1. SCENE SIZE UP

2. DOT OBJECTIVES RECOGNIZE HAZARDS AND POTENTIAL HAZARDS DESCRIBE COMMON HAZARDS AT THE SCENE DETERMINE SCENE SAFETY MECHANISMS OF INJURY/NATURE OF ILLNESS IDENTIFY NUMBER OF PATIENTS RATIONAL FOR EVALUATING SCENE SAFETY SERVE AS A MODEL FOR OTHERS

3. DEFINITION AN ASSESSMENT OF THE SCENE AND SURROUNDINGS TO ASSURE THE SAFETY OF THE EMT AND TO PROVIDE POTENTIALLY USEFUL INFORMATION ABOUT THE PATIENT.

4. SCENE SAFETY PERSONAL PROTECTION - IS IT SAFE TO APPROACH THE PATIENT? –LOOK AND LISTEN FOR OTHER EMERGENCY VEHICLES –LOOK FOR DOWNED POWER LINES –OBSERVE TRAFFIC FLOW –WATCH FOR FIRE OR SMOKE –LOOK FOR CLUES TO HAZARDOUS MATERIALS –SNIFF FOR ODORS

5. SCENE SAFETY CONT’D. PATIENT SAFETY - CAN I WORK ON MY PATIENT HERE OR MUST I MOVE HIM TO A PLACE OF SAFETY BYSTANDER SAFETY –WATCH FOR PEDESTRIANS ON THE ROAD –CURIOUS ONLOOKERS POSE MANY DANGERS

6. SCENE SAFETY CONT’D. ESTABLISH A DANGER ZONE NO APPARENT HAZARDS - 50 FT IN ALL DIRECTIONS SPILLED FUEL - 100 FT IN ALL DIRECTIONS VEHICLE FIRE - 100 FT IN ALL DIRECTIONS DOWNED WIRES - PARK ONE FULL SPAN OF POLES AWAY HAZ MAT SPILL - CHECK THE NORTH AMERICAN EMERGENCY RESPONSE GUIDEBOOK

7. SPECIAL CONSIDERATIONS CRIME SCENE WARNINGS –FIGHTING OR LOUD VOICES –WEAPONS VISIBLE –SIGNS OF ALCOHOL/DRUG USE –UNUSUAL SILENCE –KNOWLEDGE OF PRIOR VIOLENCE

8. CONSIDER THIS ONE DANGER THAT IS PRESENT AT MANY SCENES IS THE FAMILY DOG. EVEN ONES THAT LOOK HARMLESS COULD ATTACK IF THEY FEEL THREATENED. BE CAREFUL.

9. NATURE OF THE CALL MECHANISM OF INJURY –HEAD-ON-COLLISIONS –REAR-END COLLISIONS –SIDE-IMPACT COLLISIONS –ROTATIONAL IMPACT COLLISIONS –ROLLOVER COLLISIONS

10. HEAD ON COLLISIONS TWO PATTERNS OF INJURY SEEN –UP AND OVER - PATIENT GOES UP AND OVER THE STEERING WHEEL - HEAD AND NECK INJURIES COMMON –DOWN AND UNDER - PATIENT GOES DOWN AND UNDER THE STEERING WHEEL - KNEE, HIP AND LEG INJURIES.

11. REAR-END COLLISIONS HEAD AND NECK INJURIES COMMON BODY MOVES BUT HEAD REMAINS STILL PROPERLY PLACED HEAD RESTS HELP TO ELIMINATE THIS

12. SIDE IMPACT COLLISIONS BODY IS THROWN SIDEWAYS DIRECT BLUNT INJURY ANYWHERE ON THE IMPACTED SIDE HEAD AND NECK INJURIES COMMON

13. ROLLOVER COLLISIONS POTENTIALLY THE MOST SERIOUS POSSIBILITY OF PATIENT EJECTION FROM VEHICLE ALL TYPES OF INJURIES FOUND

14. ROTATIONAL IMPACT COLLISIONS VEHICLE IS STRUCK AND THEN SPINS OFTEN HAVE MULTIPLE IMPACTS SUSPECT ALL INJURY PATTERNS

15. LOOK AND LEARN DETERMINE WHERE THE PATIENT WAS SITTING SEAT BELTS? AIR BAGS? EJECTED? STEERING WHEEL BENT? WINDSHIELD DAMAGED? PEDALS BENT?

16. PENETRATING TRAUMA INJURY CAUSED BY AN OBJECT PASSING THROUGH BODY TISSUE –LOW VELOCITY - PROPELLED BY HAND (KNIVES) –MEDIUM VELOCITY - HANDGUNS AND SHOTGUNS –HIGH VELOCITY - HIGH POWERED OR ASSAULT RIFLES

17. LOW VELOCITY INJURY INJURY LIMITED TO AREA OF THE PENETRATION LOOK FOR MULTIPLE WOUNDS SUSPECT INJURY TO VITAL ORGANS

18. MEDIUM VELOCITY INJURY LOOK FOR ENTRANCE AND EXIT WOUNDS SUSPECT INJURY TO VITAL ORGANS BULLETS CAN TRAVEL ANYWHERE IN THE BODY

19. HIGH VELOCITY INJURY DAMAGE CAN BE ANYWHERE IN THE BODY –DAMAGE DIRECTLY FROM THE BULLET –PRESSURE RELATED DAMAGE - CAVITATION

20. NATURE OF ILLNESS FIND OUT MEDICAL INFO FROM: –THE PATIENT –BYSTANDERS –FAMILY MEMBERS –THE SCENE LOOK FOR MEDICINES LOOK FOR OXYGEN DEVICES

21. RESOURCES NEEDED DO YOU HAVE THE RESOURCES TO HANDLE THE SITUATION –NUMBER OF PATIENTS –FIRE DEPARTMENT? –RESCUE SQUAD? –MORE AMBULANCES?

22. THE END PRESS ESC TO END THIS PRESENTATION. I HOPE YOU ENJOYED IT.