Scene safety training exercise

30 Apr 2016 15:58
Tags first-aid how-to protest training

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This training exercise is based on the way that a long-time member of Chicago Action Medical mentors new medics when they buddy with him. As they walk around a protest, he asks questions like the ones below. One of his buddies suggested we drop most of our scene assessment lecture and replace it by assessing the actual scene (with some added imaginary elements) around the sketchy locations we hold trainings.

Actual scenes students have walked through at trainings I've led include loading docks, blind alleys, razor wire-topped fences, broken glass, no running water or handwashing stations, broken water filtration (contaminated water source), high-speed busy roads, dangerous banner drop locations, bus shelters, children and people with extremely limited moblity, and an approaching wildland fire. At several trainings, students used their breaks to control risks they had identified.

The below training text is from a 2013 training in the Piedra Wilderness Area of Colorado. It is not the whole Scene Assessment section, just the "good parts." Since 2013, I've used this exercise with modified questions in St Louis, Chicago, and Atlanta. It's always a hit!

Introduction to scene assessment

Facilitator says: Watch surroundings and communicate.

  • Look for danger.
  • Make the scene safer.
  • Be prepared for the scene to change.

Facilitator says: Scene assessment encompasses a lot of continuous observations:

  • Personal (Ethan’s here, he gets seizures).
  • Specific (the baby bloc pushing strollers is right next to the Commie bloc chanting about shooting Obama).
  • Big picture (open businesses, street grid, weather).

Facilitator says: Always assess scene and stay situationally aware—especially when things seem calm and no one is injured.

Practice communicating about a scene

Facilitator says: We’re going to practice doing scene assessment as medic affinity groups here at camp. An experienced medic will walk around camp with each group, and guide you to see the scene.

Proctors: identify selves.

Students: break into as many groups as there are proctors.

Facilitator says: before you head out, answer these questions:1

  • Who are the organizers and logistics people at this camp?
  • Is there cell reception in camp?
  • Who has a charged phone?
  • What is the local emergency number for medical/trauma emergencies? What resources exist for someone in camp who needs help with sexual/domestic violence, STI/blood-borne illness testing/treatment, mental health crisis, poisoning, or addictions recovery support?
  • If you call 911, what hospital will someone end up at?
  • What is our camp evacuation route?
  • How long would it take to evacuate one limping (assisted) or unresponsive (carried) person to a rendezvous point? All the way to definitive care?

Groups: Go assess the scene around the training location for 10 minutes. As they walk around, their proctor asks Dick Reilly-style questions like these:

  • Where are your exits?
  • Where are your treatment areas?
  • Where are the police?
  • Where are their bosses?
  • Where are the legal observers?
  • Where are children and elders?
  • Could the weather change?
  • Who is most at risk here and why?
  • What are the biggest dangers here and why?
    • What are choke points?
    • Obstacles for panicked crowd?
    • How can we calm crowd?
  • What is the state of food, water, and sanitation?
  • Where are alcohol and intoxication clustered?
  • Where can someone go to get away from all alcohol and intoxication all night?
  • Where can someone shelter-in-place out of weather?
  • How can someone leave camp to get care or go home?
  • If "…," then what would you do?2
  • If "…," who would you involve, where would you refer the person, or who could improve the situation?


Facilitator asks: How did communicating about the scene as a group change your individual perception of it?

If your team sees injured protesters

Facilitator says: Look for danger/needs/resources. Stop to decide plan and activate back-up. Scene assessment continues while your buddy team:

  1. Exits the scene,
  2. Uses available resources to control scene (but does not assesspatient or provide care),
  3. Or controls scene, engages patient, prepares to do advocacy.

Calling 911 to activate EMS

  • Know location; In city: exact address if possible, at least cross streets. In backwoods: know name of your area, directions to road-accessible rendezvous point, nearest highway mile marker, GPS coordinates.
  • If you’re a medical professional, identify your title, cert or shield number for authority drag purposes (or choose to remain anonymous).
  • Say patient’s chief complaint (if known). Follow dispatcher’s lead. Stay on phone. Response time depends on 911 dispatcher’s assessment of urgency and availability of responders.

Scene control options

Get to a safer scene by foot, car, transit, cab, or ambulance

  • Get out of cold, rain, wind, or heat.
  • Help someone back up from a fight
  • Get to wellness center or hospital.

Stay put; make scene safer around you

  • Calm, comfort, reassure: Sometimes the scene is safe but the injured person is so hyped he doesn’t recognize it is safe.
  • De-escalate and redirect hostile/nosy bystanders: Use humor, give something to do, be polite, firm, and cheerful.
  • Create privacy circle.

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