Paramedics' risk of being assaulted far exceeds risk to firefighting colleagues

Taylor did one-on-one interviews and composed a focus group with a selection of responders to discuss issues that led to the injuries. One of the major issues the paramedics brought up was a tenuous relationship with dispatchers who do not give enough information on a scene.

We’re dispatched in way too many incidents that we have no idea what we’re walking into,” one EMT said.

Responders said dispatchers are oftentimes sluggish in dispatching backup once a situation is deemed a safety issue.

Additionally, the responders in the study said they did not receive training for handling combative patients or protecting themselves.

Mixed into that is the stress of going on so many calls in so short a period of time. The department studied fielded more than 700 calls per day that required an ambulance response. Some calls do not even qualify as emergencies, such as requests from a disabled person to reach the TV remote.

Participants reflected on how this puts them in danger every time they need to respond because they drive with the same lights, sirens and speed they would for a true medical emergency,” according to the study.

According to Taylor and her research team, the workload and risk of violence may contribute to a poor work environment where medics experience high burnout levels and motivation to leave the profession.

You go back the next day and [you’re] expected to be the same person. You’re not,” one paramedic in the study said. “Every time someone does something to you, you’re different than you were the day before.”

Taylor and her team are exploring solutions to reduce stress and the chance of injury for responders.

One possibility was giving dispatchers the option to flag locations where past patient-related assaults occurred so that responders can prepare for the situation. Another was to adopt signage used in Canadian ambulances that indicate that it is a felony to assault a first responder. In addition to alerting potentially combative patients, those signs could improve morale by letting responders know they have support from leadership.

What might be the best solution, according to Taylor, is training ambulance crews in community paramedicine. By practicing community paramedicine, crews would evolve into roving medical units that are not just specifically for emergency situations, but ones that also work with individuals who rely on mobile medical units for all of their care.

Medics and firefighters are trusted in the community. And in the community there’s this stress,” Taylor said. “So let’s give the responders the community paramedicine training — and financial support — they need to serve this growing need.”

Improving the work conditions for paramedics and EMT workers would play an important role in public health.

No one has looked at what the implication is for patient and public safety if we beat our medics into the ground,” Taylor said. “For cities that are large and have a huge issue of poverty, we’re exhausting our workers. We don’t have standards for how many medics we should have per 100,000 people. I’m very worried about exhaustion, burnout, and possible emotional detachment by the responders.”