title: Self-reported provider safety in an urban emergency medical system.
abstract: BACKGROUND
  Emergency 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.
  
  
  METHODS
  This 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.
  
  
  RESULTS
  Eighty-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).
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts ; Albert Einstein Medical Center, Philadelphia, Pennsylvania.
authors.forename: Molly
authors.initials: M
authors.lastname: Furin
authors.affiliation: Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Eliseo
authors.affiliation: Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
authors.forename: Breanne
authors.initials: B
authors.lastname: Langlois
authors.affiliation: Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
authors.forename: William G
authors.initials: WG
authors.lastname: Fernandez
authors.affiliation: Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
authors.forename: Patricia
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
authors.forename: K Sophia
authors.initials: KS
authors.lastname: Dyer
mesh_terms: D000328:Adult; D017677:Age Distribution; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004634:Emergency Medical Technicians / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D009511:New England / Q000453:epidemiology; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D017751:Safety Management; D012637:Security Measures / Q000458:organization & administration*; D057566:Self Report; D017678:Sex Distribution; D014505:Urban Population; D014754:Violence / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*