FACTS ONLY: violence and death by violence in EMS

mycrofft

mycrofft

Still crazy but elsewhere
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WHAT IS THE SELF-DEFENSE NEED FOR EMS?​

Let's cut to the chase. If EMS is such a dangerous occupation, it will be reflected in labor and law enforcement statistics and the statements of health care, law enforcement and safety officials.

Everyone cites stories of "bravery under fire on the job", but when it comes to level-headed threat analysis, we are required to go to the documented facts.

No anecdotes.

This thread is to collect official statements (by administrators, legislators, bureaucrats) as directly quoted in the press or via correspondence; official statistics; and other direct verifyable data as may be gatherable regarding the danger of assault, battery, and subsequent injury, disability and/or death caused by a client/patient, a bystander, or a coworker/other official responder. PLEASE skip the quote that characterizes and concentrate upon the ones which contain quantifable data, preferably not just totals, get the ones including per capita and mean or average figures versus the population they represent. And try to "dis-include" sources with an agenda to promote such as gun abolishment groups, the NRA, American Nazi Party, Greenpeace, etc. An roganization's policy statements would be educational too.

Please include primarily field EMS workers, but to make sure we see the whole field, let's include the entire field of health workers (please try to focus on hospitals and EMS) and firefighters, since EMS workers in contact with field originating patients work there too.


(I have come to realize and respect that folks like to talk about weapons and they have a right to do so, but in this one place, let's dis-entangle fact from faith and get to the bone on this, like rational professionals).
 
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I dont the nremt will get you much, since they handle testing. I bet any figures you have are under reported. How much has osha and like organizations gotten involved in safety regulations when.you are in the back(the real dangerous aspects, ie the need for forward facing seats, seatbelt use, ect)
 
http://emj.bmj.com/content/24/11/760.full

Link goes to full text article. Below is the abstract.

Abstract

Background: International studies have shown that some 60% of paramedics have experienced physical violence in the workplace, and between 21–78% have experienced verbal abuse. To date, there is no Australian literature describing Australian paramedics’ experience of workplace violence.

Objective: To identify the percentage of paramedics who had experienced six different forms of workplace violence.

Methods: A questionnaire was developed to explore paramedics’ experience of workplace violence. Six forms of violence were included: verbal abuse, property damage or theft, intimidation, physical abuse, sexual harassment, and sexual assault. The questionnaire also included a series of demographic questions. The questionnaire was piloted using a reference group and changes made accordingly. The questionnaire was distributed to 500 rural Victorian paramedics and 430 metropolitan South Australian paramedics. Ethics approval was granted for this study.

Results: The overall response rate was 28%, with 75% being male and 25% female. The median age of respondents was 40.7 years, range 21–62 years. The median number of years experience as a paramedic was 14.3 years, range 6 months to 39 years. There were 87.5% of paramedics exposed to workplace violence. Verbal abuse was the most prevalent form of workplace violence (82%), with intimidation (55%), physical abuse (38%), sexual harassment (17%), and sexual assault (4%).

Conclusion: This study lays the foundation for further studies investigating paramedic experience of workplace violence. This study demonstrates that workplace violence is prevalent for paramedics and highlights the need for prevention and education within the profession.
Click to expand...

Biggest problem with this study; it's done by survey. We need good operational definitions to start collecting proper information on this topic.

For example, I'm sure our Workplace Safety and Insurance Board (WSIB) has records of the number of Paramedics who have claimed benefits as the result of violence, BUT, this will only covers violence resulting in a a claim.


Anything below this and we start getting too geographically specific. It doesn't advance the profession to collect information for an individual service and respond to that.

How many instances of violence result in neither a workplace insurance claim, lost time or a police report? Of course how do we track these incidents then? The above linked study was only able to get a 28% response rate.
 
Further studies via Pubmed. I haven't had the chance to actually read these and can't speak to their quality but have presented them to advance the discussion.

Abstracts only, but when I get to work tomorrow I'll see how many of these journals I have access to and can maybe pull some more info from.

