Crime Scenes, Evidence, Responder Safety and Wellness

Scene Size-Up and Responder Physical Safety

Personal safety is always the EMT's highest priority on any emergency call. During scene size-up and on-scene operations, assess hazards and protect responders before providing patient care; the cardiac Chain of Survival does not define a scene-safety hierarchy. Prioritize your own safety and the safety of your crew, then assess and address hazards to patients, bystanders, and other responders as the situation requires. Protecting yourself first is not selfish; an injured or incapacitated rescuer cannot render aid and instead adds to the burden on incoming emergency resources.

Scene size-up begins at the time of dispatch and continues throughout the entire call. Information gathered from the initial radio transmission provides a baseline, but dynamic hazards can evolve at any moment. If a scene is unsafe, EMTs should retreat or stage at a safe distance until the appropriate authorities have addressed the hazard and entry is safe. At a violent crime scene, EMTs must wait for law enforcement to declare the scene safe before entering. Entering a hostile or uncontrolled area prematurely places the entire crew at risk.

Tactical awareness and positioning dictate how responders should move through physical spaces. When knocking on an unfamiliar door, EMTs should stand to the side of the frame rather than directly in front of the door to avoid potential hazards penetrating through the opening. When entering an enclosed space, EMTs should position themselves between the patient and the exit door, and EMTs should maintain a clear escape route at all times when assessing and treating patients. This defensive posture ensures responders can rapidly withdraw if an unexpected threat emerges.

Environmental hazards outside structures require equal vigilance. On roadway incidents, EMTs must wear high-visibility reflective apparel meeting ANSI standards. Emergency vehicles should be positioned under the traffic-control plan to help shield responders and establish a safe work zone. At night, drivers should avoid blinding oncoming traffic with emergency-vehicle headlights or forward-facing lights, while maintaining the lighting needed for safety. Responders must also continuously scan for indicators of hazardous materials, such as placards, chemical odors, or vapor clouds. If hazardous materials are suspected, EMTs must stage upwind, uphill, and upstream from the incident.