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Steps to follow

  1. BSI.
  2. Scene safe.
  3. MOI / NOI.
  4. Number of patients.
  5. Additional resources.


  • BSI = Body substance isolation.
  • Gloves: always wear them.
  • Eye protection: protect eyes from body fluids for cases with active bleeding.
  • Surgical mask.
  • HEPA or N-95 mask: for tuberculosis protection.
  • Gown.
  • Helmet.
  • Turnout gear.

Scene safe

  • Never enter an unstable crash scene.
  • Traffic safety and control.
    • limit exposure to traffic.
    • control traffic with flares or cones.
    • wear reflective clothing.
    • turn the wheels of your parked vehicle to point away from the scene (if someone crashes into it, you won't get run over by your own vehicle).
  • Do not enter active crime scenes until it is under control by law enforcement. Take extra precautions if you suspect crime, or simply call for law enforcement.
  • Take precautions for unstable surfaces and slopes.
  • Ice: treat with sand, salt or gravel.
  • Frozen lakes surfaces may break.
  • Water: wear flotation device. Open water and moving water rescues require specialized training.
  • Toxic substances / low oxygen caused by:
    • Spill, leak, or fire.
    • Confined spaces such as caves require SCBA (self-contained breathing apparatus).
    • Suspect toxic environment if everyone in the area suffer from similar symptoms.
  • Scene control: tell crowds to step back. Introduce yourself to patients and always ask for their consent to any treatment. Be courteous, let patients know you are here to help.
  • Maintain an escape route.
  • If a scene turns hazardous at any point, leave.


  • MOI = Mechanism of injury. For trauma patients.
  • NOI = Nature of illness. For medical patients.
  • Index of suspicion: your judgment of whether and how severely the patient is injured.
  • The MOI is the basis for you index of suspicion.
  • High index of suspicion for trauma patients include:
    • Falls.
    • Crashes and collisions.
    • Explosions.
    • Violence.
    • Burns.
  • Look for signs and symptoms.

Number of patients

  • Estimate the total number of patients involved. If it's more than your unit can handle, call for backup.

Additional resources

  • Can your unit handle this? If not, call for additional resources.
  • Additional EMS units.
  • Law enforcement.
  • Fire department.
  • Hazmat team.