Fire Engineering Persons,
When reading “The Crime Scene and the EMT” by Drew Fried, EMT-B, I was confused as to what comes first. Is it patient care or crime scene preservation? In our department EMTs and PMs rarely enter the scene if it is not “secure”. In larger cities with paid members, this is often the case. But it concerns me that volunteers and firefighters in “combination” departments might get a mixed message and believe they “share” roles with police agencies. I believe that an EMT who must think like a police officer is not providing what taxpayers are paying him or her for. During CPR I will not be putting “scene preservation” at the top of my list, if I can address it at all.
Please print articles that are more clear on this point. Example: The EMT determines that the patient is deceased and then can “change hats” and begin to “preserve evidence”. Certainly the information is relevant but the “dual responsibility” implied confuses the first responder and gives the citizens less quality service for their tax dollars.
Author Response
Thank you for your comments about the article, “Crime Scene and the EMT”. I agree that patient care comes first. This point was expressed many times in the article, as nothing should stand in the way of patient care. You are correct that the safety of the emergency workers is also very important. Even though law enforcement might be on the scene and the scene is safe one of the responsibilities of an EMT or Paramedic should be preservation of evidence. Many times entry into a scene is done by responding EMS crews prior to the arrival of law enforcement. I would hope that as part of the scene size up the determination that the scene is safe is always made.
It was not the intent of this author to imply that EMS crews should share roles with law enforcement, but when they are first on the scene there are four steps that must be followed. They are, “learn to identify and preserve evidence, be observant, remember what you touch, and minimize you impact on the scene” (Essentials of Emergency Care 3Ed). Many times, law enforcement will not know what has been moved, touched, or even what clothes the victim was wearing without your help. Taxpayers are paying an EMT or Paramedic to cooperate with law enforcement and give the citizens complete quality service whether they are paid or volunteer professionals. In New York State, we have many agencies with a mix of paid and volunteer personnel, with the higher numbers being volunteer. We all need to work together in EMS; this is how we give good quality service.
Click HERE to read, “The Crime Scene and the EMT,” in the fireEMS section.
