Scene Safety at Violent Scenes: Dispatch, Approach, Cover, and Retreat Practice Questions

25 multiple-choice questions on Scene safety at violent scenes: dispatch, approach, cover, and retreat for paramedic and EMT students, from Chapter 53 (Crime Scene Awareness). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. At a tense scene with several people present, which part of each person should you watch most closely?

   1. A. Their hands
   2. B. Their eyes and facial expression
   3. C. Their feet and how they are standing
   4. D. Their clothing and visible tattoos
   Show answer

   Answer: A. Their hands

   Hands hold, draw, and use weapons, so watching each person's hands, and anything they reach toward, gives the earliest warning of an attack; hands you cannot see should be treated as a threat. Eyes and facial expression can hint at intent, such as glancing at a target or an exit, but they cannot hurt you. Stance, such as blading, is a useful but secondary cue and is easy to miss in a group. Clothing and tattoos may suggest an affiliation but say nothing about an immediate threat.

2. You are dispatched to an address where a crew was assaulted last year. The most useful added information from dispatch is:

   1. A. The caller's name and a callback number for the scene
   2. B. The name of the nearest receiving trauma center
   3. C. Prior calls and any hazard alerts for the address
   4. D. The patient's age and chief complaint
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   Answer: C. Prior calls and any hazard alerts for the address

   Many dispatch centers flag addresses with a history of violence, weapons, or dangerous animals. That premise history helps you decide whether to stage. A callback number, the patient's age and complaint, and the nearest trauma center help with care and transport but tell you nothing about the danger at the address.

3. You are a few blocks from a reported domestic fight at night. To approach safely, you should:

   1. A. Keep the siren on so the people know you are coming
   2. B. Light up the house with the spotlight as you pull up
   3. C. Park in front with all lights on as a deterrent
   4. D. Turn off the siren and lights before you arrive
   Show answer

   Answer: D. Turn off the siren and lights before you arrive

   Shutting down the siren and warning lights before arrival keeps you from announcing yourself and lets you watch the scene before you are noticed. Lighting up the house makes the crew the most visible target on the street.

4. At a residence where violence is possible, the ambulance is best parked:

   1. A. In the driveway with the nose facing the house
   2. B. Short of or past the house, set up for a quick exit
   3. C. Directly in front of the door to shorten the stretcher carry
   4. D. Behind the patient's car so the crew can work fast
   Show answer

   Answer: B. Short of or past the house, set up for a quick exit

   Parking a short distance from the house lets you observe before you are seen and avoids being boxed in. A unit parked in the driveway or nose-in can be blocked and is hard to leave in a hurry.

5. Shots are fired as you walk toward a stopped car at night. Which nearby object gives the best cover?

   1. A. The engine block of a car
   2. B. An open car door
   3. C. A thick row of tall hedges
   4. D. A wooden privacy fence
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   Answer: A. The engine block of a car

   Cover stops bullets; the engine block and wheels are the most solid parts of a vehicle. A car door, a hedge, or a wooden fence only hides you (concealment), and most bullets pass through them.

6. Gunfire breaks out. The only thing near you is a dense hedge, and a concrete wall is 30 feet away. Your best plan is to:

   1. A. Lie flat behind the hedge until the shooting stops
   2. B. Use the hedge briefly, then move to the wall
   3. C. Stay standing behind the hedge so you can see out
   4. D. Run back across the lawn to the unit
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   Answer: B. Use the hedge briefly, then move to the wall

   A hedge is concealment only: it hides you but will not stop rounds. Use it to break line of sight, then move to true cover such as the concrete wall; staying behind the hedge leaves you hidden but unprotected.

7. When you use a flashlight while walking up to a dark house, you should hold it:

   1. A. Centered on your chest to free both hands
   2. B. Close to your face to see past the beam
   3. C. Aimed at the windows to see inside
   4. D. Off to the side, away from your body
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   Answer: D. Off to the side, away from your body

   A person aiming at a light usually aims at its center, so holding the flashlight away from your body moves that point off you. Holding it at your chest or face puts the brightest target right over your vital organs or head.

8. On a night call, your partner leaves the headlights on behind you as you walk toward a house. The main danger is that you are:

   1. A. Blinding your partner as he watches the scene
   2. B. Night-blinded whenever you look back at the unit
   3. C. Silhouetted and easy to see from the house
   4. D. Casting a shadow that hides hazards ahead
   Show answer

   Answer: C. Silhouetted and easy to see from the house

   Lights behind you outline your body for anyone inside, while you stare into the dark. Approach out of your own unit's lights, or shine them toward the house so the people inside, not you, are lit. Glancing back into the lights or walking in your own shadow are minor problems next to being an easy, lit target.

