Educator’s Corner: Teaching Street Smarts

This Educator’s Corner was from 2007—and still very relevant today. It seems violent encounters involving EMS are on the rise. This might be a good time to review some techniques for teaching street smarts to our students.

We would all like our students to be more street smart when they leave our classrooms. The challenges come from creating realistic training—with the limited time available. Here are a few points I use when teaching my students.

Reward Observation

The best thing we can teach our students to be is observant. It is always best to observe and avoid the danger than to deal with it—even when trained to deal with it. Set up skills practice with signs of danger obvious. This may include sounds of fighting from inside a residence, evidence of intoxication or drug use—and other signs that students can use to decide to avoid danger before they encounter it. All too often we want our students to react to scenarios of danger when the best outcome is to avoid it.

Teach safety Teamwork

We can’t always avoid danger. Observing danger is best done by a team. Make sure students know to watch out for each other—and communicate potential dangers early. Will your students know what to do if one finds a weapon on the patient during a rapid trauma exam? If one crew member sees danger can it be effectively and safely communicated to others?

When in Danger

The most practical and successful strategy when an EMS provider (not a dual-trained cop or tactical medic) observes or encounters danger is retreat. It goes against our personalities in many cases but it is the most practical and easiest to remember. When teaching this important strategy remember:

• Retreat is not just one move—it is a series of moves. Get away from the danger. Put both distance and solid objects (cover) between you and the danger.
• Use diversion strategies such as throwing a first-in bag to trip up an aggressor (throwing 12 lead monitors is profoundly unpopular with bosses). Close doors as you exit or wedge a stretcher in the doorframe to buy time.

Reality

It is clear that EMS providers may face danger.   But safety skills must be taught practically to assure the proper perspective. EMS is basically safe. Technically, taxi drivers and convenience store workers are statistically more likely to be injured by violence than EMS providers. BUT…EMS providers are more likely to be injured or killed in a motor vehicle crash or to blow out their backs lifting a patient as well as face violence. Perspective is important. Students must feel what you are teaching applies to them.

Make Scenarios Win-able

We like to create situations that are fast-moving and dramatic. Ones where students get the feel of danger and out-of-control people. Remember to incorporate clear points where the students can make a decision and do the right thing. Too often these scenarios are lose-lose and students don’t receive a message other than “These situations are giant clusters.”

The other street situation students want to know about—and the consequences are high in—is the crime scene. Realistic crime scenes can be created in the classroom if you keep your eye on what students really need to know. These concepts don’t require elaborate scenario recreation and are:

• Students will be asked “What did you see?” and “What did you hear?”
• Students should be able to recognize potential evidence.
• Students should remember what they touch—and touch as little as possible.

Create a simple scenario. Choose a room where you can drop a little blood on the floor and make a small mess. Turn the lights off and strategically place a few things between the student and a simulated patient that will have to be moved.

Have your students run the scenario as a routine call (e.g. man down). When they approach and enter, the guidelines for feedback are:

• How long did it take them to realize it was a crime scene?
• Did they act appropriately for safety?
• Did they remember what they touched? (e.g. turning on the light, moving things to get to the patient, etc.)
• Did they avoid contamination (e.g. stepping in blood) or disturbing other evidence?

Having taught these scenarios for many years, very few students remember everything. Thus, students realize the challenges of a crime scene. It is up to you whether you set this up as a “crime scene” scenario or quietly add the crime scene angle in the middle of a medical or trauma emergencies lab. The former gets students worked up—much like they would be going to a crime scene. The latter may also be a reality when they go into a call and suddenly find that the scene is actually a crime scene.

I hope these tips help you prepare your students to be safe on the street.