Self-Reported Provider Safety in an Urban Emergency Medical System

Abstract

IntroductionEmergency Medical Service (EMS) personnel often respond to dangerous scenes and encounter hostile individuals without police support. No recent data describes the frequency of physical or verbal assaults or which providers have increased fear for their safety. This information may help to guide interventions to improve safety. Our objective was to describe self-reported abuse and perceptions of safety and to determine if there are differences between gender, shift, and years of experience in a busy two-tiered, third service urban EMS system.MethodsThis was a secondary analysis of an anonymous, cross-sectional work safety survey of EMS providers. This survey included demographics, years of experience, history of verbal and physical assault, safety behavior following an assault and perceptions of safety. Descriptive statistics were generated.ResultsEighty-nine percent (196/221) of EMS providers completed the survey. Most were male (72%) and between the ages of 25 and 50 years (66%). The majority of providers had worked in this service for more than five years (54%), and many for more than ten years (37%). Verbal assaults were reported by 88% (172/196, 95% CI [82.4%–91.6%]). Although 80% (156/196, 95% CI [73.4%–84.6%]) reported physical assaults, only 40% (62/156, 95% CI [32.4%–47.6%]) sought medical care and 49% (76/156, 95% CI [41%–56.6%]) reported the assault to police. The proportion of those who sought medical care and reported the assault to the police was not the same across years of experience (p<0.0001). Fear for personal safety was reported by 68% (134/196, 95% CI [61.6%–74.5%]). There was no statistical difference in assault by gender; however, females feared more for their safety compared to men (38/50, 76% v 96/142, 68%, p=0.02). The proportion of those who have ever been physically assaulted was not the same across shift worked (p=0.01).ConclusionThe majority of EMS providers surveyed reported an assault and certain groups had a higher rate of assault. Most assaults were not reported to the police and medical care was infrequently sought following an event. The majority of providers reported feeling fear for their personal safety. Further research into enhancing safety mechanisms is needed.

A qualitative study of workplace violence among healthcare providers in emergency departments in India

“…Over 90% of ED healthcare providers interviewed described personal experience with workplace violence. This is consistent with prior studies conducted in more developed countries, which have found a prevalence of violence against ED healthcare providers between 80% and 100% [5,[12][13][14].…”

“…While most of the reported violence is verbal abuse, almost one in five providers reported experience with physical abuse. This is also consistent with prior studies conducted in higher resource settings, which demonstrate similar incidents of both verbal and physical abuse [5,13,14]. The commonalities between the patterns of workplace violence in India as compared with higher resource settings can likely be attributed to factors that make the ED especially prone to violence in general.…”

Violence against emergency medical services personnel: A systematic review of the literature

“…The studies documented the high risk of exposure to violence. Boyle and Brough found high rates of verbal abuse, while Deniz, Furin and Suserud documented that about 80% of personnel had been subjected to some form of violence . Petzäll found that about two‐thirds of EMS personnel experienced threats or violence while Rahmani found that it was 75% of respondents that had experienced workplace violence .…”

Qualitative Research of Violent Incidents Toward Young Paramedics in the Czech Republic

“…Several related studies 17,18,19 highlight the serious personal, organizational and professional consequences, as well as inadequate job safety, as some of the costs of violence. 20,21 Other related studies have mentioned minor and serious physical injury (eye and face injuries, bites, kicks, dislocations and fractures, bruises, and scratches) and psychological consequences such as stress irritability and headache, anxiety, depersonalization, depression, sleep disorders, irritability, fear of safety, and disturbing memories. Psychological injuries cause social consequences, including impact on social interactions, isolation, and personality changes in the workplace.…”