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.
Department of Emergency Medicine, Loma Linda University Medical Center, CA 92354, USA.
S W
SW
Corbett
J T
JT
Grange
T L
TL
Thomas
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*