CRIME SCENE AWARENESS Dr Miada Mahmoud Rady Awareness

CRIME SCENE AWARENESS Dr. Miada Mahmoud Rady

Awareness q it is ability to recognize and handle indicators of violence in any crime scene before becoming involved : q it is necessary as paramedics may arrive at a scene before law enforcement so If you feel the scene is not safe: A. Contact law enforcement personnel. B. Retreat to your ambulance. C. Wait for them to secure the scene.

Indicators of Violence q. There are no fixed indicators of violence so as a paramedic you should: 1. Always expect aggressive behavior. 2. Identify potentially dangerous situations and remove yourself, your team, and the patient to a safe place. 3. Continuously evaluate the scene.

Standard Operating Procedures q Standard operating procedures (SOPs) : they are special standardized guidelines which may be in place for dealing with potentially violent incidents. q If they exist paramedic should review the SOPS contents, and use them as the basis for your approach.

Approaching the Scene 1. Your safety strategy begins as soon as you are dispatched on a call. 2. Never follow police units to a scene. 3. Rather than risk becoming injured or killed, err on the side of safety. 4. If you suspect a violent situation, retreat and request back-up.

Highway and Rural Road Incidents q Account for bulk of serious injuries to EMS q Be aware of: 1. Violent patients. 2. Moving vehicles. 3. Drivers gawking at the incident.

Retreating from high way and rural incidents 1. The safest means of retreat is to back away and call for law enforcement assistance. 2. Provide the dispatcher with the following: 1. Number of aggressors. 2. Number and type of injuries. 3. Number and type of weapons. 4. Make, color, body style, and license number of the vehicle. 5. Direction of travel if vehicle leaves the scene.

Retreating from high way and rural incidents 3. If your partner is injured while approaching the motor vehicle, back away and call for assistance.

Residential Incidents q Standard procedure for any call involving domestic violence: 1. Allow law enforcement personnel to secure the scene before entry. 2. Ensure scene is safe before going in. 3. Continually reevaluate the situation while providing patient care.

Never approach the scene until you are advised that it is secure

Approaching a Residence 1. When you arrive at residence: A. Listen for loud, threatening voices. B. Glance through windows for signs of struggle. C. Look for visible weapons. D. Any time you perceive danger, back away to your vehicle.

Entering a Residence 1. Use an alternative path to approach. 2. Stand on the doorknob side of the door. 3. Knock and announce yourself.

Entering a Residence 4. Ask whoever answers the door to lead you to the patient. 5. Pick a primary exit and secondary exit. 6. As you arrive at the patient’s location, scan the room for weapons. 7. Back out of the residence if there is a gun/knife and Call for law enforcement assistance. 8. Be aware of objects that can be used as weapons.

Domestic Violence 1. If a violent dispute is in progress, wait for law enforcement. 2. Use good communication skills, eye contact, and appropriate body language. 3. Conduct yourself as a professional. 4. Crisis intervention should be left to the professionals. 5. You may be required to report certain conditions to local authorities.

Domestic Violence q. Tempers may flare while you are treating a patient so use Contact and cover technique : 1. One paramedic makes contact with the patient. 2. The second paramedic obtains patient information and gauges the level of tension. 3. Warns partner at the first sign of trouble.

Clandestine Drug Laboratories q Clandestine are laboratories set up by drug dealers to manufacture controlled substances. q Commonly manufactured drugs include methamphetamine, LSD, crack, and more. q Drug raids on clan labs can frequently turn into hazmat operations. q Labs can be found anywhere.

Clandestine Drug Laboratories q. Methamphetamine is the most popular substance manufactured in clandestine labs. q. Highly flammable and toxic chemicals

Clandestine Drug Laboratories q Once a clandestine laboratory is identified: 1. Remain clear of the area until secured. 2. Take any patients with you if you can. 3. Patients should be decontaminated before you approach them.

