Exposure of prehospital care providers to violence.
OBJECTIVE
To evaluate the experience of prehospital care providers with violence.


METHODS
A survey addressing experiences with prehospital violence was administered to a convenience sample of emergency medical services (EMS) providers in a southern California metropolitan area. Descriptive statistics are reported.


RESULTS
Of 774 EMS providers surveyed, 522 (67%) returned the questionnaire. Members of law enforcement were excluded because their experience with violence, weapons, and tactics is not typical of most paramedics. This left a sample of 490 for further analysis. These prehospital care providers had a median of ten years' experience on the job. They tended to be male (93%) and white (80%). All together, 61% recounted assault on the job, with 25% reporting injury from the assault. Respondents reported a median of three episodes, and the number of assaults for each individual was unrelated to the number of years of experience on the job (r = 0.068). Of those injured, 37% required medical attention. On the other hand, 35% reported that their company had a specific protocol for managing violent situations and 28% stated ever having received formal training in the management of violent encounters. This limited training notwithstanding, nearly all (95%) providers described restraining patients. Use of protective gear was reported (73%), and some (19%) admitted to ever carrying a weapon on the job.


CONCLUSIONS
By their own report, EMS providers encounter a substantial amount of violence and injury due to assault on the job. Formal training and protocols to provide a standardized safe approach for such encounters are lacking. Although the limitations of survey data are recognized, further research characterizing the level of violence and potential interventions seems warranted.
Corbett
S W
SW
Department of Emergency Medicine, Loma Linda University Medical Center, CA 92354, USA.
Grange
J T
JT
Thomas
T L
TL
D000328:Adult; D002140:California / Q000453:epidemiology; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data*; D005260:Female; D005389:Firearms; D006801:Humans; D008297:Male; D016272:Occupational Health / Q000706:statistics & numerical data*; D011481:Protective Clothing; D012637:Security Measures; D011795:Surveys and Questionnaires; D014504:Urban Health; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data*