1 Scene Safety and Hazard Recognition
Learn how to assess scene safety, recognize hazards, select appropriate protective equipment, and decide whether and when to enter.
before patient contact
Before approaching a patient, assess whether the scene is safe for you, your crew, the patient, and bystanders. A rescuer who is injured or exposed may be unable to help and may create another emergency. Scene conditions can change, so continue watching for hazards throughout the response.
Recognizing scene hazards
Pause at a safe distance as you approach. Look, listen, and gather information from dispatch, witnesses, and other responders. Do not focus only on the patient: assess the surroundings and use the type of incident, visible damage, odors, warning signs, and people's behavior to anticipate danger.
Hazards to consider
Traffic and vehicles: moving traffic, poor visibility, unstable vehicles, fuel leaks, and collision damage.
Fire and utilities: smoke, flames, hot surfaces, downed power lines, exposed wiring, and leaking gas.
Hazardous substances: spills, fumes, powders, containers with warning labels, and unknown materials.
Violence and security: weapons, threats, fighting, unsafe crowds, and an uncontrolled scene.
Environmental and structural dangers: unstable buildings, falling debris, water, ice, steep ground, extreme temperatures, and poor lighting.
Exposure risks: blood, body fluids, airborne particles, and contaminated objects.
Never approach an unknown substance to identify it by touch or smell.
Selecting appropriate PPE
Choose according to the hazards you can reasonably anticipate and your agency's procedures. Depending on the situation, it may include gloves, eye protection, a mask or respirator, protective clothing, or high-visibility apparel near traffic.
Gloves and eye protection may be appropriate when blood or body-fluid exposure is possible. At a roadway incident, high-visibility clothing and a protected work area may also be needed. If a chemical release may be present, ordinary EMS PPE is not a substitute for hazardous-materials training and protective equipment.
Deciding whether to enter
Enter only when hazards are controlled well enough for you to work safely. Before entry, consider:
What hazards are present or likely?
Can they be avoided or controlled using available precautions and PPE?
Do you have the training, equipment, and authority required for this scene?
If the scene is unsafe or the hazard is unknown, do not enter. Move to a safe location, warn others if appropriate, communicate the hazard, and request the necessary resources. These may include fire services, law enforcement, utility personnel, or a hazardous-materials team. Wait for the scene to be secured or declared safe by the appropriate personnel. Reassess before entry and stay alert for changing conditions.
Applying the entry decision
At a crash scene, a vehicle is smoking beside moving traffic and a downed power line. Do not approach the vehicle. Stay clear of the line and traffic, report the hazards, and request fire and utility response. Patient access comes after the hazards are controlled.