Drexel Receives $1.5 Million FEMA Grant to Study Stress and Violent Injuries in Fire Departments’ EMS Workers

An EMT crouching in the dark with a patient outside an ambulance

A new project by a Drexel University-led team studying what leads to stress and injuries in attacked fire-based EMS workers has received a $1.5 million grant from FEMA and the Department of Homeland Security. 

The project, called Stress and Violence in fire-based EMS Responders, or SAVER, is the first-ever R&D grant from FEMA to focus on EMS responders in fire departments, even though they account for up to 90 percent of the work done in some places.

“The fire service has changed a lot over it’s 200 year history. What started as out as fire suppression response has evolved into providing emergency medical treatment for communities,” said Jennifer Taylor, PhD, director of the FIRST Center and associate professor in the Drexel’s Dornsife School of Public Health. “Like many jobs where the nature of the work changes historically, organizations may not be resourced appropriately, nor their culture changed sufficiently to adapt to the new demands of changing work.”

FIRST (Firefighter Injury Research and Safety Trends) will be the lead research entity on the project funded by the Assistance to Firefighters Grant Program. The goal is to develop a standardized checklist for violence against EMS workers in fire departments that is efficient and easily reproducible, something that does not exist at a system-wide level, currently.

The system would need to record organizational outcomes — such as burnout and job satisfaction — mental health outcomes — like depression and PTSD prevalence — and injuries suffered by EMS workers.

“The public has no idea that fire-based first responders are receiving physical and verbal violence from the communities who call them for service,” Taylor said. “While we’ve all been asleep, the fire service has had to deal with this the best they can, but the coping mechanisms that they employee may not be the healthiest choices. We need to get good data to help the fire service understand this issue.”

Such work is important because an earlier study led by Taylor found that EMS workers are 14 times more likely to be violently injured on the job than their firefighter colleagues. It’s something that many paramedics have expressed that they feel is “part of the job.”

“We want firefighters and EMS responders to serve whatever the community needs, but we have to resource them appropriately and give them opportunities for rest and recovery,” Taylor said. “That’s what’s missing on this issue: Because people don’t know of the violence first responders are experiencing, they aren’t aware that there are stress-reducing needs that responders have.”

For SAVER, FIRST will collaborate with Joseph Allen, PhD, of the University of Nebraska at Omaha and Jin Lee, PhD, of Kansas State University, who they’ve worked with before. It will also collaborate with the Center for Leadership, Innovation and Research in EMS (CLIR) in St. Cloud, Minnesota.

Over three years, the checklist for violence will be developed using recent studies and industry literature as a guide. The checklist will also cover all stages of calls EMS workers respond to — from traveling to calls to their return to service afterward. 

After developing the checklist, the team will put it to use in fire departments in Chicago, Miami-Dade, Philadelphia, and San Diego. Interviews and focus groups of the EMS workers will be among the ways the checklist will be evaluated.

“I’m very excited to get this study going. What motivates me on a daily basis are memories of the EMS responders have participated in our studies,” Taylor said. “There’re a lot of paramedics, EMTs, and firefighters around the country who have spent an incredible amount of time educating me about violence on the job. I bring those people to work with me every day and want the SAVER project is to honor their stories and service.”