EMS is a dangerous job?

Consider all the statistical quirks.

Such as, how many single incidents involving MVA generate multiple morbidities and mortalities?
And still and again, 67% MVA either in the vehicle or stricken by one. There may be numbers two and three (actually, there ARE numbers two and three) but they have to divvy up only the remaining 43%.
I bet they don't list the morbidity/mortality of volunteers responding to their firehouse or directly to the scene pin their POV's.
Or those of associated professions (firefighters, law enforcement) at EMS scenes...still, mostly MVA and heart attacks.
 
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Such as, how many single incidents involving MVA generate multiple morbidities and mortalities?
And still and again, 67% MVA either in the vehicle or stricken by one. There may be numbers two and three (actually, there ARE numbers two and three) but they have to divvy up only the remaining 43%.
I bet they don't list the morbidity/mortality of volunteers responding to their firehouse or directly to the scene pin their POV's.
Or those of associated professions (firefighters, law enforcement) at EMS scenes...still, mostly MVA and heart attacks.

For fatality....yes........MVA much higher than assault. BUT..... one out of every 20 calls does not result in an MVA....... according estimate Skip just put out...... approximately one in every 20 EMS call has the potential for assault.

The UK has a national campaign to bring awareness to the subject. They experience at least one assault per day. They bring it to light. They call the US the Wild West.......and I am supposed to believe we have LESS than them? Seriously???

Again........I am all for safety............ one of the reasons I agreed to be the subject matter expert for the NAEMT's Safety Course. Just so happens I am only claiming to be an expert in my area.

Now..... with that said....again........ there are MULTIPLE driving classes....... and even mandates now to wear the fancy yellow vests.........

How much time did you spend on actual scene safety training in your EMT school? How much further do you as a trainer take it past "BSI... Scene Safe" for your students?

We are the department of redundancy department when it comes to BSI.... but actually catching a disease from a patient is way down the list of injury or DEATH on the job of EMS.

Again........ I am made aware of assaults almost daily on EMS/Fire and healthcare....... I am NOT familiar with almost daily crash rate in EMS or Fire.

Just in my service alone........ I know of two bad wrecks recently (past six months)....... but I am familiar with quite a few assaults that have occurred.

We can agree to disagree.

I am still at a loss here........ if Dr. Maguire says that the risk of assault if 30 times that of other private sector jobs...... and fatal assault is three times that of other private sector jobs....... do we have 30 times the crashes of other private sector jobs?
 
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Ok.

But don't let the United Mine Workers, the AFFF, or the guys hauling timber or king crabs hear you say stuff like that in one of their bars.

The only EMT I knew killed by violence was working as a reserve deputy and shot as he entered a dwelling for a domestic disturbance. Period.
 
But don't let the United Mine Workers, the AFFF, or the guys hauling timber or king crabs hear you say stuff like that in one of their bars.

The only EMT I knew killed by violence was working as a reserve deputy and shot as he entered a dwelling for a domestic disturbance. Period.

Then please look HERE at the ones I know of:
http://dt4ems.com/forums/index.php?board=16.0

SO you are not aware of the ones listed above? And you are telling me I am confused?
 
I was only speaking of my personal experience.

A simple reply. Press on.
 
Well, the 90 minutes I took to contribute to this was lost when my whatever crashed so I'm across the street at the laundromat and as such this will be quick.

Am I correct in assuming (please thrash me if I am wrong) that there are those that would rather take the stance that all is well in EMS services across the country and that we do not suffer violent attacks because The Discovery Channel can better market how dangerous it is to catch crabs? Really, who cares what is worse than what? Honestly, I am in EMS and I care what myself and others that do this have to deal with. If every other profession or whatever got their teeth knocked out 36 times more frequently than me and mine should I not care that we still (having NO training to do so) deal with this stuff? I recon I should I care. The devil gang with ya if you don't.

Really, if you do not deal with violence directed towards yourself while on the job please afford those of us that have (and do) the respect to demand that someone care and do something about it.

Jeff
 
Morbidity<=>injuries

Saying that more people are injured by X is meaningless if you're not quantifying the degree of injury. More EMS providers are probably injured by falling down and skinning their knees than anything else, but it's not counted or a valid comparison because of the difference in severity of injury. Like I said, not trying to be difficult just as someone with a love of injury epidemiology, I'd like to see something more substantial than crude statistics. I'm going to be a little more of a stickler on this because I also know that you have a job that relies on this sort of information and even thought I like you, I trust no one when it comes to these sorts of discussions.

