hand. Obviously, there is the danger of knives and other sharp objects, but there are also things like small appliances, pots and pans that could be thrown or used as a weapon.
Bedrooms also may have hidden weapons. There are many people who keep a loaded gun or knife near their bed. Many times, the weapon is kept in between the mattress or just behind the headboard.
Maybe it is in the nightstand drawer. I have had multiple medical calls where a concealed weapon is in the room. Most times, simply asking politely if it can be moved or disarmed is all it takes to lower the danger of sudden attack. You may ask your partner to stand next to the weapon while you assess the patient.
Keeping a close eye and never turning your back to the weapon in the room is very important. Vehicles, just like homes, can also have hidden dangers. If a vehicle is running when you approach, ask the occupant to turn the vehicle off. One example of this threat includes a real-life experience where a crew responded to a call about an unresponsive male in a car.
When the provider arrived, it was quickly determined the male patient was suffering from an opioid overdose. The paramedic quickly administered naloxone, and within a minute or so the patient became responsive. The patient, not wanting to get in trouble with police, suddenly put the vehicle in reverse and floored the gas pedal. The open door slammed into the paramedic and the driver dragged him for several hundred feet before the patient rammed the ambulance and then proceeded to put the car in drive and drove off.
Luckily, the first responder was fine except for a few superficial injuries. It all happened so fast he did not have enough time to react. After finding the patient was altered or unresponsive, turning the vehicle off and removing the keys from the ignition before initiating treatment would have given the responder more time to react safely and move to a safer location.
Realize that center consoles, glove compartments, and under the seat are popular areas for hidden weapons in vehicles. Sudden movements toward those locations in a vehicle should be a sign of a possible safety threat. Perceiving that movement as a threat, processing the danger, predicting this as an assault, deciding there is a need to move, and letting others know there is danger is exactly how scene safety management is done.
Training your mind in this process is key to implementing situational awareness. Trust your gut, it is usually right. Build the muscle memory necessary to perceive, process, and act quickly. Communication between responders is important to not only keep yourself safe but your crew and your patient. Many times, staying calm and standing in a non-threatening way can de-escalate aggressive behaviors. Throwing hands up and slowly backing away is also a key de-escalation skill. In addition, how you respond can be very important in slowing or calming an irate patient.
There are many types of content that keep your department running, from organizational tools to training materials. Some content is lifesaving, while other content keeps things running smoothly. All of it should be easily accessible by your staff and first responders. Together, these pieces of content culminate into Operational Readiness; the state of preparedness essential for handling any scenario that might cross the paths of your first responders.
Of course, having the right content in place is one important step toward safe and efficient work. A tool like PowerDMS will empower your team to access critical content in critical moments, ensuring safety when it matters most. The most important thing is not what you decide to call your policies, but the effectiveness and comprehensiveness of their content. When written and communicated effectively, they provide a clear roadmap to employees and give them a North Star to follow in all scenarios.
A cloud-based policy management platform like PowerDMS lets first responders access these critical documents anywhere, even from a mobile device. Learn more about policy and procedure management for the fire service and first responders. The two can often overlap, but both of them serve entirely unique purposes. Think of fire department SOPs as a means of procedural guidance. While technical guidelines provide technical instructions, SOPs explain performance expectations and requirements.
Since the development of SOPs is based on command policies, they help standardize all department activities, from administration to emergency response. This makes SOPs a great tool for training employees, and one they should be able to reference as needed. Whether responding to an emergency or dealing with repairs, your employees need the right information and resources at their fingertips.
Having technical guidelines available in the cloud not only saves time but encourages compliance in operations across the board. If you are not currently using a cloud-based document management software, you probably have to file away pre-plans in a folder or in binders. For optimal safety, these documents need to be readily available at all times.
With a central repository like PowerDMS, you can assess the building and immediately implement the pre-plan as early as the day the building was assessed. If dispatch receives a call from that property, responders can immediately pull it up in PowerDMS without the turnaround time common with a paper-based process.
EMS personnel responding to emergencies are the trusted authorities for medical issues and medication. First responders are only human, and sometimes after a long day of response calls they can forget crucial drug information. Having medical references with common drugs and their intended usage on hand can help determine the best course of action for any scenario requiring narcotics administration. Unpreparedness or confusion could cost someone their life.
Certain classes of medication can be lethal when given in the wrong dose. Having dosage charts in the cloud means employees can quickly access the information they need in critical moments. While organizational content like surveys may seem less crucial than, say, SOPs, you might be surprised how useful they are.
From surveying staff on the best fire gloves to deciding on the best course of action for radio communications, survey results can guide your operations and boost morale by giving your employees a voice.
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