SA国际传媒

SA国际传媒

How to use L.C.E.S. for car accident scene situational awareness

A busy roadway is hands-down the most dangerous environment where we routinely work

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Use L.C.E.S to make sure everyone goes home from a car accident scene

Photo Greg Friese

EMT Esteban Bahena鈥檚 last Facebook post referenced a call he had just completed and ended with the simple phrase, 鈥淚 love my job.鈥 Eight hours later , struck by a vehicle at the scene of a car accident where he was providing care.

Esteban鈥檚 story, while tragic, isn鈥檛 rare. Each year, the news stream at SA国际传媒 is bound to bring us a baker鈥檚 dozen of stories about EMTs, firefighters, police officers and paramedics while working on the roadway.

As the snow starts to fall here in Colorado and the roads get icy, my thoughts turn to busy, accident filled rush-hours and the hours I will inevitably spend on dangerous roadways in awful conditions. And I .

A busy roadway is hands-down the most dangerous environment where we routinely work. Let鈥檚 talk about an acronym we can use to remind us of four elements that can help us stay safe and maintain situational awareness when we are working in the unpredictable environment of a busy roadway.

The acronym is L.C.E.S. If that sounds familiar, it鈥檚 because wildland firefighters have been using it for more than three decades. Wildland firefighters know a few things about working in dangerous and unpredictable environments. To make sure everyone goes home safe, firefighters use L.C.E.S. You can, too. Let鈥檚 walk through it.

L stands for Lookouts

Someone needs to be looking up the road and watching what鈥檚 coming. Don鈥檛 assume that everyone is going to yield appropriately. Passing drivers, craning for a look at the scene will do some amazingly dangerous things.

Find the crew member who鈥檚 looking for something to do and post him in a spot where he can see the whole scene and the oncoming traffic. Let him know that he鈥檚 responsible for making sure nobody steps into traffic and making a bunch of noise if anything looks wonky farther up the road.

Posting a lookout also serves as a critical reminder to everyone on scene that they are working in a dangerous place.

C stands for Communications

There鈥檚 no sense in having a lookout if that person can鈥檛 communicate quickly and effectively with everyone on scene. The lookout should be in shouting distance of everyone operating on scene. If voice contact isn鈥檛 feasible, the lookout should have a radio in their hand.

Everyone should also know the plan. It doesn鈥檛 need to be a big production, but all of the elements of LCES should be communicated to everyone on scene. Let folks know who is looking out for them, where the safe operating areas are and where everyone is planning on going if things go bad in a hurry.

E stands for Escape Routes

It isn鈥檛 enough to know that a car might fail to yield and enter the scene, you need to have a route to safety if one does. The shoulder of the road is always preferable to an alternate lane of traffic. The opposite side of a guardrail is even better (as long as there鈥檚 solid ground on the opposite side). But you should decide on a place to go before things go badly.

S stands for Safety Zone

Natural and man-made barriers like trees and guardrails are great places to retreat if you need to escape to a safety zone, but I also like to create a safe working area right there on the road.

My favorite working area is about 200 feet down stream of a big, heavy engine. Position those large fire apparatus right in the involved lanes of traffic and angled away from the nearest shoulder.

If you鈥檙e working in a dicey area and these no engine coming, call one. Even if you don鈥檛 need the extra hands, you need the protection of the apparatus to create a safe working area.

Once you鈥檝e created a safe working area, work in it and watch each other鈥檚 backs. It鈥檚 easy to get focused on patient care and accidently step the wrong way into an unsafe area. The more serious the accident, the more important it is to watch out for each other.

L.C.E.S. isn鈥檛 just for wildland firefighters. You can use it effectively in any unsafe environment. With designated lookouts, effective communication, pre-established escape routes and attention to safety zones, we can reduce injuries to EMS personnel on traffic accident scenes.

Steve Whitehead, NREMT-P, is a firefighter/paramedic with the South Metro Fire Rescue Authority in Colo. and the creator of the blog The EMT Spot. He is a primary instructor for South Metro鈥檚 EMT program and a lifelong student of emergency medicine. Reach him through his blog at steve@theemtspot.com.

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