# EMS is a dangerous job?



## DrParasite (Nov 25, 2011)

From the article on the study:

Finally a formal study confirms what we knew in our heavy hearts: EMS has far too many line-of-duty deaths and work-related injuries. The data examined from 2003–2007 comes from a series of credible national sources: The Bureau of Labor Statistics, Census of Fatal Occupational Injuries, the National Institute for Occupational Safety and Health and the occupational supplement to the National Electronic Injury Surveillance System. 

The researchers discovered a total of 65 EMS fatalities (13 per year). The EMS fatality rate was 7.0 per 100,000 full-time equivalents (FTE) EMS workers with a 95% confidence interval (CI) of 4.7–9.3.  By comparison, the average for all workers is 4.0 and 6.1 for firefighters in the same four-year period. 

It’s also possible that not all line-of-duty EMS deaths [and non-fatal injuries] were reported as such due to lack of centralized tracking, or definition.

read more: http://www.jems.com/article/health-and-safety/studies-show-dangers-working-ems


----------



## canadianparamedic (Nov 25, 2011)

Love it would not trade it for any other job.


----------



## mycrofft (Nov 25, 2011)

*67% due to "highway accidents" and being struck by other vehicles..*

See my earlier thread quoting the Philadelphia statistics.

THIs tidy seems to be a pretty good one and cites the shortcoming you will find when you try to download the data yourself...there is no recognized division between "street EMS" and any other sort of medical worker. In fact, "EMS WORKER" per se does not appear to be a recognized category (as our frequent internecine rassling points out).

You are still more likely to succumb to bad driving on the part of your self or your driver, or other drivers, on slightly over a fifty-fifty basis. (I would hazard the other causes of death as vehicles incident in station, falls, slips, and leftover chicken salad).


----------



## mikeward (Nov 27, 2011)

The original ground-breaking work done by Brian Maguire:

Occupational fatalities in emergency medical services: A hidden crisis 
Maguire BJ, Hunting KL, Smith GS, Levick NR
Annals of Emergency Medicine - December 2002 (Vol. 40, Issue 6, Pages 625-632) 

1)  Motor Vehicle Accidents
2)  Cardiovascular/cerebrovascular
3)  Homicide

Keeping rescuers safe 
Garrison HG
Annals of Emergency Medicine - December 2002 (Vol. 40, Issue 6, Pages 633-635).  

Occupational Injuries among Emergency Medical Services Personnel Brian J. Maguire, Katherine L. Hunting, Tee L. Guidotti, Gordon S. Smith
Prehospital Emergency Care - October/December 2005 (Vol. 9, Issue 4, Pages 405-411).


----------



## BF2BC EMT (Nov 27, 2011)

But the FD and their union go on and on about how they constantly risk their lives while pulling in a 100k+ a year but an EMT is lucky to get 40.


----------



## Handsome Robb (Nov 27, 2011)

I'd say safety depends on your response area as well. 

I don't have time to read the articles right this second, I'll read 'em when I get a chance and come up with a better response.


----------



## usafmedic45 (Nov 27, 2011)

> Finally a formal study



There have been several prior studies on the subject.  The most obvious being the one by Maguire (as previously mentioned) and the one that pointed out that working on HEMS has a mortality rate of about 3 times that of the next most dangerous jobs in the US (mining, commercial fishing, etc).  Just because it finally made JEMS doesn't mean that the occupational safety folks haven't been paying attention.


----------



## mikeward (Nov 27, 2011)

usafmedic45 said:


> Just because it finally made JEMS doesn't mean that the occupational safety folks haven't been paying attention.



In talking to Professor Maguire, he has had no contact by worker compensation or industrial/occupational representatives.

Police and fire are required to pay more into their state worker compensation programs because of their claim (injury, long-term disability and death) experience.

Mike


----------



## usafmedic45 (Nov 27, 2011)

> In talking to Professor Maguire, he has had no contact by worker compensation or industrial/occupational representatives.



There's more to occupational safety than workman's comp, etc.  It's a huge part of injury epidemiology, probably only secondary to the mind-numbingly boring violence prevention part. When I mentioned it, I wasn't even thinking about that aspect of it because it's a secondary concern.


----------



## Handsome Robb (Nov 27, 2011)

Again being quick, I'd love to see a study about back injuries and the compensation required associated with EMS. We use the Stryker Power Pros and are told they have reduced worker's comp claims due to back injuries from lifting. My agency is currently replacing our entire fleet and considered the new Powerload system referencing compensation due to back injuries as their number one motivator to spend the money. Personally I'd say the lift into the back of the unit is the safest one we do. It's controlled (for the most part) and on a pivot point acting as a fulcrum. I wonder how many injuries actually happen during this lift. 

