Trending Topics

3 ways to enhance EMS situational awareness

Learn how providers can increase their visibility and awareness of approaching hazards in the field to identify potential risks


Situational awareness pertains to safe driving, crew accountability and patient interaction safety.

AP Photo/Nick Ut

“BSI ... scene safe.” This needs to stand for more than just a declaratory statement in a testing scenario. It needs to be clearly understood and applied by every EMS provider, and on every call.

Barking dogs aren’t a likely safety consideration while responding to a nursing home; neither are down power lines at a sporting event injury scene. So, what does this statement mean for day-to-day operations?

It means being situationally aware. Simply stating “scene safe,” or even asking the station evaluator, “is the scene safe?” hardly accomplishes this.

Instead, providers must prepare themselves for all aspect of the call – from response through arrival, entrance to egress, and transport through transfer. This encompasses more than just barking dogs, downed power lines, or even active shooter situations. Situational awareness pertains to safe driving, crew accountability and patient interaction safety. These factors represent situational awareness on nearly 100% of your calls, not just 1%.

1. Safe driving

Let’s face it, driving “hot” is fun, but that doesn’t mean that it’s safe. Many agency policies express an allowance for driving up to 10 mph over the speed limit. So, who’s there to actually monitor this?

Utilizing GPS tracking, driving cameras and ambulance black boxes can all extend a hand of accountability toward promoting safe driving practices throughout an entire agency. Even aside from the fear of “big brother” watching over all of us, just waiting to greet us with a pink slip at every corner, video monitoring devices can also act as a form of saving grace to release our crews from public accusations. Being accused of causing an accident sounds bad enough, but having video footage to prove your innocence in the matter can quickly turn the table on any accuser (and save face for your organization in front of any insurer or lawyer).

In a non-punitive sense, installing back-up cameras in all of your vehicles provides each driver confirmation that he or she is less likely to cause any harm by simply being able to see better behind their vehicle. Most private vehicles come equipped with back-up cameras nowadays, something that you truly love once you have it (and wonder how you ever functioned safely without it when you didn’t).

2. Crew accountability

Imagine your EMS agency providing special event staffing at a large concert, public gathering or sporting event. What if your incident command or operational team could “see” where you were located as you’re roaming throughout the crowds? Wouldn’t that make response planning and operations easier?

GPS functionality can extend beyond tracking where your system status management, roaming ambulance is located. It can also be adapted to individuals through either individual devices or smartphone apps. Heck, how many of us have this feature activated within our own families to see when our spouse has left the house and arrived safely at their destination, or to see where your teenage child actually goes after school? Why not allow our employers – the one’s responsible for us while we’re at work – to have that same level of accountability while we carry our agency-assigned phone during working hours?

3. Patient interaction

“Get the KED board.” That was my crew’s “safe word,” indicating that the scene was no longer safe, and that we needed to discretely exit the residence and call for law enforcement assistance. This was our form of closed-circuit communications, and also the beginning of informing others that the scene was no longer safe.

Take this one step further and integrate in different pieces of technology. Panic buttons on your radio, body cams on your person (yes – they’re being used in EMS), and even interior cameras on either a one-way circuit between the cab and the patient compartment, or a recorded circuit with reviewing capabilities. This is where situational awareness is enhanced, validated and made practical in today’s emergency services setting.

Of course, policies still need to be in place, and providers still need classroom training on defense tactics, and overall situational awareness and readiness, but for those times when intuition, didactics and psychomotor learning aren’t enough, technology certainly has a place. We don’t always see danger coming at us, despite our situational awareness. Providing a means to enhance it, however, can certainly increase the odds in our favor.

Tim is the founder and CEO of Emergency Medical Solutions, LLC, an EMS training and consulting company that he developed in 2010. He has nearly two decades of experience in the emergency services industry, having worked as a career firefighter, paramedic and critical care paramedic in a variety of urban, suburban, rural and in-hospital environments. His background includes nearly a decade of company officer and chief officer level experience, in addition to training content delivery and program development spanning his entire career. He is experienced in EMS operations, community paramedicine, quality assurance, data management, training, special operations and administration disciplines, and holds credentials as both a supervising and managing paramedic officer.

Tim also has active experience as a columnist and content developer with over 200 published works and over 100 hours of education content available online, and is a social media influencer on LinkedIn within the EMS industry. Connect with him on LinkedIn or at