Emerg Med J doi:10.1136/emermed-2013-202823
  • Cases from HEMS

A safe scene?

  1. Matthew Wyse3
  1. 1Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation Research, Birmingham Heartlands Hospital, Birmingham, UK
  2. 2HEMS Paramedic, The Air Ambulance Service, Derby, Derbyshire, UK
  3. 3HEMS Doctor/Clinical Lead, The Air Ambulance Service, Derby, Derbyshire, UK
  1. Correspondence to Dr Carl McQueen, Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation Research, MIDRU Building, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK; carl_mcqueen{at}
  • Received 7 May 2013
  • Accepted 12 May 2013
  • Published Online First 4 June 2013


Safety of personnel and patients is of paramount importance in prehospital environments. Establishment and maintenance of scene safety should be the first action of emergency personnel on arrival at incidents. Scene management is usually multidisciplinary, with personnel from agencies including the Police and Fire Rescue Services contributing to establishing a safe working environment. This case illustrates the challenges that can be faced by prehospital teams arriving at the scene as the first emergency services resource and the importance of an innovative and adaptable approach to scene management in such cases.

Case notes

The prehospital team was called to reports of a motorcyclist who had been injured in an accident on a motorway slip road. Other road users had witnessed the accident and had called the emergency services. One caller had identified herself as an off-duty doctor and described the patient's condition to the call handler as ‘time critical’. The incident had occurred at one junction south-bound from the air ambulance base at East Midlands Airport. At the time of the …

Free sample
This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of EMJ.
View free sample issue >>

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.


Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

Navigate This Article