"Exposure of French Emergency Medical Personnel to Violence" Duchateau et al.
http://www.ncbi.nlm.nih.gov/pubmed/12534120

"Violence Against Emergency Medical Services Personnel" Grange and Corbett. Preshospital Emergency Care. April-June 2002.
http://www.ncbi.nlm.nih.gov/pubmed/11962565
(I have full txt on this one through my subscription)

"Hurting Those Who Save: Violence Against EMS" Spivak. Emergency Medical Services. May 1998.
http://www.ncbi.nlm.nih.gov/pubmed/10179414
(No Abstract or full txt but maybe someone has access to this journal. I've never heard of it though.)

It is worth noting that the majority of articles that came up under violence referred to Nurses and staff in long term care facilities. Given their prolonged exposure, patient population I would not be surprised in the least to see that their rates of violence against providers far surpassed our own.
 
OK, coming in.

OSHA figfures...I'm not getting much there because I've been focusing on homicides, which are unambiguous statistics. Intreresting is the comparison of homcides of health workers by friends/associates versus patients.

I sent an email to BLS asking for specifics, or at least the categories EMS workers are summed into.
 
Lucid, good point about MVA versus homicide.

By my myopic count, 16 in Calif. The same state lost 11 peace officers to homicide last year.
 
Wolfman, that's why I'm focusing on homicides.

Incidentally, my googling turned up a few press articles about New Zealand and Australia. No homicides cited, but they are citing a growing trend towards ambulance personnel being slapped or otherwise manhandled.

Whenever I read or hear about "the skyrocketing problem of ____", I usually find there is an equal or faster increase in the type of folks who will fall prey to that sort of thing, so the per capita rate is same or lower.
 
Bandagebrigade I think you're right.

Sometimes whomever reads you email will have a lead, though.
 
A paramedic that I met came into the office when a guy on PCP threw her to the floor on the ambulance. Her partner wrapped her arm up & took her to the office. She was in alot of pain & couldn't fill out the sign in packet, so I helped her out with that & her vitals. The doctor examined her & gave her a script to get an x-ray at the hospital. When she brought the results back, thankfully it wasn't broken, but she did have to come back for a few follow up appts. Just made me think how you always have to be on guard, especially in the city.
 
I think any official statistics are going to be skewed because of the number of assaults that don't get reported,or get reported and don't go anywhere because the charges are dropped or whatever.
 
Progress report

Bureau of Labor Statistics (BLS) sent a reply including multiple URL's. I will send back for a clarification of what job classes EMS workers fall into. Sending query to IAFF.
 
The study's a little outdated, but . . .

Hope this helps, I remember reading about it in JEMS a while back. Google: "Occupational Fatalities in Emergency Medical Services: A Hidden Crisis". It was a study by an EMT-P published by the American College of Emergency Physicians reviewing some of the statistics your looking for, but he was only able to search 1992 - 1997 (the study was published in 2002, I believe). Anyway, it shows that throughout that period a total of 10 EMS workers were killed by homicide alone.
 
Since we're including all health care workers, I'll tell you we send PD out to take assault reports for staff members several times a week at our local detox facility.
 
IAems, got a URL for me?

Sounds interesting! The end of that time frame coincides pretty closely with the beginning of the BLS figues on their website.
 
Lucid, sure. I didn't think about that.

I imagine detox, psych and Alzheimers wards/faclites generate batteries daily.

I've had my innings with detox and OBS/dementia patients too.
 
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Clarification on terminology

ASSAULT: A purposeful attempt to create an unwanted contact with another. Swinging a baseball bat at someone is an assault.

BATTERY: the baseball bat makes contact; an unwanted touching.

HOMICIDE: in this case, loss of life due to a battery intended to harm the EMS worker.

For the purposes of this execise, I want to limit this to intentional "serious" batteries which cause injury with the reasonable potential to hospitalize or kill the victim (EMS worker). Since the big question is supplying EMS workers with lethal force, we are talking life and limb and purposeful assault.

An interesting extension would be all uses for defense iclduing one's partner or patient, but not today. Feel free to start yout own thread!
 
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