The PowerLoad looks cool but I feel like it's just something more that can go wrong, especially in some of the uneven surfaces we end up parked on here.


----------



## usafmedic45 (Nov 27, 2011)

> I wonder how many injuries actually happen during this lift.



Contact Stryker.  They should be able to provide those numbers based upon the marketing claims they are making.


----------



## systemet (Nov 28, 2011)

NVRob said:


> The PowerLoad looks cool but I feel like it's just something more that can go wrong, especially in some of the uneven surfaces we end up parked on here.



I haven't used this model, but I did use (trial? I think) one of the earlier Ferno power stretchers.

It was a bit of a mixed bag.  Yes, it saved you from the repetitive lift into the ambulance, and even from a lot of other lifts.  But it weighed a ton.  And while, in an ideal world, you'd move the stretcher as close to the residence as possible without having to lift, it just doesn't work that way in reality.  Sometimes you have to lift the things, and then the extra weight is an extra load on the back. 

For what it's worth, I don't recall anyone having issue with the stretcher falling over on an uneven surface.  It seemed like a real concern when we first got them, as you don't feel like you're in control of the lift any more. But even working with a lot of snow and ice, I don't recall anyone having issues.  That being said, I know several people who have done severe and potentially career-ending injuries from trying to grab falling stretchers.  

Obviously this is just my (n=1) experience and a brief appeal to the experience of a few people I talked to.


----------



## DT4EMS (Nov 28, 2011)

Taking the subject back to the OP.

Here is a recent one by Skip Kirkwood :
http://www.jems.com/article/training/ems-providers-need-scene-safety-training

and I can assure you there are way more injuries due to assaults than vehicle accidents:

My collection of EMS/Fire assaults are here:
http://dt4ems.com/forums/index.php?board=16.0

and against nurses here:
http://dt4ems.com/forums/index.php?board=39.0


----------



## systemet (Nov 28, 2011)

DT4EMS said:


> and I can assure you there are way more injuries due to assaults than vehicle accidents:



Do you know if this has been recorded in the literature anywhere?  I know that this is your area of expertise, but given the culture of not reporting assault and outright battery in EMS, I'd be surprised if the number of incidents was higher.


----------



## DT4EMS (Nov 28, 2011)

systemet said:


> Do you know if this has been recorded in the literature anywhere?  I know that this is your area of expertise, but given the culture of not reporting assault and outright battery in EMS, I'd be surprised if the number of incidents was higher.



I can promise you......the numbers are way higher than what is reported. There is a main underlying reason for under-reporting........ "culture".

People that have been around a while like to sound tough and tell newbies "It's just part of the job". There is also a mentality of administrations to "advise against" prosecution/reporting of incidents.

OSHA, Bureua of Labor Statistics,  CDC, Brian J. Maguire, Dr.PH, MSA, EMT-P, NAEMT, ENA, and others have released studies. I quote several of them during presentations.

Skip did a great job of pointing out some particulars in the article I linked previously.


----------



## DT4EMS (Nov 28, 2011)

DT4EMS said:


> I can promise you......the numbers are way higher than what is reported. There is a main underlying reason for under-reporting........ "culture".
> 
> People that have been around a while like to sound tough and tell newbies "It's just part of the job". There is also a mentality of administrations to "advise against" prosecution/reporting of incidents.
> 
> ...



Here are just a few........ (Notice the dates)

•	EMS office received 113 reports of personnel being threatened, verbally assaulted or physically assaulted.
•	23% verbal.
•	15% actual physical.
•	6% victim of threat.
2002 Wyoming Study
Source: WY EMT Registry 4-03

•	14% of  responding agencies reported having incidents of assaults in the 6 months prior to the survey.
1995 BEMS Study
Used with Permission of Greg Natsch

•	More than  one in two (52%) assaulted by a patient- NAEMT Survey 2005


•	A June 2008 study showed that workers in the healthcare sector are 16 times more likely to be confronted with violence on the job than any other service profession. A study by the Emergency Nurses Association in the spring of 2007 found that more than 1/2 of emergency nurses reported experiencing physical violence on the job. 

The risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers per year; the national average is about 1.8 cases per 10,000 workers per year. So the relative risk for EMS workers is about 30 times higher than the national average. The relative risk of fatal assaults for EMS workers is about three times higher than the national average.”
•	Brian J. Maguire, Dr.PH, MSA


----------



## usafmedic45 (Nov 28, 2011)

> and I can assure you there are way more injuries due to assaults than vehicle accidents:



But what's the actual morbidity associated with that?  



> •	EMS office received 113 reports of personnel being threatened, verbally assaulted or physically assaulted.
> •	23% verbal.
> •	15% actual physical.
> •	6% victim of threat.



