Protecting EMS Responders from Violence

Violence is the second most frequent cause of nonfatal injuries to emergency medical services (EMS) providers according to 2020 data from National Institute for Occupational Safety and Health (NIOSH) data tracking. Most of these injuries are caused by the patients EMS providers are treating.

Recommendations for personal safety vary from department to department and include:

• Understanding that emergency scenes are dynamic and that violence to emergency responders is always a possibility.
• Monitoring surroundings/situational awareness.
• Creating distance and shielding while treating patients.
• Wearing personal protective equipment (PPE) that can guard against a knife or a bullet.
• Learning basic self-defense techniques.

An EMS department in Austin, Texas is implementing a training program that focuses on changing how violent patients are approached, including how to detect a possibly violent patient early in the incident.

Although important, situational awareness, self-defense skills, and PPE may not be the entire solution. The SAVER Systems Checklist shifts the responsibility of safety and health from that of the individual first responder to the organization. The checklist contains items organized by 6 phases of EMS response:

1. Pre-event.
2. Traveling to the scene.
3. Scene arrival.
4. Patient care.
5. Assessing readiness to return to service.
6. Post-event.

These items are the focus of safety actions that leadership can institute through training, policy and environmental modifications.

Drexel University's Center for Firefighter Injury Research and Safety Trends (FIRST), Stress and Violence in Fire-Based EMS Responders (SAVER) program, developed the checklist using the findings of the 2017 U.S. Fire Administration study, Mitigation of Occupational Violence to Firefighters and EMS Responders PDF.