Scene Safety for Bike Medics

     The EMS responder who becomes a victim is no help to anyone. That axiom is the basis of this column, which focuses on aspects of scene and provider safety, as well as patient-safety issues. This month's installment looks at scene safety for bike medics. Please send ideas for future columns to nancy.perry@cygnusb2b.com.

     Advocates of EMS bike teams cite approachability as one of their benefits. And it's undeniable that a bike medic just seems somehow more accessible than one in an ambulance. You can approach him, ask him questions and make conversation without feeling like you're necessarily intruding.

     The flip side of that, though, is vulnerability. That big, imposing rig that walls you off from the common folk is also your primary source of protection when a scene goes bad. You can hide behind it, retreat into it and even use it for a hasty departure if needed.

     Lacking that protection, bike medics face some extra challenges when it comes to scene safety.

     "Because you're more vulnerable on a bicycle than you'd be in an ambulance, it makes the scene assessment even more important," says Capt. Mike Hudspeth, who will speak on the subject at the International Police Mountain Bike Association's annual conference, slated for April 14 -21 in Baton Rouge, LA. "We try to teach folks to not get tunnel vision. You're there to help a victim, but you can't focus all your attention on that victim. You have to be aware of everything else around you."

     That's good advice no matter how you get to a scene; you should always be alert to things like weather, terrain and the potential for a quick, ugly turn of mood among family members or bystanders. But bikes come with additional considerations.

     For one, on a bike, you're essentially at eye level. You lack the raised perspective of the ambulance, which means you may miss things you'd see in a vehicle. And because bike medics typically work in festival or other large-crowd environments, this problem can be compounded by having lots of people surrounding you.

     "There's a lot of vision impairment," says Hudspeth, who also leads Guilford County (NC) Emergency Services' bike team, "so we encourage people to ride a circle around their scene before entering. That gives you a 360-degree view. You can identify the best ways to approach and get out, and see if there are hazards on one side that you might not be able to see from the crowd."

     Related to that is a degree of disconnection from colleagues and backup. Bike medics won't typically have mobile data terminals or computers with them, so they may get limited dispatch information. If a scene changes (and boy, can they ever do that), it then becomes even more vital to update dispatch and keep your colleagues - that is to say, your potential backup - abreast of what's happening.

     "You don't actually know what exactly you're going into prior to getting to the scene," Hudspeth notes, "and as we all know, the patient never seems to be exactly where dispatch sends us. So communicating with dispatch to let them know your exact location is paramount. If you get into trouble, they have to send help to the right location."

     While it's not as effective as an ambulance, a bike is not without value as a barrier. It's more psychological than physical - most people won't move bikes to impose on your scene. Working in teams of two allows you to park them in a rough V shape that shields both you and your patient. Make sure they're far enough away they don't inhibit your care or fall on your patient.

     In general, a lot of the scene safety principles EMS providers routinely embrace translate to the cycling world; they just require a bit of modification.

     "It's really just kind of the daily routines you get accustomed to doing, mainly to protect yourself," Hudspeth says. "They teach you in school that safety's the most important thing, and that has to become ingrained. If you become a victim yourself, then you're not doing anybody any good."