Hand signals for EMS

[Asysin2leads]

Hey all, here's something I'd like to think about. What would be some good universal hand signals for working at an MCI? In a perfect world, of course, everyone would have the best radios that work all the time and all agencies involved would work together in a seamless fashioned. Unfortunately, that's rarely the case. I think that EMS should add the use of hand signals for line of sight communication in case of transmission problems with radios. For instance, let's say you were doing triage, and wanted to relay your count back to the incident commander. You could point to your eyes for "I see" then make a signal for "patients", then hold your fingers up for how many, and at a hand signal for the appropriate color, red, yellow, green, or black. I think a big one would be a universally recognizable signal for "evacuate", something equivalent to what three blasts of a fire truck's air horns mean. Something that when you see it, you relay it quickly and then GTFO. What other signals could be useful?

[Bieber]

I would say if we're going to use hand signals, we should try to use a system that already exists. My initial thoughts were aviation runway signals or military signals, but after a quick search it doesn't quite look like such a system that would be applicable to EMS or MCI's really exists. ASL is another option, but I think that the signs done in ASL aren't as full bodied and visible as runway or military signals; ASL wasn't exactly intended for long distance communication.

The most important thing would be that it is universally adopted, so that providers from all agencies could "speak" the same language; meaning it would have to be FEMA adopted. There's also the issue of retention and provider adherence to the approved signals. How many times have you had a backer and they used a different signal to turn or stop than what your partner and you use?

It's an interesting concept, though, Asys, and I agree that it would be helpful to be able to communicate non-verbally--even if you did have access to radios, just to keep radio chatter to a minimum.

http://www.lefande.com/hands.html

http://www.traron.org/docs/Marshaller%20Handsignals.pdf

http://www.brooksidepress.org/Products/OperationalMedicine/DATA/operationalmed/Manuals/FMSS/CombatFormations/COMBATFORMATIONSANDSIGNALS.htm

[Arctickat]

Why not a programmable lighted sign mounted on the command post that can be seen for 500 yards for directions from command and an adaptation of scuba signals for person to person?

Or maybe tree climbing signals?

http://www.treeworld.info/attachments/f9/15711d1275624661-hand-verbal-signals-tree-climbing-crew-tw-hand-signals.jpg

Edited May 12, 2012 by Arctickat

[croaker260]

Well, completely different use, but one of my (many) FTO books has a list of hand signals for "non-verbal" prompts for the FTO to help his rookie through the call when needed without taking over the call and keeping the learning going.

[Arctickat]

The biggest concern is uniformity. When you have 5 different agencies responding to an MCI, are they all going to have the same hand signals? Who are the hand signals to be directed at? How are you going to get the attention of the person on the receiving end of your signal if he/she is not looking at you?

[HERBIE1]

Asys- Interesting idea, but I question how practical it could be. If you are line of sight, then I suppose simple gestures may work, but how many times are there vehicles, personnel, bright lights, bystanders, or other obstructions that clutter a scene? I totally agree that the weak link in an MCI is always communication. In nearly every critique of a large scale- or even smaller scale event with multiple agencies or responders, the number one complaint always relates to communication problems. Either you encounter a dead spot in radio reception, there is too much unnecessary chatter(most often the case), there are interoperability issues, or not everyone has access to their own radio.

I have found that especially in MCI's, a runner- someone in staging, or that is not specifically assigned to triage, patient care, FSR activities, or other duties can serve as a means of communications when all else fails. Obviously these would need to be simple messages- ie "Please inform the transport officer we have 2 yellows and are awaiting an assigned destination", or "We need more manpower for lifting help or to assist with patient care," since we all know what happens to messages as they are passed from person to person.

I supposed a standardized signal method IS possible in theory, since one of the basic tenets of NIMS training is to utilize standardized language on the radio and omit 10-codes and other agency specific language. I just wonder how useful it would be unless you have direct eye contact with the intended message recipient.

[Asysin2leads]

I know line of sight isn't always possible, especially at night, but especially in a scenario that involves hot, warm, and cold zones, usually command has a pretty good view of the area. People operating in an MCI ideally should have a buddy system, and keep in line of sight with each other. Hand signals are already used in helicopter extraction so the person on the ground can communicate with the spotter in the air.

If an MCI is run according to the play book, the first arriving unit should break into two different roles. One person goes and gets a quick triage count while the other relays the incident to dispatch. Depending on the area, the communications person may have to be utilizing multiple frequencies just to get the information out, and point to point communication may not be possible. However, if the triage person can stay within line of sight, or return to line of sight, with a few hand gestures you should be able to relay the number of patients and the severity of each. Or signal "Oh crap, start the engine! run, run RUN!"

[Richard B the EMT]

In all my years, I thought the signal for "all crews to evacuate immediate scene" was all drivers vehicle operators/chauffeurs to "tie down" the air horns and sirens on their (all agencies) apparatus for about a minute. That would be a holdover from before everyone had a portable radio, and possibly still used as a backup if there is a radio "dead zone".

3 Air horn blasts is a new one on me, but it could be a local protocol.

Edited May 13, 2012 by Richard B the EMT

[DFIB]

We have two hand signals that we use. One is means "I am in danger" and the other means "I need help" as in man power. The combination reads "I am in danger, I need help". Anything else we yell if radios are out.

[HERBIE1]

I know line of sight isn't always possible, especially at night, but especially in a scenario that involves hot, warm, and cold zones, usually command has a pretty good view of the area. People operating in an MCI ideally should have a buddy system, and keep in line of sight with each other. Hand signals are already used in helicopter extraction so the person on the ground can communicate with the spotter in the air.

If an MCI is run according to the play book, the first arriving unit should break into two different roles. One person goes and gets a quick triage count while the other relays the incident to dispatch. Depending on the area, the communications person may have to be utilizing multiple frequencies just to get the information out, and point to point communication may not be possible. However, if the triage person can stay within line of sight, or return to line of sight, with a few hand gestures you should be able to relay the number of patients and the severity of each. Or signal "Oh crap, start the engine! run, run RUN!"

I'm trying to think about the various types of MCI's I have been involved in and where hand signals could possibly have been used. If we were close enough to see hand signals, we would have been close enough to yell, or even take a second and run over to talk face to face.

The only things I can think of off the top of my head would be cases where law enforcement is the primary duty and we are standing by- ie a HBT, high risk warrant stand bys, or bomb threats. In each of these situations, things are generally quiet, we are not moving around, and we had a controlled perimeter so there were no extra responders or bystanders running around, getting in the way, or making noise. SWAT and TEMS teams use hand signals, and I see the value there for obvious reasons.

When we deploy with LEO's, a major issue is communication. As you mentioned, ambient noise may be a problem, or radios may malfunction. The problem is, EMS is usually in a safe zone, and depending on the number of officers, their locations relative to EMS, and where EMS may be located- in multiple places, under cover- we cannot see those hand signals and are not aware of what actions are taking place. Generally there is an officer assigned to EMS units to protect them and keep them informed of what is happening, but that's not always the case either.

Interesting topic. Making me think.