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Addressing Violence, Training, and Burnout For Paramedics abd EMTs

Updated: Nov 1, 2023

Research Sheds Light on the Challenges Faced by First Responders: Addressing Violence, Training, and Burnout

A study conducted by the Dornsife School of Public Health at Drexel University has revealed that emergency medical technicians (EMTs) and paramedics face a significantly higher risk of sustaining job-related violent injuries compared to the firefighters they collaborate with.

Research Sheds Light on the Challenges Faced by First Responders: Addressing Violence, Training, and Burnout
Research Sheds Light on the Challenges Faced by First Responders: Addressing Violence, Training, and Burnout

By analyzing data sourced from the Firefighter Injury Research and Safety Trends (FIRST) project, which is funded by the Federal Emergency Management Agency, and by conducting interviews with a group of paramedics who had experienced injuries caused by patient aggression, the researchers at Drexel found that injuries resulting from assaults often go unreported and are inadequately acknowledged by administrative authorities.

Consequently, these incidents tend to be internalized by the EMTs and paramedics, who come to accept them as an unfortunate but inevitable aspect of their profession.

Paramedics are 14 times as likely to be assaulted, the research team found that male paramedics are more than 12 times as likely to be assaulted than their male firefighter colleagues (women paramedics were 9.3 times as likely to be assaulted when compared to their firefighter counterparts). -Drexel University study

"First responders constitute a unique and dedicated group of professionals who enter their line of work with a clear intent to assist and protect. However, they often find themselves facing situations for which their training may not have fully prepared them," noted Dr. Jennifer Taylor, Associate Professor in the Dornsife School of Public Health and the lead investigator behind the study titled "Expecting the Unexpected: A Mixed Methods Study of Violence to EMS Responders in an Urban Fire Department."

Initially, the research sought to explore violent injuries as a potential gender issue, as data indicated that female members of fire departments were over six times more likely to be victims of violence. However, the focus quickly shifted to the responder's occupation within a fire department as the key determinant.

"As an epidemiologist, I started describing the risk factors that public health researchers usually use: age, race, sex, etc. But we had some members of the responder community tell us to look at the paramedics because women are more likely to be paramedics than firefighters.

This is why stakeholder engagement is so important in all phases of scientific research. By having a group of advisers who could look at preliminary data, they prevented me from making an incomplete conclusion."

In the department under examination, the ratio of women paramedics to women firefighters was considerably higher, and it was discovered that paramedics were 14 times more likely to experience assaults.

Male paramedics were over 12 times as likely to face assault compared to their male firefighter counterparts. This revelation made the gender gap in violence statistically insignificant.

Dr. Taylor conducted one-on-one interviews and focus groups with responders to uncover the factors leading to these injuries. Among the issues raised by paramedics was their challenging relationship with dispatchers, who often fail to provide sufficient information about the situation they are entering.

"We're dispatched in way too many incidents that we have no idea what we're walking into," expressed one EMT.

Responders also mentioned that dispatchers were frequently slow to send backup when a situation was deemed unsafe. Additionally, they felt ill-prepared to handle combative patients or to protect themselves in such scenarios.

Another stressor was the high volume of calls responders had to attend to in a short time. The department in question received over 700 ambulance calls per day, including non-emergencies such as requests from disabled individuals to reach the TV remote.

"Participants reflected on how this puts them in danger every time they need to respond because they drive with the same lights, sirens, and speed they would for a true medical emergency," noted the study.

The combined impact of these challenges, including the workload and the risk of violence, creates a less than ideal work environment. It contributes to high levels of burnout and a decline in motivation to stay in the profession.

"You go back the next day and [you're] expected to be the same person. You're not," shared one paramedic in the study. "Every time someone does something to you, you're different than you were the day before."

Dr. Taylor and her team are actively exploring potential solutions to reduce stress and the risk of injury for responders.

One proposed solution is to allow dispatchers to flag locations where past patient-related assaults have occurred, enabling responders to prepare for potentially dangerous situations. Another suggestion is to adopt signage used in Canadian ambulances that indicates it is a felony to assault a first responder. Such signs would not only alert potentially combative patients but also boost morale by demonstrating support from leadership.

Paramedics - EMTs Violence Prevention And Response Training

Training plays a pivotal role in equipping paramedics and EMTs with the knowledge and skills necessary to identify potential violence and prevent harm in their line of work. By undergoing specialized training programs, responders can learn to recognize early warning signs and assess the risk of violence in various situations.

They gain insights into effective communication and de-escalation techniques, enabling them to defuse tense encounters and manage aggressive behavior more effectively. Moreover, training empowers them to make informed decisions on requesting law enforcement support when a situation warrants it.

Ultimately, well-prepared paramedics and EMTs are better positioned to prioritize their safety and the safety of their patients, ensuring that their noble mission of providing care remains a cornerstone of their profession.

"Medics and firefighters are trusted in the community. And in the community, there's this stress," Taylor explained. "So let's give the responders the community paramedicine training — and financial support — they need to serve this growing need."

Improving working conditions for paramedics and EMT workers plays a crucial role in promoting public health.

"No one has looked at what the implication is for patient and public safety if we beat our medics into the ground," Taylor emphasized. "For cities that are large and have a huge issue of poverty, we're exhausting our workers. We don't have standards for how many medics we should have per 100,000 people. I'm very worried about exhaustion, burnout, and possible emotional detachment by the responders."

Violence Prevention and Self Defense Resources

CVPSD non-denominational, and apolitical organization originally founded in response to the reemergence of violent anti-Semitism and religious bullying affecting communities across the world. CVPSD quickly evolved to become a community-wide partner, helping all Americans who are being intimidated and bullied.

The goal of the Center for Violence Prevention and Self Defense is to stop violence by educating at-risk people and empower them with the skills needed to protect themselves both online and live training. CVPSD's live training is available to people of all ages in New Jersey including children, adults and the elderly.

Live conceptual seminars teach the origins of violence and how to assess risk and set boundaries for healthy relationships. Experiential classes teach hands-on interpersonal skills and strategies to prevent and stop assault.

The Center for Violence Prevention and Self Defense reaches individuals and communities through partnerships with schools and other nonprofits, community groups, as well as classes for the public. By reducing the fear and impact of violence, we help to create a community where people live powerfully, experience freedom.


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