Treading Silently Through Mimefields

Sunday, March 06 2005

In the last post I may have given the impression that, once on site, EMS providers zoom in, lock on, and descend onto “target” patients ala Ahnold-as-Terminator. “Owah mission is to protect John Cahtah – Theah he is.” (This, if one is charitable; persons unkind will liken us to George Romero’s zombies as we stagger, arms outstretched, towards the patient, the while groaning, “Spliiiinnt!”)

If this was the impression, forgive me. My fault entirely.

As every Good EMT knows, Scene Size Up is one of the first orders of business we take care of on-scene. The fire guys have RedHats, and we have Thirds – “Third person on the bambulance.” Also known as Canaries, from the old West Virginia coal mining days.

“Say, DTs, there’s our patient pinned beneath that chemical truck!”

“I see him. It looks danger… ah, serious. Quickly then, Bandage Boy, wade through the liquid spilling from within to his rescue! I will watch from afar to, uh, direct your progress.”

This would be a Bad Thing. DTs would get into so much trouble. I mention this (redhat/third) = canary myth, which some may have heard, to dispel it as the scandalous slander it is. What we do instead, at a spill, is stop at a safe distance (rule of thumb – cover the spill with your outstretched thumb – if you can’t, you’re too close) and figure it out through binoculars while Hazmat guys suit up.

Scene size-up should occur in every situation, and not just MVAs.

Called out to an “injury from an assault”? Is the assaulter still around, perhaps taking exception to your plugging up the nice bullet holes he made?

Gladys Kravitz delivers a pie and sees, through the window, Samantha and Darrin sprawled on the carpet. Rush in, O EMT, ‘cuz a bad guy bopped them on the head, or suspect a gas leak?

Size up the scene, man.

Personal safety is not the only reason. It helps the docs plan their treatment when they know what went on Out There. Did the airbag deploy? Was the car T-boned, and if so, was the door dented in? By how many inches? Was the patient driver’s side, passenger side, front or rear seat? Seat belt? Steering column deformed?

We once ran a bicyclist who was standing with his bike, about 50 feet from the roadside. Asked what happened, he replied, “Well, I was following a car, and they stopped, and I didn’t and hit them.” We walked with him back to the road and took him to the hospital for a look-see.

No biggy, yes? Indeed not! Bad DTs, bad! No cookie!

It would have been a Good Thing To Know that yes, he hit the car – doing 40 or 50mph – and his bike stopped but he continued on like a rocket sled over the trunk, turning the back window of the car into musical dust and stopping with his torso between two back-seat passengers. All he needed were sparklers in each hand to produce that genuine Vegas effect.

Being 50 feet from the roadside, though, did DTs go and check the car? He did not, because in EMT class we learn Scene Size Up… then some stuff… then do Patient Stuff. DTs was already doing Patient Stuff, so that other junk was skipped over and dispensed with.

Live and learn. Size up that scene, baby.


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