9. You arrive at a house for a reported fight. Which finding is the strongest reason to hold back and wait for police?

   1. A. A neighbor is standing on her porch watching you
   2. B. The house is dark and silent after a call about yelling
   3. C. The porch light is on and the front door is closed
   4. D. A car in the driveway has its engine running and lights on
   Show answer

   Answer: B. The house is dark and silent after a call about yelling

   Sudden silence or a darkened home after a report of a violent argument is a classic warning sign: someone may be hurt, hiding, or waiting. A watching neighbor or a closed door is ordinary and does not suggest new danger.

10. In the 'contact and cover' approach to a scene, the cover provider's main job is to:

    1. A. Do the hands-on patient assessment and care
    2. B. Carry the heavier equipment bags
    3. C. Watch the people and scene for threats
    4. D. Talk with the family and bystanders
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    Answer: C. Watch the people and scene for threats

    One provider (contact) talks with and treats the patient while the other (cover) stays back, watches hands and movement, and is ready to call for help or signal retreat. If both crew members focus on the patient, no one sees a threat coming.

11. A man pulls a knife during your assessment. Your equipment bags are beside the patient. You should:

    1. A. Grab the bags so you can resume care
    2. B. Wait for police with the patient
    3. C. Ask the man to set the knife down first
    4. D. Leave the bags and get to safety
    Show answer

    Answer: D. Leave the bags and get to safety

    Equipment can be replaced; you cannot. Retreat at once and leave anything that slows you. Staying with the patient or trying to negotiate while within reach of the knife puts the crew at serious risk.

12. A man lunges toward you in a narrow hallway as you retreat. Which evasive tactic is most appropriate?

    1. A. Put the stretcher between you and him
    2. B. Tackle him before he is able to reach you
    3. C. Stand still and keep talking to him
    4. D. Grab for the knife he is holding
    Show answer

    Answer: A. Put the stretcher between you and him

    Evasive tactics such as placing an object (a stretcher, a chair, a bag) between you and an attacker buy time to escape. Tackling or grabbing for a weapon is a law enforcement task that greatly raises your risk of injury.

13. After you leave a scene because of real danger, your partner worries about abandonment. Which statement is correct?

    1. A. You may not leave a patient once care has begun
    2. B. Retreating from real danger is not abandonment
    3. C. You need the patient's consent before you leave
    4. D. You need an order from medical control to leave
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    Answer: B. Retreating from real danger is not abandonment

    Abandonment is ending care without cause; a genuine threat to the crew is a valid reason to withdraw. Notify dispatch, document exactly why you left, and return when police make the scene safe. Care already begun does not oblige you to stay in danger. A patient's consent is not needed to retreat from a threat. Medical control does not have to approve a safety withdrawal before it happens.

14. Police have the shooter in custody, and you are treating his victim on the sidewalk. A man arrives shouting that he will 'get' the shooter's family. You should:

    1. A. Have police handle him and move the patient to the unit
    2. B. Stop care and try to calm the man down on your own
    3. C. Continue care on the sidewalk and ignore what the man says
    4. D. Leave the patient and drive the ambulance away now
    Show answer

    Answer: A. Have police handle him and move the patient to the unit

    Scene safety is reassessed throughout the call; a new threat calls for police to manage it while you move the patient to the ambulance. Trying to calm him yourself takes you away from the patient and puts you in harm's way.

15. Police wave you into a house after a stabbing and say the suspect has fled. Before you go in, the most useful thing to ask the officer is:

    1. A. What the argument was about at first
    2. B. How long ago the stabbing happened
    3. C. The victim's name and date of birth
    4. D. Who else is inside, and where
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    Answer: D. Who else is inside, and where

    Knowing who else is in the home, such as family, friends, or a possible second suspect, and where they are tells you whom to watch and whether any room has not been checked; other people are how a 'secure' scene turns dangerous. What started the argument is for investigators and does not change your entry. The time of the stabbing and the victim's name help with care and records but can be learned once you reach him; they do not tell you who might still be a threat.

16. You respond to a welfare check with no police assigned. As you reach the porch, you hear screaming and breaking glass inside. You should:

    1. A. Knock loudly and announce that EMS has arrived
    2. B. Enter quickly because someone may be injured
    3. C. Back away and ask for police before entering
    4. D. Look in through the windows to find the patient
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    Answer: C. Back away and ask for police before entering

    Signs of active violence mean the scene is not safe. Withdraw to a safe place and request law enforcement; entering or peering through windows exposes you to an unknown threat.

17. Before a call to a bar fight, your partner hangs his stethoscope around his neck. The main safety concern is that it:

    1. A. May pick up trace evidence at the scene
    2. B. Can be used to choke him
    3. C. Can catch on a door as he retreats
    4. D. Can be crushed in a scuffle
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    Answer: B. Can be used to choke him

    Anything looped around the neck, such as a stethoscope, a lanyard, or a tie, can be grabbed and used to choke or control a provider; at volatile scenes carry it in a pocket or bag. Picking up trace material is a minor evidence issue, not a threat to the crew. A stethoscope catching on a door frame or getting crushed in a scuffle is a nuisance next to being choked with it.

