A state trooper and I were responding to a Priority One call for a rollover on a parkway near my town. I had followed his state police car in my POV (privately owned vehicle) from an entrance ramp for about a mile when I saw him pull off on the left side of the road. As we've all been taught since driving school, if you're pulling up on a police car, you park behind it. But as we got out of our vehicles he said to me, "Don't block my lights!" I thought this was unusual, but he was right! He had a multitude of blue, red and amber LEDs, and tail-light strobes, flashers and reflective decals compared to my little blue/white rear-facing LED. His car would provide much better warning to approaching motorists than mine. I moved my car, got my trauma bag and went to work (see Figure 1). I knew my small warning light was nothing compared to the candlepower, visibility and variety of colors and reflectors on the trooper's vehicle.
That got me thinking that most EMTs and fire department volunteers light up the forward-facing part of their vehicle so cars in front of them will (hopefully) move over when they are responding to a scene. But little attention is paid to rear-facing warning lights, reflectors and other methods of protecting ourselves. Once police vehicles, ambulance or fire engines arrive, the protection comes from larger vehicles, brighter lights and more people to handle traffic, but until they arrive, we put ourselves and our patients at risk without proper scene safety.
As we all learned in EMS 101, our first duty is to protect ourselves and the second is to act as an advocate for patients and protect them from further injury. If you come upon a scene that is unsafe, the book says "Don't go in!" So while you wouldn't even think about disarming a man with a knife, you think an accident or medical victim on a highway or roadway is different because the scene is safe. Or is it?
The scene may not be safe because of traffic, and you're probably not going to wait for additional help. So what can you do to quickly make the scene safer? You pull up behind the patient's car to protect it, but what protects you? Your 4-way flashers are a start, but they don't tell oncoming traffic to slow down because there are first responders working at the scene or to move over and give you room to exit your vehicle or return to it for a secondary trauma bag or O2 kit.
I often beat fire and EMS vehicles to a scene because our emergency vehicle drivers have to stop by the rescue squad to pick up a vehicle, while I generally respond in my own POV. This probably happens more often than not and is something that should be considered by almost every squad. Quite often, it is a POV that first warns traffic of a problem ahead and places itself between the accident scene and traffic.
Following are some considerations for first responders at a scene before the manpower, high-powered lights and large vehicles arrive.
Vests and Colored Jackets
The most simple personal safety item is an ANSI 2- or ANSI 3-compliant reflective vest or outerwear. ANSI is a standard established by the American National Standards Institute. The clothing is now mandatory for fire/EMS and others working near highways. Adding reaction time to sight times, studies have shown that at 60 mph it can take a motorist up to 260 feet to notice and stop for a first responder. A person wearing blue or black can be seen at 55 feet, one in red at 80 feet, in yellow at 120 feet and one in white at 180 feet. But a reflective vest with contrasting fluorescent red-orange or green-yellow can be seen at 1000 feet!1 The ANSI-compliant clothing is required to identify the wearer as a person, as opposed to a sign or vehicle, which gives motorists plenty of warning and time to slow down. So wearing an approved vest, jacket or other clothing is extremely important as you move around the scene. To further protect yourself, put on your ANSI clothing when you first get in your vehicle so you're protected and ready to go to work when you exit your vehicle at the scene.