So they actually received reports of 26 _assaults_, not 113.  If I reported every time I got cussed at or threatened, I'd never get any real work done....and that's just counting the PMs I get on here from outraged/offended/twisted panty wearing newbies.

I'm not saying it's not a problem, I'm just saying that the acuity of these sorts of events is generally pretty low in my experience and I've not seen any substantial evidence to the contrary.  "Lost work days" isn't exactly the same level of evidence as a evidence for serious or fatal injury from a MVC.


----------



## DT4EMS (Nov 28, 2011)

I am not pointing out morbidity. I am saying more are injured due to assault than crashes.
I want the same attention given to assaults as te attention paid to crashes.

I have specifically spoken to provides that have been shot, stabbed, had limbs, ribs, jaw and noses broken..... It changes your perspective.

For crashes there are now driving courses, fancy reflective vests etc....

There is mandatory annual training for blood borne diseases....

There are back tests and proper lifting and moving of patients to prevent back injuries in EMS

Now re-read the studies on injuries and show me the logic in how we train entry level folks for what they face on the job.

No matter how many surveys, studies or recommendations get printed some folks will always scoff. I didn't write the studies. I have lives them and talked with others who have too

Rather than complain, I did something about it. For over a decade people stated there was no need to train in recognition, avoidance and escaping violent encounters for EMS. For the past six years.... Many have changed their mind.

It's not important to you until its important to you. Meaning once you or someone you care about is assaulted you will just think its a waste of time.

Remember a person doesn't have to die to be scarred/changed for life.



Sorry for the brevity. I am responding with my phone.


----------



## usafmedic45 (Nov 28, 2011)

> I am not pointing out morbidity. I am saying more are injured due to assault than crashes.



Morbidity<=>injuries

Saying that more people are injured by X is meaningless if you're not quantifying the degree of injury.  More EMS providers are probably injured by falling down and skinning their knees than anything else, but it's not counted or a valid comparison because of the difference in severity of injury.  Like I said, not trying to be difficult just as someone with a love of injury epidemiology, I'd like to see something more substantial than crude statistics.  I'm going to be a little more of a stickler on this because I also know that you have a job that relies on this sort of information and even thought I like you, I trust no one when it comes to these sorts of discussions.


----------



## DT4EMS (Nov 28, 2011)

usafmedic45 said:


> Morbidity<=>injuries
> 
> Saying that more people are injured by X is meaningless if you're not quantifying the degree of injury.  More EMS providers are probably injured by falling down and skinning their knees than anything else, but it's not counted or a valid comparison because of the difference in severity of injury.  Like I said, not trying to be difficult just as someone with a love of injury epidemiology, I'd like to see something more substantial than crude statistics.  I'm going to be a little more of a stickler on this because I also know that you have a job that relies on this sort of information and even thought I like you, I trust no one when it comes to these sorts of discussions.



I get that, I really do. But I can also assure you, no one has researched this particular subject more than I have. You are correct with the "types" of injuries but the wording "lost work time" means more than just a skinned knee. 


•   According to Brian J. Maguire, Dr.PH, MSA, Clinical Associate Professor, University of Maryland, Baltimore County:

“The risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers per year; the national average is about 1.8 cases per 10,000 workers per year. So the relative risk for EMS workers is about 30 times higher than the national average. The relative risk of fatal assaults for EMS workers is about three times higher than the national average.”

Non-fatal is 30 times higher FATAL is 3 times higher.........
No one, to my knowledge has done a more extensive statistical gathering than Dr. Maguire.

The surveys abound........ but don't get any press......

Here is another one........

2006 survey conducted as part of a research project for the National Fire Academy’s Executive Officer Program  (Source: firefighternation.com) 
–   461 respondents
•   410 (88.9%) had been threatened
•   256 (55.5%) had been assaulted
•   41 (8.8%) had carried a weapon on the job for self defense

•   2009 survey of 518 Arizona firefighters (Source: firefighternation.com)
–   442 (85.3%) had been verbally threatened
–   283 (54.6%) had been physically assaulted
–   217 (42.8%) stated that violence is just part of the job


My point is...... we have failed as educators...... we are way behind the 8ball...... report after report after report...... are finally coming out about the assaults actually happening. 

See........ obtaining numbers for something........when people don't want to report it (because they feel pressured not to) makes any study of the subject difficult to obtain.


With that said........... here are news reports of regular occurrences... 

http://dt4ems.com/forums/index.php?board=16.0

Those have names, and actual incidents.... (well for as well as the media can get it)

If you can give me a better place to go than Dr. Maguire, I would quote them too 

I don't think until their is actual recognition and reporting with a real database (nationally) like an the national database for auto accidents will there truly be a way to obtain true data.

Instead we have to go with the surveys and the reports from the respected ones out there. 