Mass Shootings, Active Shooters, and Snipers q Tactical paramedics are used where there is actual violence or potential for violence q Their Primary function is to care for law enforcement teams making entry into violent situations

Mass Shootings, Active Shooters, and Snipers q If find yourself on the scene with an active shooter: 1. Take direction from law enforcement personnel about whom to treat and when to treat 2. Document any requests or demands to deviate from your local protocols.

Mass Shootings, Active Shooters, and Snipers 3. Paramedics should remain in the staging area until the scene is secured.

Mass Shootings, Active Shooters, and Snipers 4. Paramedics need to know how to use cover and concealment : § Cover objects are impenetrable to bullets. § Use concealment when cover is not available.

Mass Shootings, Active Shooters, and Snipers 5. Paramedics should consider having a training session with local police to: 1. Learn how to assess a shot police officer. 2. Address specific topics. 3. Establish protocol for who removes weapons and how.

Hostage Situations q Paramedic in hostage situation work under the jurisdiction of law enforcement q Hostages are usually held as collateral. q You can increase your chances of survival if you can anticipate feelings and actions of hostage taker.

Hostage Situations q. If you are taken hostage: 1. Do not attract unwanted attention. 2. Do no stare at your captors. 3. Remove badge, collar pins, and patches. 4. Ask to help the wounded.

Safety tactics q Definition : Procedures used to provide protections in case of violent scenes q They include : 1. Retreat. 2. Cover and concealment. 3. Distraction and evasion. 4. Contact and cover. 5. Self defense.

If you suspect a violent situation, retreat and request back-up.

Contact and Cover q. Remember the objects that provide cover and those that offer concealment only. q. Make your body conform to the shape of the object as much as possible.

Using Walls as Cover q Determine if the type of wall gives you cover or concealment : 1. Brick and concrete are safer. 2. Most interior walls are not impenetrable.

Evasive Tactics q Change your locations only if new location is: 1. Better cover 2. Farther from the hostile atmosphere 3. Reached without revealing yourself to attacker 4. Before changing locations, look out from your cover several times look from different heights and angles.

Evasive Tactics

Concealment Techniques q Concealing yourself ( concealment techniques) : is placing your body behind an object that can hide you from view. q Tall grass, shrubbery, and dark shadows are considered areas of concealment. q More common after dark than in daylight hours q In rural areas, tall grass or cornfields can conceal you.

Self-Defense and body armour q Consider taking a self-defense course. q Body-armour manufacturers have responded by designing vests specifically for the EMS community.

Patient approach in violent situations A. Identify yourself. B. If someone prevents you from reaching your patient : 1. Instruct the person to move away. 2. Inform the person that the patient may die. 3. Radio your dispatcher and request law enforcement personnel assistance.

Patient approach in violent situations C. If the person in your way does not move: 1. Take a side step and repeat the verbal challenge. 2. Inform the person that police will be summoned. D. Always make sure your exit path is not blocked and you can easily retreat.

EMS rule at Crime Scenes 1. The goal of performing EMS at crime scenes is to provide high-quality patient care while preserving evidence. 2. Never endanger patient care for the sake of evidence. 3. Police and EMS are on the same side…talk!

EMS rule at Crime Scenes q. Assisting law enforcement personnel to maintain the integrity of the crime scene increases the probability that a suspect will be captured and convicted.

Preserving Evidence q. Two types of evidence: 1. Testimonial ( patient wards ) 2. Real or physical e. g. blood , semen , bullets patient clothes pieces of glass. and

Preserving Evidence 1. Do not disturb, damage, or alter physical evidence at a scene 2. Be aware that anything on or around the patient may be considered evidence. 3. Whenever in doubt, save or treat an object as evidence. 4. Develop an awareness of evidence. 5. Record only the facts at the scene of a crime, and record them accurately.

Preserving Evidence 6. If you must remove a piece of evidence in order to treat the patient : a. Place each piece into a brown paper bag. b. If the item is saturated, place the paper bag into a plastic bag.