Scene Size-Up & Safety is 15–19% of the EMT exam and 19–23% of the EMR exam. The items are rarely difficult. They are lost because candidates want to get to the patient — and the exam is checking whether you will.
What size-up covers
- Scene safety — hazards to you, your crew, bystanders and the patient.
- Standard precautions — the protection the situation calls for.
- Mechanism of injury or nature of illness — what happened, and what it suggests.
- Number of patients — and whether you have enough resources for them.
- Additional resources — law enforcement, fire, hazardous materials teams, more units, advanced life support.
The rules the exam expects you to follow
If the scene is not safe, you do not enter. You stage at a safe distance, call for the resources that can make it safe, and wait.
- Your safety comes first. An injured responder becomes another patient and removes a rescuer.
- Call for help early. When you realize there are more patients than you can manage, request resources before you start treating.
- Reassess the scene. Scenes change. A crowd, a fire or a returning assailant can make a safe scene unsafe.
- Suspect hazards you cannot see. Several people with the same vague symptoms in one enclosed space should make you think of a toxic gas such as carbon monoxide — and back out.
A quick self-test
When a stem describes a scene, ask three questions before reading the options: Is it safe? How many patients? What else do I need? If an option addresses one of those and the others go straight to patient care, that option is very often the answer.