EDIT* I wish I was well versed on obtaining statistics. I also wish I would have taped conversations (interviews) I had with victims over the years. I never thought a hobby would have become a passion. Plus if I would have realized there was such a reluctance for the profession to recognize the danger I would have approached things different over the years.

At least now, finally........ I have earned the respect of some pretty influential people in EMS who have now started referring people my way. Not because I am the smartest.......but I am passionate about the subject and about improving the breed of EMS....... leaving it better than the way I found it.

Thoughts?


----------



## mycrofft (Nov 28, 2011)

*Consider all the statistical quirks.*

Such as, how many single incidents involving MVA generate multiple morbidities and mortalities?
And still and again, 67% MVA either in the vehicle or stricken by one. There may be numbers two and three (actually, there ARE numbers two and three) but they have to divvy up only the remaining 43%.
I bet they don't list the morbidity/mortality of volunteers responding to their firehouse or directly to the scene pin their POV's.
Or those of associated professions (firefighters, law enforcement) at EMS scenes...still, mostly MVA and heart attacks.


----------



## DT4EMS (Nov 28, 2011)

mycrofft said:


> Such as, how many single incidents involving MVA generate multiple morbidities and mortalities?
> And still and again, 67% MVA either in the vehicle or stricken by one. There may be numbers two and three (actually, there ARE numbers two and three) but they have to divvy up only the remaining 43%.
> I bet they don't list the morbidity/mortality of volunteers responding to their firehouse or directly to the scene pin their POV's.
> Or those of associated professions (firefighters, law enforcement) at EMS scenes...still, mostly MVA and heart attacks.



For fatality....yes........MVA much higher than assault. BUT..... one out of every 20 calls does not result in an MVA....... according estimate Skip just put out...... approximately one in every 20 EMS call has the  potential for assault.

The UK has a national campaign to bring awareness to the subject. They experience at least one assault per day. They bring it to light. They call the US the Wild West.......and I am supposed to believe we have LESS than them? Seriously???

Again........I am all for safety............ one of the reasons I agreed to be the subject matter expert for the NAEMT's Safety Course. Just so happens I am only claiming to be an expert in my area.

Now..... with that said....again........ there are MULTIPLE driving classes....... and even mandates now to wear the fancy yellow vests......... 

How much time did you spend on actual scene safety training in your EMT school? How much further do you as a trainer take it past "BSI... Scene Safe" for your students?

We are the department of redundancy department when it comes to BSI.... but actually catching a disease from a patient is way down the list of injury or DEATH on the job of EMS.

Again........ I am made aware of assaults almost daily on EMS/Fire and healthcare....... I am NOT familiar with almost daily crash rate in EMS or Fire. 

Just in my service alone........ I know of two bad wrecks recently (past six months)....... but I am familiar with quite a few assaults that have occurred. 

We can agree to disagree. 

I am still at a loss here........ if Dr. Maguire says that the risk of assault if 30 times that of other private sector jobs...... and fatal assault is three times that of other private sector jobs....... do we have 30 times the crashes of other private sector jobs?


----------



## mycrofft (Nov 28, 2011)

*Ok.*

But don't let the United Mine Workers, the AFFF, or the guys hauling timber or king crabs hear you say stuff like that in one of their bars.

The only EMT I knew killed by violence was working as a reserve deputy and shot as he entered a dwelling for a domestic disturbance. Period.


----------



## DT4EMS (Nov 28, 2011)

mycrofft said:


> But don't let the United Mine Workers, the AFFF, or the guys hauling timber or king crabs hear you say stuff like that in one of their bars.
> 
> The only EMT I knew killed by violence was working as a reserve deputy and shot as he entered a dwelling for a domestic disturbance. Period.



Then please look HERE at the ones I know of:
http://dt4ems.com/forums/index.php?board=16.0

SO you are not aware of the ones listed above? And you are telling me I am confused?


----------



## DT4EMS (Nov 28, 2011)

DT4EMS said:


> Then please look HERE at the ones I know of:
> http://dt4ems.com/forums/index.php?board=16.0
> 
> SO you are not aware of the ones listed above? And you are telling me I am confused?



There are 27 pages of assault related news on EMS/Fire there...... and even more on the in-hospital side.


----------



## mycrofft (Nov 28, 2011)

*I was only speaking of my personal experience.*

A simple reply. Press on.


----------



## DT4EMS (Nov 28, 2011)

mycrofft said:


> A simple reply. Press on.



Ah....gotcha  it's all good my man. I am just truly passionate because it happens so frequently...but the powers that be don't give it the same merit.


----------



## JeffDHMC (Nov 28, 2011)

Well, the 90 minutes I took to contribute to this was lost when my whatever crashed so I'm across the street at the laundromat and as such this will be quick.

