In response to a number of major incidents over the last couple of years, active shooter, WMD, and terrorism classes are once again all the rage. I wonder sometimes though if we are putting our eggs in the right basket. These are not the incidents that are injuring and killing providers in the field as often as altercations with a single patient, lifting injuries, and motor vehicle accidents.
Maybe we need to shift our focus back to scene awareness (not scene safety). Some of the incidents, namely the hostage incident in Georgia, was a response to a routine call that went horribly wrong when the crew arrived. I wonder if they looked back at it though if they would identify any warning signs that they missed. I wonder if they walked into the scene with the level of complacency that many of us do when responding to a ‘routine” emergency. It is something every one of us have done, myself included. We get tunnel vision. We forget to really get a look at the room we are walking into, or ask where that vicious lhasa apso is when we see the “BEWARE OF DOG” sign on the door. Or even something as making sure the keys are out of the ignition on the call for the unresponsive or disoriented person behind the wheel.
We rely far too often on the police and assume that their presence alone means that a scene is safe when that could not be farther from the case. I have had plenty of “we need to get out of here right now” moments on scenes that were deemed “safe” prior to my arrival. Now that statement does not exist to take anything away from the job that they do, because personally I rely on the police for a lot. They often are able to offer a lot of information, and while maintaining a scene is their prime responsibility, our own safety needs to be our responsibility regardless of who else is there, or what the nature of the call is.
Sometimes it just takes a few simple approaches to our day to make a big difference in its outcome, and chances are if we did those little things we would not notice their impact because an incident was prevented. Take an extra look at an intersection to clear it before you enter it, and don’t rely on your siren, or your lights, or your opticom. They help, but they do not instantly make driving safer. Not everyone is going to get out of your way. Do you have an onboard computer in your truck? Take an extra second to read the notes of your call before you go into it. Those little updates that are not passed along by the dispatcher could make a huge difference in your approach.
Finally, do everything you can to avoid tunnel vision. Condition yourself for it. When you get out of your truck, just look both ways. Look over the entire house when you are approaching it. Just glance at the windows, and the door, and whatever is visible. When you walk into a room, just give it a quick once over, and greet your patient from a distance as you do. Watch their demeanor, and know your surroundings, and know how you got in. It will be your quickest way out.
Our job is dangerous for a number of reasons. Incidents like Newtown, the Boston Marathon, and the hostage situation in Georgia are the ones that make the news, but countless others happen every day on more routine calls. Don’t let yourself get too focused on those major incidents at the expense of becoming complacent on the more “routine” runs.