Do you know what the most important step of CPR really is? I’ll give you a hint: it has nothing to do with compressions, airway, or breathing. Scene safety is paramount to any successful resuscitation of a patient experiencing sudden cardiac arrest. In fact, if issues of scene safety are not properly addressed at the onset of a response, the consequences could be tragic or even fatal not only for the patient, but the rescuer as well. Public safety and health care professionals should have a solid foundational understanding of scene safety principles; however, there are countless individuals performing CPR every day outside of the hospital and without a background in emergency response. Ensuring the safety of everyone involved in an emergency response is my number one goal as a CPR instructor and instructor trainer.
Many movies and television shows depict concerned citizens jumping into an emergency situation and heroically saving the life of the victim. These actions are certainly admirable, but prove to be a great risk to the safety of all involved. A smart rescuer would ensure his or her safety first, thus paving the way for a safe response and allowing greater focus to be placed on the patient. In other words, a rescuer can choose to be a rescuer or a victim, but not both. When rescuers become injured or even killed because of hazards on the scene, he or she is obviously no longer an asset to the rescue. In fact, more resources will be needed to assist the downed rescuer and attention thereby diverted from providing care for the primary patient.
So, what can you do to be ready to respond safely?
It’s quite simple. First, you must always have a plan to respond. That means you should be situationally aware wherever you are and have an idea of some basic concepts. It’s always a smart idea to know your local emergency response number, which is usually 9-1-1. Workplaces often have an emergency response team that can be activated as well to assist in an emergency situation. Additionally, make yourself aware of nearby AEDs and first-aid kits. These tools will become invaluable should someone collapse of sudden cardiac arrest. If traveling or outside of your home town, make note of nearby hospitals and healthcare facilities. Having an understanding of each of these pieces can help you to be better prepared to respond safely.
As you approach the scene, whether it’s at home, church, work, at the mall, or sporting event, now is the time to assess your surroundings for potential hazards. The same hazard that may have caused the patient to suffer from sudden cardiac arrest may also be a threat to your safety. Common threats to scene safety of rescuers outside of the hospital can include downed power lines, fire, smoke, chemical spills, traffic, violent persons, blood-borne pathogens, and even weather. I personally teach all of my students to implement what I call 540° of awareness. This means that a rescuer should assess 360° horizontally for any hazards as well as 180° vertically. This provides for the greatest assessment of possible threats while using the senses of hearing, smelling, and seeing. Some hazards are easily mitigated. For example, a small trashcan on fire can be extinguished with a fire extinguisher. Other hazards require additional resources to handle. An example of this would be downed power lines following a motor vehicle accident near the roadway. As one can see, summoning emergency services by calling 9-1-1 is an important part of the overall scene safety process.
They are also a few items they can help keep you safe while providing CPR. These include gloves, safety glasses, and CPR barrier devices for giving breaths. Gloves offer the rescuer additional protection from bodily substances as well as blood-borne pathogens that could be present when providing CPR to a victim. Safety glasses protect the eyes of the rescuer and help prevent any substances from entering the eyes. Finally, a CPR barrier device allows rescuers to give breaths while blocking any bodily fluids from coming in contact with the rescuer. Each of these devices plays an equally important role in the overall safety during a resuscitation.
In closing, all of the elements of ensuring scene safety can work together to provide the safest environment in which to provide CPR to someone in need. If you haven’t already, find and register for a CPR/AED training class near you to help you develop the necessary skills to be a safe responder in any CPR-related emergency. Remember, your safety is the first priority.