Am I correct in assuming (please thrash me if I am wrong) that there are those that would rather take the stance that all is well in EMS services across the country and that we do not suffer violent attacks because The Discovery Channel can better market how dangerous it is to catch crabs? Really, who cares what is worse than what? Honestly, I am in EMS and I care what myself and others that do this have to deal with. If every other profession or whatever got their teeth knocked out 36 times more frequently than me and mine should I not care that we still (having NO training to do so) deal with this stuff? I recon I should I care. The devil gang with ya if you don't.

Really, if you do not deal with violence directed towards yourself while on the job please afford those of us that have (and do) the respect to demand that someone care and do something about it. 

Jeff


----------



## Tigger (Nov 28, 2011)

usafmedic45 said:


> Morbidity<=>injuries
> 
> Saying that more people are injured by X is meaningless if you're not quantifying the degree of injury.  More EMS providers are probably injured by falling down and skinning their knees than anything else, but it's not counted or a valid comparison because of the difference in severity of injury.  Like I said, not trying to be difficult just as someone with a love of injury epidemiology, I'd like to see something more substantial than crude statistics.  I'm going to be a little more of a stickler on this because I also know that you have a job that relies on this sort of information and even thought I like you, I trust no one when it comes to these sorts of discussions.



I doubt anything more than "crude statistics" exist. As noted there are some local studies, but nothing that can be realistically extrapolated across a wide area to in fact prove that there is a problem.

More importantly though, the absence of statistics does not denote the absence of a problem. At this point the numbers just don't exist to prove anyone's point, which can only show that there is a lack of data (duh) and a lack of data gathering mechanisms on this specific claim. But that doesn't make the problem meaningless, we have to start somewhere, no?


----------



## systemet (Nov 29, 2011)

DT4EMS said:


> I
> See........ obtaining numbers for something........when people don't want to report it (because they feel pressured not to) makes any study of the subject difficult to obtain.



I absolutely agree that this is an important issue, and that it needs to be addressed.  Collecting anecdotes of assaults in EMS is one way to draw attention to the problem, and I commend you for doing it.

However, if this data hasn't been published in a peer-reviewed journal, then it's less likely to be taken seriously.  As they say, "the plural of anecdote is not data".  That's not to knock you personally in any way.  I appreciate your role as an advocate.  But it's hard to make claims about the relative risk of vehicle trauma versus personal assault, if the data hasn't been collected and reported in a rigorous manner.

As others have pointed out, whether vehicle trauma or assault are the leading causes of morbidity or mortality amongst EMS workers is a less important question than whether either is present at a significantly elevated risk.  Accepting that vehicle trauma may be more prevalent doesn't preclude us from addressing assaults.

As a paramedic, it's hard sometimes to see the data that the nurses produce about their risk of violence in a hospital setting, and then think that the severity of assaults or the frequency wouldn't be higher in EMS.  But until we collect and report the data, it's going to be hard to know.

If you have any citations, i.e. indexed on Pubmed or similar, it would be great if you could link to them, if you have time.

All the best.


----------



## DT4EMS (Nov 30, 2011)

So, let me get this correct.......... Dr. Maguire's study out of UMBC is not considered credible?

It is cited all over........


----------



## usafmedic45 (Nov 30, 2011)

> It is cited all over........



So were the studies on eugenics, the "Piltdown Man", the "surgeon's photo" of the Loch Ness Monster and numerous other things that were later proved to be be outright false.  I'm not saying that's the case here but you need to remember that just because an idea is popular doesn't mean the data is inherently valid or able to be extrapolated from.  I mean for crying out loud, most people in the US believe in some form of an invisible man in the sky who watches over and protects us.  A similarly unbelievably large portion of the population believes that we're being visited by aliens that travel extremely long distance to cut up cows and abduct and butt rape the bottom 0.001% of your average Southern small town's population.  Like I said, just because it gets repeated a lot does not make it true. 



> So, let me get this correct.......... Dr. Maguire's study out of UMBC is not considered credible?



There's a difference between 'credible', 'scientifically valid' and 'we can apply this broadly across the nation'.  There's a fair amount of credible evidence that Sasquatch _may_ exist.  Most mainstream scientists don't believe it reaches the threshold of scientific validity to prove the existence of the species and don't believe that it's sufficient to allow extrapolation.  It doesn't mean the data is necessarily not credible, it just means that the data is insufficient to mean much beyond what it can be directly shown to imply.


