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EMS More Commonly Face Physical, Verbal Assault on the Job

ESO Staff

Is it becoming more dangerous to work in the EMS industry? Recent studies, both international and domestic, are suggesting that EMS personnel are increasingly experiencing workplace abuse, both physical and verbal. Even more telling, nearly 70% of first responders said physical assaults were “unavoidable” in their jobs, while 94% of communications staff said verbal assaults were unavoidable.

In real pre-hospital situations, EMS personnel are often on the receiving end of a wide range of triggers: insulin shock overcoming reason, substance abuse enabling superhuman strength, the incapacitated acting out on delusions, and career criminals attacking responders even as they are attempting life-saving efforts.

Even so, it is likely that assaults on EMS personnel are largely under-reported, as tools for reporting such experiences are under-utilized and only assaults involving physical injuries typically reported. A culture of acceptance of these more “minor” encounters, whether personnel are embarrassed or simply taught to believe that this comes with the territory, allows these assaults to remain largely unaddressed and undercounted.

Assaults Are Common, Expected

A recent study conducted by Austin-Travis County Emergency Medical Services (ATCEMS) is the most recent example of a study attempting to quantify the scale of the issue, releasing its findings that suggest EMS personnel are more regularly the victims of aggression and violence while on-duty. Sadly, it seems that assault is not only more common but more expected and accepted as unavoidable by first responders.

First-responders said physical assaults most often occurred in the back of ambulances, with 63% of those answering the survey saying they’ve been attacked more than once in the last two years; 86% of communications personnel reported being verbally assaulted in that timeframe.

A key area for improvement is the need for more training specific to these threats; Nearly 63% of first-responders said they didn’t feel they were properly trained on de-escalation techniques when dealing with aggressive behaviors; 64% said they didn’t feel they were trained to escape situations involving aggressive behavior.

Additionally, easier channels for reporting assault – and a more cohesive database that could offer a more accurate picture of the state of the industry – are other potential options for addressing the situation. Some officers additionally cite the need for stricter enforcement of punishment on those assaulting emergency personnel.

What Can Be Done?

While many one-the-job safety resources are available for EMS regarding traffic, health, and situational safety, not much is readily published relating to assault while on the job. Most EMS personnel receive self-defense training as part of their training hours, but, again, more could be focused on recognizing potentially dangerous situations and de-escalating them, or even how to simply escape a physically dangerous situation.

A series of training specific to EMS is currently gaining popularity, known as Escaping Violent Encounters (EVE) for EMS. Many training videos are available online along with formal training opportunities. A recent EMS World article also outlined the basic pillars of the EVE training, which focus on a multi-faceted approach.

  • Train the mind of the practitioner: EMS practitioners need to understand that it’s not just part of the job to be assaulted, and EMS agencies also need to acknowledge that employees being assaulted is not acceptable. Practitioners need to understand and believe that it is acceptable for them to defend themselves when attacked and that there is an appropriate way to deal with non-cooperative patients that is different from defending against and escaping from attack.
  • Train for the street: EMS practitioners need to learn and maintain proficiency in a small number of easy-to-learn, easy-to-maintain physical skills that facilitate escape from violent encounters. Maintaining proficiency is a major issue because like most psychomotor skills, defensive skills are lost if not practiced or used.
  • Train for the media: EMS practitioners forced to defend themselves need to know how to present themselves in a manner that demonstrates a lack of aggression, and have at their disposal techniques to make it clear that they are the victims, attempting to escape harm. While much of the workday is now on video, it must be clearly understood that the EMS practitioner was trying to avoid, not engage in, a fight.
  • Train for the courtroom: The aftermath of any violent encounter involves other people and other agencies. Proper documentation of an event, using the correct terminology of the law of self-defense, and correct interaction with law enforcement and judicial officers will assure that this stage of the encounter winds up favorably to the medic.

As the conversation continues to gain visibility, it is hopeful that a mind shift will soon occur, making it more acceptable for personnel to report all assaults, and encouraging agencies to do more to address and prepare their employees for this potential risk. While emergency responders know their jobs are inherently dangerous, they should not be exposed to additional threats from those they are trying to treat.

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