18. Before a high-risk call, your crew agrees on a code phrase. Its main purpose is to:

    1. A. Warn each other of danger without alerting others
    2. B. Shorten radio reports to the receiving hospital
    3. C. Signal a grave prognosis without upsetting family
    4. D. Confirm to dispatch that police have cleared it
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    Answer: A. Warn each other of danger without alerting others

    A prearranged code phrase lets one provider tell the other to leave, or tell dispatch to send police, without tipping off a hostile person. It is a safety tool, not a radio shortcut, a way to discuss a patient's outlook, or a scene-cleared signal to dispatch.

19. Your partner is in a house while you are at the ambulance. He does not answer two radio checks. You should:

    1. A. Go in at once to look for your partner
    2. B. Wait 15 minutes, then try him on the radio again
    3. C. Sound the horn to get his attention
    4. D. Request police rather than going in alone
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    Answer: D. Request police rather than going in alone

    An unanswered check-in at a possible hostile scene may mean your partner is in danger. Going in alone may create a second victim; request police and give dispatch your partner's last known location.

20. You decide to walk away from a man who is drunk, angry, and arguing with you on a sidewalk. You should move back to the ambulance by:

    1. A. Turning around and walking quickly to the cab
    2. B. Walking past him to reach the curb side of the unit
    3. C. Backing away while you watch him
    4. D. Waiting for him to walk away from you first
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    Answer: C. Backing away while you watch him

    Keeping your eyes on a threat while you open distance lets you see a sudden move and react to it; if he advances, put a barrier such as the stretcher or a vehicle between you and keep leaving. Turning your back removes your only warning of an attack. Walking past him brings you within his reach. Waiting for him to leave keeps you in a situation you have already judged unsafe.

21. Dispatch tells you a domestic call is 'over' and the man involved has left. Police are still several minutes away. You should:

    1. A. Drive straight up, since the danger has passed
    2. B. Skip staging and go in without knocking first
    3. C. Approach as if the threat may still be present
    4. D. Cancel police, since they are no longer needed
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    Answer: C. Approach as if the threat may still be present

    Dispatch information is second-hand and can be wrong or out of date; the man may still be nearby or may return. Use the same cautious approach and keep police coming.

22. Before opening the ambulance doors at a dark, possibly hostile scene, you should switch off the cab's dome light because it:

    1. A. Drains the battery during long scene times
    2. B. Lets bystanders see into the patient area
    3. C. Interferes with the portable radio signal
    4. D. Lights you up as you step out of the unit
    Show answer

    Answer: D. Lights you up as you step out of the unit

    Interior lights make the crew visible to anyone outside the moment the doors open, while the crew's eyes are not yet adjusted to the dark. Turning them off keeps you from being silhouetted. Privacy in the patient area is handled with closed doors and shades, and the dome light has no real effect on the battery or the radio.

23. A paramedic who must pass a group of hostile bystanders to reach a patient should first:

    1. A. Ask for police before going through the group
    2. B. Walk through quickly with eyes straight ahead
    3. C. Ask the loudest bystander to help you through
    4. D. Turn on the siren to make the group move away
    Show answer

    Answer: A. Ask for police before going through the group

    A hostile crowd can turn on responders in seconds. Request police to control the crowd before you enter; pushing through or using the siren may provoke the group.

24. Which statement about EMS uniforms at violent scenes is most accurate?

    1. A. A uniform protects you from most acts of violence
    2. B. Police-style uniforms can draw hostility
    3. C. Uniforms make no difference to how people react
    4. D. A dark uniform is easier to see from a distance
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    Answer: B. Police-style uniforms can draw hostility

    People who are hostile toward police may not tell a paramedic from an officer, especially at night, so police-style uniforms can draw anger. Clearly marked EMS clothing helps, but no uniform protects you from violence. Uniforms do shape how people react, for better or worse. Dark clothing is harder, not easier, to see at a distance.

25. You pull up to a call for a 'man down' in an alley at 2 a.m. Before getting out of the ambulance, you should:

    1. A. Get out at once, since he may be in arrest
    2. B. Sound the horn so the patient knows you are here
    3. C. Pause and scan the area from inside the unit
    4. D. Turn on all lights and walk straight to him
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    Answer: C. Pause and scan the area from inside the unit

    A short look from inside the vehicle lets you spot people, weapons, or other hazards while you still have a fast way out. A 'man down' can be an injured victim, an intoxicated person, or a setup, so rushing in skips your best chance to see danger.