Expecting the unexpected: A mixed methods study of violence to EMS responders in an urban fire department

Abstract

BackgroundStruck by injuries experienced by females were observed to be higher compared to males in an urban fire department. The disparity was investigated while gaining a grounded understanding of EMS responder experiences from patient‐initiated violence.MethodsA convergent parallel mixed methods design was employed. Using a linked injury dataset, patient‐initiated violence estimates were calculated comparing genders. Semi‐structured interviews and a focus group were conducted with injured EMS responders.ResultsParamedics had significantly higher odds for patient‐initiated violence injuries than firefighters (OR 14.4, 95%CI: 9.2–22.2, P < 0.001). Females reported increased odds of patient‐initiated violence injuries compared to males (OR = 6.25, 95%CI 3.8–10.2), but this relationship was entirely mediated through occupation (AOR = 1.64, 95%CI 0.94–2.85). Qualitative data illuminated the impact of patient‐initiated violence and highlighted important organizational opportunities for intervention.ConclusionsMixed methods greatly enhanced the assessment of EMS responder patient‐initiated violence prevention. Am. J. Ind. Med. 59:150–163, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

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

“…However, about 6% of the cases of violence against EMS personnel were perpetrated by friends or family members of the patient . In other studies, about 4% of physical assaults were perpetrated by a “colleague” and bystanders were perpetrators for some cases …”

“…This review demonstrated that there is a paucity of published data on critical questions such as how risks of violence for EMS personnel may vary based upon demographic factors. Three studies published between 2006 and 2016 found that female EMS personnel had higher risks of violence than males . Maguire found that female EMS personnel have a higher overall rate of injuries than male EMS personnel and that female EMS personnel might have a higher risk of homicide than males .…”

“…When designing future studies researchers should consider ways to: define as well as quantify violence, intentionality, threats of violence, verbal abuse, and bullying (bullying should be included based on the WHO's finding that verbal abuse and bullying results in emotional injury leading to trauma to the worker and a negative effect on the performance and efficiency of the organization); examine differences among personnel such as sex, age, EMTs versus paramedics, and firefighter versus non‐firefighter because differences found between different demographic types and job titles may contribute to an improved understanding of risk factors; examine and recommend uniform case definitions as well as standardized and reliable reporting policies, procedures and practices; determine the economic cost of violence against EMS personnel and the cost/benefit of risk reduction strategies; capture near‐miss cases because near‐miss incident data can be useful in incident prevention; consider utilizing a mixed‐methods approach when investigating the problem; develop a consensus on incident reporting collection including methods to identify the perpetrators (eg, patient, patient family member, person known to victim, coworker) and outcomes to the staff (eg, amount of lost work time, need for medical care, long‐term disability, career termination); design and evaluate interventions to reduce the risk of violent incidents because reducing the risk of assaults has the potential to save lives, prevent injuries, reduce agency costs, reduce personnel turnover, improve morale, and may ultimately improve the delivery and quality of ambulance services; implement ongoing monitoring to determine if the intervention solved the problem and to ensure widespread adoption; and determine if the intervention created unintended consequences such as an increase in heat emergencies among EMS personnel after deploying bullet‐proof vests.…”

Sexual harassment and its relationship with depressive symptoms: A nationwide study of Korean EMS providers

“…Emergency medical service (EMS) providers are subject to workplace violence, including sexual harassment and abuse . Sexual harassment is defined as “unwanted sex‐related behavior at work that is perceived by the recipient as offensive, exceeding the individual's coping resources or threatens their well‐being.” In a study of 260 paramedics, 38% of women and 10% of men experienced sexual harassment in the preceding 12 months .…”

Bruised apples: violence against women in the education sector

“…In first responder industries men have described not reporting violence for fear of not looking ‘macho’,9 while women have discussed adherence to reporting as a way to protect their tenure and employee health benefits 10. This has been hypothesised to drive increased reporting of violence by women versus men in first responder industries.…”