Stress and Violence in fire-based EMS Responders (SAVER)
There are an estimated 900,000 full-time, part-time, and volunteer Emergency Medical Services (EMS) workers who treat 22 million patients a year (Maguire & Smith, 2013). These emergency health care workers have a variety of responsibilities that include responding to emergency calls and transporting patients to hospitals and health care facilities (CDC, Emergency Medical Services Workers, 2013). Despite working in a profession characterized by helping people, an estimated 2,100 EMS workers visited U.S. hospital emergency departments in 2011 to treat an injury resulting from patient violence (CDC, NIOSH Workplace Safety, 2013).
Using data from the National Fire Fighter Near Miss Reporting System (NFFNMRS), a secure and non-punitive reporting system created by the International Association of Fire Chiefs, our research team confirmed the violence problem among this population. We reviewed emergency medical call reports and analyzed their narrative text fields. Of 185 reports, violence (n=48) was the most commonly identified mechanism of near-miss or injury. We found that emergency medical responders were threatened or assaulted by patients, as well as family members and bystanders. Common underlying factors included: violent patients, patients with mental health issues, and patients with particular health conditions (e.g. seizure, hypoglycemia). Read the Paper
From a local perspective, this problem of violence affects the Philadelphia Fire Department (PFD)--an urban, inner city department serving 1.5 million people. Data from the Firefighter Injury Research and Safety Trends (FIRST) project served as a catalyst to investigate this particular issue more deeply. We gathered injury data from the Philadelphia Fire Department Safety Office for the period 2005-2011 and analyzed it by cause of injury stratified by males and females. Most causes of injury were of equivalent proportion between males and females. However, the “struck by” category showed a disproportionate percentage of females (22%) who reported this cause of injury compared to their male counterparts (9%). To investigate the “struck by” injuries more deeply, the narratives from the first reports of injury were reviewed. These narratives often referred to violence by a patient as the injury cause. However, most females in the PFD are paramedics, so we stratified by occupation and the gender difference disappeared. But paramedics (compared to firefighters) were 14 times more likely to experience a struck by injuries from a patient. Read the Paper
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We are currently seeking funding to address the complexities of violence against EMS responders by developing a survey to obtain the baseline frequency and variability of assault, along with other contributing circumstances to these events (e.g. legal system, community expectations, work environment, etc). Once a baseline is established, the path will be laid for the development of targeted interventions to reduce violence to EMS workers.
From our Fire Service Safety Climate study, see what firefighters are saying about the changing nature of their work. Read the Paper
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