EMS safety at crime scenes

• EMS providers must prioritize personal safety while ensuring patient care at crime scenes
• It is critical to understand how to safely operate in high-risk environments, this will also ensure the integrity of the scene

Recognizing Indicators of Violence

• EMS providers must identify the signs that a scene is unsafe

Environmental Indicators

• Examples include gunshots, broken windows, or forced entry points
• Blood on the ground, walls, or furniture is another indicator
• Weapons in plain sight like knives, firearms, or blunt objects can provide cues
• Drug paraphernalia, evidence of substance abuse, or gang-related graffiti may occur at a crime scene

Behavioral Indicators

• Watch out for aggressive or erratic behavior from bystanders, patients, or suspects
• Note individuals who refuse to cooperate or display threatening body language
• Look for unconscious or unresponsive individuals in unusual positions, these indicate possible attack

Verbal Indicators

• Threats directed at EMS, police, or others on scene are key verbal indicators
• Shouting, screaming, or escalating conflict may occur
• Bystanders discussing potential harm to others or retaliation can signify danger

Warning Signs of a Potentially Dangerous Scene

• EMS providers must remain vigilant because a safe scene can rapidly turn volatile
• Sudden changes in demeanor of bystanders or family members can indicate a change
• Escalation in verbal threats or aggressive gestures may lead to violence
• Individuals reaching for pockets, waistbands, or concealed areas may have weapons
• Unexpected arrivals of new individuals who could be hostile should be noted
• Law enforcement actively drawing weapons or assuming defensive postures can signify danger

Steps to Protect Yourself at a Crime Scene

• Waiting for law enforcement clearance before entering crime scenes, especially those involving weapons or violence, is essential

Scene Size-Up and Approach

• Park away from the immediate scene to allow for quick egress, if needed in the future
• Keep emergency lights to a minimum in high-risk areas to avoid drawing attention to yourself
• Cautiously approach while being aware of potential hiding spots, or ambush points

Maintaining Situational Awareness

• Continuously scan for threats, weapons, or hostile individuals.
• Communicate effectively by working closely with law enforcement and keeping the team informed
• Control positioning, avoiding turning your back on unknown individuals or unsecured areas
• Limit distractions by focusing on both the patient, and the surroundings

Interaction with Law Enforcement

• Follow instructions given by police officers because they are responsible for scene security
• Avoid touching/moving weapons, evidence, or any forensic material unless necessary for patient care
• Coordinate with law enforcement to ensure safety when removing a patient from an active crime scene

Preserving Evidence While Providing Care

• Minimize scene contamination by avoiding unnecessary movement of objects or blood evidence
• Enter and exit using a direct path
• Carefully document scene conditions, the patient's position, and any interactions with law enforcement
• Avoid altering the patient’s clothing or appearance unless required for medical intervention

Exiting the Scene Safely

• Leave immediately if the scene becomes dangerous
• Follow the police evacuation instructions, if given
• Create distance, use barriers, and request law enforcement assistance if approached by a hostile individual

Special Situations

• It is important to follow correct protocol in special situations

Domestic Violence Scenes

• These scenes can be extremely volatile with the suspect potentially still present
• Always wait for law enforcement clearance before entering
• Victims may be reluctant to speak freely out of fear of their abuser

Active Shooter or Hostage Situations

• Never enter unless law enforcement has secured the scene
• Stage in a safe area until directed to enter
• Anticipate multiple casualties and chaotic conditions with needed medical assistance

Drug-Related Incidents

• Drug use and trafficking increases the risk of violence
• Be aware of hazardous substances like fentanyl, which can cause accidental exposure
• Never needlessly handle unknown substances and notify police of any suspicious materials involved

Conclusion

• Crime scene awareness is essential for every EMS provider
• Recognize indicators of violence, stay alert for warning signs, and follow safety measures for self-preservation while ensuring patient care
• Prioritize personal safety, coordinate with law enforcement, and thoroughly document everything to maintain medical and legal integrity