----------



## DT4EMS (Nov 30, 2011)

usafmedic45 said:


> So were the studies on eugenics, the "Piltdown Man", the "surgeon's photo" of the Loch Ness Monster and numerous other things that were later proved to be be outright false.  I'm not saying that's the case here but you need to remember that just because an idea is popular doesn't mean the data is inherently valid or able to be extrapolated from.  I mean for crying out loud, most people in the US believe in some form of an invisible man in the sky who watches over and protects us.  A similarly unbelievably large portion of the population believes that we're being visited by aliens that travel extremely long distance to cut up cows and abduct and butt rape the bottom 0.001% of your average Southern small town's population.  Like I said, just because it gets repeated a lot does not make it true.
> 
> 
> 
> There's a difference between 'credible', 'scientifically valid' and 'we can apply this broadly across the nation'.  There's a fair amount of credible evidence that Sasquatch _may_ exist.  Most mainstream scientists don't believe it reaches the threshold of scientific validity to prove the existence of the species and don't believe that it's sufficient to allow extrapolation.  It doesn't mean the data is necessarily not credible, it just means that the data is insufficient to mean much beyond what it can be directly shown to imply.



So, I find you post uber-funny! But then I ask...... so if news reports, studies and surveys are done and there is still no major player with a central database for assaults on EMS.....what do you suggest be done?

Also......... let me ask this.......... (because this is the approach I teach)........

How many surgical cric's have you done in your career? How many people do you uwork with have actually done one?
 I ask that very question in state conferences and courses all across the country to make this point......... 

Since it is such a rare occurrence in your area.......then you should not practice or prepare for it. The idea being....... you may never be assaulted in YOUR position........ but "if" it happens..the hope is you practice for it. 

See.........there is much more than just physical skills involved  in training for escaping a violent encounter in EMS......... 


For instance.......... where do you stand when you knock on a door? Why would it matter?

Have you ever been called "officer" on a medical scene? What are some things we can do to separate ourselves from being perceived as police officers?

Are there "tactics" you already employ for patient care that can be used to "buy a second" to escape should the need arise?

Is there a difference between an uncooperative patient and an "attacker"?

Is there a law that actually covers patient restraint? When am I allowed to apply restraints? Who should actually be applying restraints? What is the NAEMSP's position on it?

If you are ever assaulted........ is there a way to document the event that would help in prosecution? (this helps bring awareness to the problem)

Why have so many states started making LAWS for assaulting EMS if it is not a problem?


But since it never happens.....

http://www.nbcmiami.com/news/local/...ami-Firefighters-With-Knife-120170299.html?dr

http://www.youtube.com/watch?v=y3YMt8GADkw&feature=player_embedded

http://www.youtube.com/watch?v=5e4e7FI9_PM&feature=player_embedded

http://paramedictv.ems1.com/Media/1857-Man-punches-paramedic-in-face/


----------



## DT4EMS (Nov 30, 2011)

DT4EMS said:


> So, I find you post uber-funny! But then I ask...... so if news reports, studies and surveys are done and there is still no major player with a central database for assaults on EMS.....what do you suggest be done?
> 
> Also......... let me ask this.......... (because this is the approach I teach)........
> 
> ...




and one of the better ones.............. that never happened...............
http://paramedictv.ems1.com/Media/671-Man-attacks-paramedic/


----------



## usafmedic45 (Nov 30, 2011)

> so if news reports, studies and surveys are done and there is still no major player with a central database for assaults on EMS.....what do you suggest be done?



The main problem is underreporting and the lack of a cohesive national tracking system combined with the wide variance between jurisdictions.  As an example: what's a threat here on the west side of Indianapolis, did not exist where I worked at in rural Illinois.  We had practically no minorities, save for the few migrant farm workers in the area (who were all hard working, generous and decent people) and the few blacks we dealt with were professionals working at a local industrial plant.  Not exactly your average knife and gun club like you encounter here on the west side due to the black and Hispanic gangs that proliferate the area.  We were seldom without county or city LEOs on the scene even for medical calls (one of the three people I most often had as a partner was a deputy sheriff at his other job).  The percentage of drug and alcohol related calls were much lower.  So trying to compare one to the other to justify training isn't exactly going to work based on current evidence. 



> Why have so many states started making LAWS for assaulting EMS if it is not a problem?



The same reason why they started putting those "move over" laws into place.  Because of a few high profile cases.  Why do you think so many of them have someone's name attached to them?  To quote Stalin, "One death is a tragedy.  A million deaths is a statistic." 



> How many surgical cric's have you done in your career? How many people do you uwork with have actually done one?
> I ask that very question in state conferences and courses all across the country to make this point.........




I think six. I don't keep track of anyone else I currently work with.  



> Since it is such a rare occurrence in your area.......then you should not practice or prepare for it. The idea being....... you may never be assaulted in YOUR position........ but "if" it happens..the hope is you practice for it.



You do realize that you're basically fear-mongering right? 



> For instance.......... where do you stand when you knock on a door? Why would it matter?



Off to the side in case someone decides to fire through the door.  The problem being that a lot of drug houses have realized cops do this and have installed breakaway panels on the sides of the door to allow fire to pass through.  



