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Scene safety and body substance isolation (BSI) are some of the first phrases taught to EMTs to consider before every scenario. “Scene is safe, BSI” in fact almost becomes a mantra during training scenarios. There are some scenarios however in which scene safety is not a given. All medical providers, not just medics and EMTs need to be aware of the unique challenges inherent in every scenario. Sometimes a patient will be in a hazardous location or weather condition which requires adaptations. Other times a patient may require the use of inherently dangerous procedures such as an extrication that places the rescuer at risk. More frequently, however, providers are being exposed to potentially violent encounters that place themselves and patients at risk. This article will attempt to give a brief overview of plausible scenarios providers may find themselves in, ways to mitigate the risks, and also special considerations when treating patients in a hostile environment. Workplace violence is a serious and unfortunately growing area of concern for many people, especially those in healthcare. Workplace violence can be anything on a spectrum from harassment and verbal threats to assaults and even homicide. It is one of the leading causes of workplace fatalities in the United States.[1]