Scene Management and Safety Notes

Dynamic and Constant Reassessment: Scene assessment is not a one-time task; it requires continuous evaluation due to changing circumstances.
Hazards: Identify potential dangers within the environment.
People: Observe individuals present and their behaviors for insights into the situation.
Mechanisms: Determine the cause of the problem, especially in traumatic injuries.
Out-of-Place Elements: Recognize inconsistencies or things that don't fit as clues for assessment.

Who is There?: Identify all individuals present at the scene.
Relationships: Determine the connections between people on-scene (family, friends, strangers, conflicting parties).
What Happened Before Arrival?: Ascertain the nature of the event.
Plausibility of the Story: Verify the consistency between the story and the visible evidence.
Inconsistencies: Note any elements that do not align with the given narrative.
Reactions: Observe how individuals are responding to events.
Pre-Arrival Information: Compare information from dispatch with the current scene; acknowledge potential limitations of dispatch systems.
Safe and Quick Exit: Plan potential escape routes for safety or patient transport.

PPE (Personal Protective Equipment): Determine necessary protective gear based on risks (helmets, gloves, reflective vests).
Backup: Assess the need for additional paramedics or support services.
Lines of Communication: Establish communication channels with patient, family, backup, control, and other services.
Boundaries: Create appropriate boundaries for bystanders.
Communication Strategies: Use closed-loop communication to ensure everyone is informed.

The READ model is used by New South Wales Ambulance
- R - Identify the Risk
- E - Determine equipment needed to make the situation safer
- A - Consider what actions to take
- D - Discuss options and get feedback from the rest of the crew.
Dynamic revision and discussion: Continuously revise the assessment and discuss safety measures.
Debrief: Conduct post-incident debriefing to gather learnings.

Elimination: Remove the hazard entirely (most effective).
Substitution: Replace the hazard with a less dangerous alternative.
Engineering Control: Isolate the hazard or move it away.
Administrative Control: Implement safer work processes.
PPE (Personal Protective Equipment): Use protective equipment (least desirable as a primary control).

The way that you react to a risk is by doing what is considered reasonably practicable.
Factors in determining 'reasonably practicable':
- Information available at the time.
- Nature of the risk.
- Capabilities.
- Potential harm.
- Resource availability.

Vehicle Placement: Strategic positioning of vehicles.
Equipment Placement: Organize equipment for accessibility and safety.
Interaction with Other Services: Coordinate effectively with other responding agencies.
Privacy: Protect patient privacy from bystanders.
Bystander and Family Management: Address the needs and potential distress of bystanders and family members, recognizing they may have information or be emotionally overwhelmed.