> Have you ever been called "officer" on a medical scene? What are some things we can do to separate ourselves from being perceived as police officers?



Stop dressing like cops.  I've never had the problem but then again I've never worked anywhere where we were forced to dress like LEOs. 



> Is there a difference between an uncooperative patient and an "attacker"?



Yeah, one's getting restrained with sux and a sedative and the other with handcuffs and possibly a Tazer.


----------



## usafmedic45 (Nov 30, 2011)

> But since it never happens.....



Will you stop arguing that we're saying it "never happens"?  It's make you sound like you're either paranoid or just out to make money off your classes.  No one is saying that it doesn't happen.  We're saying that there's insufficient evidence to say how _often_ it happens.


----------



## DT4EMS (Nov 30, 2011)

usafmedic45 said:


> The main problem is underreporting and the lack of a cohesive national tracking system combined with the wide variance between jurisdictions.  As an example: what's a threat here on the west side of Indianapolis, did not exist where I worked at in rural Illinois.  We had practically no minorities, save for the few migrant farm workers in the area (who were all hard working, generous and decent people) and the few blacks we dealt with were professionals working at a local industrial plant.  Not exactly your average knife and gun club like you encounter here on the west side due to the black and Hispanic gangs that proliferate the area.  We were seldom without county or city LEOs on the scene even for medical calls (one of the three people I most often had as a partner was a deputy sheriff at his other job).  The percentage of drug and alcohol related calls were much lower.  So trying to compare one to the other to justify training isn't exactly going to work based on current evidence.
> 
> 
> 
> ...




"Fear-Mongering" Bwahahahaha! Good one. 

Two good points.......... on the side of the door is correct........... but the side with the door knob is what is preferred. Reason............. you can see inside before they can see you.

And uniform is 100% correct. I have been ad advocate for folks wearing non-LEO  appearing uniforms for years.


Like I said before.......... you are 100% welcome to come free of charge to see what I do. I  will save you a seat in Daytona Beach in March. Then call me a fear-monger...........or tell folks that my message is foolish.......

You are super-smart........... way better at typing/writing than I. But like hundreds of others.........once you actually see what I am sharing........ you will be able to make an informed decision.

See you there?


----------



## usafmedic45 (Nov 30, 2011)

> Like I said before.......... you are 100% welcome to come free of charge to see what I do. I will save you a seat in Daytona Beach in March. Then call me a fear-monger...........or tell folks that my message is foolish......



I don't believe it's foolish.  I think it should be part of the basic training we get as EMS providers.  I just don't agree with the way you're promoting it on here.  It's kind of like how a lot of people criticize me for the way I say things even though they agree with the message behind it.  "You could word that a little better"....

I may take you up on the offer but I don't think Daytona Beach will work unless my better half (KatGrl2003) OKs it.


----------



## FourLoko (Nov 30, 2011)

I look forward to the opportunity for potential assault. Going to take quite a change though. As it stands, most of our patients can't even get out of bed.


----------



## DT4EMS (Nov 30, 2011)

usafmedic45 said:


> I don't believe it's foolish.  I think it should be part of the basic training we get as EMS providers.  I just don't agree with the way you're promoting it on here.  It's kind of like how a lot of people criticize me for the way I say things even though they agree with the message behind it.  "You could word that a little better"....
> 
> I may take you up on the offer but I don't think Daytona Beach will work unless my better half (KatGrl2003) OKs it.



Then I will be your student........... how better to approach it? I have tried every way with the exception of lying and claiming "How to fear no man on earth" or some kill a man in two moves approach.

We open our classes with the it may never happen approach.......but if we don't train people what is appropriate (reasonable) they respond like a caveman they end up unemployed and possibly prosecuted themselves (Medic in Denver sentenced to 12 years in prison last year).

See  my mission is to prevent assaults......be it to a provider or the patient. 

Now........... this is why I do what I do.......... ( and it has never been about the money )

If you ever wondered "Why" DT4EMS exists.......... well here is why.

For years I would work with EMS partners who knew  was a martial artist and a police officer. I would be asked about techniques. They would ask "Hey, how would you get out of this hold or stop this type of attack. I would show them an escape technique  or a skill to evade a specific attack.

Then after a while it dawned on me; I need to show more than just the technique, how to not be there in the first place. Hence the first DT4EMS class was formed. I really created it simply as a hobby.

My hobby became a passion one morning working on a rural ambulance.

It was a cool fall morning. The sun had not come up yet. My partner and I were dispatched to a report of a patient who had a “pacemaker malfunction”.

We arrived on scene, treated the patient and began our transport to a hospital that was about 40 miles away in Jefferson City. The patient was in her late 70’s and her daughter, who was in her 40’s, accompanied us (she rode in the front passenger seat).

