What If?

Situational awareness is more than a catch phrase

• June 2009 JEMS Vol. 34 No. 6
• 2009 Jun 1

Dear Sirenhead,
I had a recent call that I’d like your opinion on. I don’t want to say too much about the call due to HIPAA, but here are the basics. 

Last month, as I was waiting in our squad for my partner to come out of a store with his lunch, I had a suicidal patient walk up to me with a broken bottle held to his neck. I talked the patient down, got backup and police there, and things ended well. 

As soon as the patient was gone, though, I broke down and went over and over in my head what I could or should have done differently. We’re taught from day one about scene safety and not doing anything until the scene is secure, but how do you handle things when the unsafe situation walks right up on you? My boss and others said the only thing they would have done differently was not get in the squad with him. But I justified this in my head. 

How can we stay safe in these types of situations? Did I put myself in danger due to lack of experience? I have only two years of experience in the field. Or was I right by judging the patient and going with my gut?
Second Guessing

DEAR SECOND GUESSING
In 1513, Niccolò Machiavelli penned the treatise  Il Principe  ( The Prince ).   The overall theme is that the end justifies the means, which means if what you did worked out well, then you must have done the right thing. I’ve always enjoyed that book, but I’ve never really agreed with Niccolò. 

What you experienced was a lesson. And with only two years on the job, you’ve got a lot more lessons in front of you. But let’s consider what you learned from this incident.

It sounds like you’ve got a good handle on "verbal judo." You’ll definitely use this skill again, so keep working on it. Talking your way out of a fix beats bleeding. 

You called for backup. Good job, because there’s nothing like putting the odds in your favor. From watching my buddy Bullethead over the years, I can guarantee that the police come with a lot more than verbal judo. They’re your friends, so keep ’em on your side. 

You were scared, and that’s a really good thing. I’ve seen a lot of EMTs and medics who thought they were the cat’s meow. They ran their mouths and tried to bully their way through similar situations, but all they ended up with was their tail tied in a knot. Fear is a gift—treasure it. 

Another good point is that it sounds like you stayed calm.  Flipping out never works well. In your case, it would’ve definitely escalated the situation into a whole bucket of ugliness. 

And you asked your boss’s opinion later.  Getting the perspective of someone who’s been around awhile is usually a smart move. You can take this approach a step further and see what else they know about being streetwise. It’s a great way to learn that getting punched in the mouth does in fact hurt without having to get the fat lip yourself.

Now, it’s time for some Sirenhead butt kickin’, because no one gets off easy here.

I’ve heard a lot of folks over the years claim that they do self-critiques. Some of them probably do a good job, but most of them justify bad decisions to make themselves feel better. That’s not just dumb, it can kill. If you want a real critique, ask someone who probably won’t agree with you. Admitting you made a mistake and learning from it is a lot healthier than pretending you’re always right.

Did you put yourself in danger because of inexperience? Maybe. Or maybe you just weren’t paying attention. Complacency isn’t just an old man’s disease. It’s a trap that makes us think nothing can happen to us. Situational awareness is the word (or words) we need to remember. It’s basically the concept of aligning your perception with reality. 

So, prepare for the unexpected by playing "what if." While you’re on the street, imagine possible situations and what your response would be. For example, think to yourself,  If this guy on the curb pulls out a knife, I’m gonna ... . Then, run these situations by the old, salty medics and see what they say. Listen with an ear to learn from them, not argue with them. I bet you’ll get some interesting stories. JEMS

Tell Someone Who Cares
Got a question or complaint? Let Sirenhead hear all about it. He’ll answer you with 124 dB of traffic-stopping noise. E-mail sirenhead@elsevier.com, and then brace yourself!

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