 En route, dispatch advised us of a “body in a ditch” and asked if we could check on it.
In a very rural setting, that type of request was not all that uncommon at the time. My patient was stable and I advised my partner he could stop and check on the “body” and relay the information back to dispatch.

I recall sitting on the bench seat and looking up and through the windshield as I felt the ambulance slow down. I could see a man wearing a white t-shirt and blue jeans, prone on the grass near the road.

My partner made a U-turn and pulled onto what little shoulder there was. We were now facing south on the northbound shoulder. I began to apologize to my patient and her daughter for the delay and explained we would be moving again shortly. 

Suddenly the back door of the ambulance opened. Immediately I could smell a strong odor of an intoxicating beverage fill the back of the ambulance. Rather than allowing the “subject” to get into the back of the ambulance. I told my partner to have the guy sit on the bumper and to “call him a ride”. I said it in a tone to signal my partner to call the police.

The back door shut and what seemed like only seconds passed when I heard the door chime. I then watched in disbelief as a black arm put the ambulance in drive. My partner was not African-American. As the ambulance began to pull forward, I lunged through the crawl space between the patient compartment and the cab of the ambulance.
I was in an outstretched position on my knees. I grabbed the gearshift with my right hand and shoved it into park. It made the most God-awful grinding noise. 

Then the guy punched me in the left side of my face. I remember thinking “man….he hit like a girl”. Wanting to stop the threat…. while in a kneeling position I attempted to chop his neck with my hand. The strike proved worthless because I was kneeling and he was sitting up in a drivers’ seat. He simply raised his shoulder to block the blow. So……. I did the next best thing…… with his hand over the top of mine on the gearshift, me trying t keep it in park, him trying to pull it down as he floored the accelerator, I placed my left hand in his face. I began to yell at the daughter who was seated in the passenger seat to take the keys from the ignition.

It was obvious her fear had frozen her. She was praying out loud. Suddenly the passenger side door opened. It was my partner. I yelled to him to take the keys from the ignition. He started to climb over the daughter ….then went to the other side.

Once he opened the driver’s door, he turned off the ignition. I was still pushing the guys face as a distraction when I yelled to my partner “jerk this mother-f***er out-a here!”. My partner grabbed the guy by his feet and pulled. I watched as the guy bounced off the floor then off of the running board.

I went out the door after him. I remember being so angry. I was a full-time police officer working part time on the ambulance…… I never, ever wanted to injure anyone. But this guy……. Wow…… the feeling of anger was so much I stepped forward toward him and just before I did something stupid…… “Force Options/Continuum” went flashing through my head. I knew if I struck him…… I would be the aggressor.

When the officer arrived and took custody I told him the story. I later found out the guy was charged with DWI and simple assault. I was enraged because I could only imagine what would have happened if that would have occurred while I was in a PD uniform. 

Not only would have officers and the courts treated him differently………but it would have made the national news. It was then I decided to take this “hobby” of DT4EMS and make it a passion.


----------



## DV_EMT (Dec 2, 2011)

side note... a EMT got held at gunpoint a few weeks ago in LA with our new company..... just sayin


----------



## Sasha (Dec 2, 2011)

DT4EMS said:


> "Fear-Mongering" Bwahahahaha! Good one.
> 
> Two good points.......... on the side of the door is correct........... but the side with the door knob is what is preferred. Reason............. you can see inside before they can see you.
> 
> ...



Daytona Beach in March, hmm?

My opinion is EMS is a dangerous job. Dangerous to my back and overall health. We are routinely exposed to nasty little germies that you while you might run into off the job, you wouldnt go getting all up in like you would at work.

Also in danger of dying in a crash because people drive like retards.

I work IFT, I've been whacked, bitten, spit on by hiv pts, swung on and growled at. 

One of our medics had to call for pd due to a vet psych having some PTSD episode and trying to kill him with the lifepak. 

Not to call it dangerous is silly, but don't go to work fearing that everyday is your last. 

Life in general will kill you.

Sent from LuLu using Tapatalk


----------



## DrParasite (Dec 2, 2011)

this is kinda relevant (well, the reasoning for, not what should be done as a result): http://www.emsworld.com/article/10442064/call-to-arms?page=1


----------



## firetender (Dec 2, 2011)

*What is really dangerous?*

Look around you, check out your peers. What percentage of them will be working with you three years from now? How about  five?

Most will be gone, but not because they were exposed to the dangers you all have cited. They'll be out the door psychologically, psychically, emotionally, spiritually, yes, even morally burned out.

In that respect perhaps the danger itself isn't quite as damaging as the constant exposure to the *potential* for danger. It ain't the muscles, it's the nerves! The ripples in the pond from that affect everything else; including the ability to respond adequately to real danger.


----------