I doubt anything more than "crude statistics" exist. As noted there are some local studies, but nothing that can be realistically extrapolated across a wide area to in fact prove that there is a problem.

More importantly though, the absence of statistics does not denote the absence of a problem. At this point the numbers just don't exist to prove anyone's point, which can only show that there is a lack of data (duh) and a lack of data gathering mechanisms on this specific claim. But that doesn't make the problem meaningless, we have to start somewhere, no?
 
I
See........ obtaining numbers for something........when people don't want to report it (because they feel pressured not to) makes any study of the subject difficult to obtain.

I absolutely agree that this is an important issue, and that it needs to be addressed. Collecting anecdotes of assaults in EMS is one way to draw attention to the problem, and I commend you for doing it.

However, if this data hasn't been published in a peer-reviewed journal, then it's less likely to be taken seriously. As they say, "the plural of anecdote is not data". That's not to knock you personally in any way. I appreciate your role as an advocate. But it's hard to make claims about the relative risk of vehicle trauma versus personal assault, if the data hasn't been collected and reported in a rigorous manner.

As others have pointed out, whether vehicle trauma or assault are the leading causes of morbidity or mortality amongst EMS workers is a less important question than whether either is present at a significantly elevated risk. Accepting that vehicle trauma may be more prevalent doesn't preclude us from addressing assaults.

As a paramedic, it's hard sometimes to see the data that the nurses produce about their risk of violence in a hospital setting, and then think that the severity of assaults or the frequency wouldn't be higher in EMS. But until we collect and report the data, it's going to be hard to know.

If you have any citations, i.e. indexed on Pubmed or similar, it would be great if you could link to them, if you have time.

All the best.
 
So, let me get this correct.......... Dr. Maguire's study out of UMBC is not considered credible?

It is cited all over........
 
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It is cited all over........

So were the studies on eugenics, the "Piltdown Man", the "surgeon's photo" of the Loch Ness Monster and numerous other things that were later proved to be be outright false. I'm not saying that's the case here but you need to remember that just because an idea is popular doesn't mean the data is inherently valid or able to be extrapolated from. I mean for crying out loud, most people in the US believe in some form of an invisible man in the sky who watches over and protects us. A similarly unbelievably large portion of the population believes that we're being visited by aliens that travel extremely long distance to cut up cows and abduct and butt rape the bottom 0.001% of your average Southern small town's population. Like I said, just because it gets repeated a lot does not make it true.

So, let me get this correct.......... Dr. Maguire's study out of UMBC is not considered credible?

There's a difference between 'credible', 'scientifically valid' and 'we can apply this broadly across the nation'. There's a fair amount of credible evidence that Sasquatch may exist. Most mainstream scientists don't believe it reaches the threshold of scientific validity to prove the existence of the species and don't believe that it's sufficient to allow extrapolation. It doesn't mean the data is necessarily not credible, it just means that the data is insufficient to mean much beyond what it can be directly shown to imply.
 
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536381800448e62c69376f.gif




So were the studies on eugenics, the "Piltdown Man", the "surgeon's photo" of the Loch Ness Monster and numerous other things that were later proved to be be outright false. I'm not saying that's the case here but you need to remember that just because an idea is popular doesn't mean the data is inherently valid or able to be extrapolated from. I mean for crying out loud, most people in the US believe in some form of an invisible man in the sky who watches over and protects us. A similarly unbelievably large portion of the population believes that we're being visited by aliens that travel extremely long distance to cut up cows and abduct and butt rape the bottom 0.001% of your average Southern small town's population. Like I said, just because it gets repeated a lot does not make it true.



There's a difference between 'credible', 'scientifically valid' and 'we can apply this broadly across the nation'. There's a fair amount of credible evidence that Sasquatch may exist. Most mainstream scientists don't believe it reaches the threshold of scientific validity to prove the existence of the species and don't believe that it's sufficient to allow extrapolation. It doesn't mean the data is necessarily not credible, it just means that the data is insufficient to mean much beyond what it can be directly shown to imply.

So, I find you post uber-funny! But then I ask...... so if news reports, studies and surveys are done and there is still no major player with a central database for assaults on EMS.....what do you suggest be done?

Also......... let me ask this.......... (because this is the approach I teach)........

How many surgical cric's have you done in your career? How many people do you uwork with have actually done one?
I ask that very question in state conferences and courses all across the country to make this point.........

Since it is such a rare occurrence in your area.......then you should not practice or prepare for it. The idea being....... you may never be assaulted in YOUR position........ but "if" it happens..the hope is you practice for it.

See.........there is much more than just physical skills involved in training for escaping a violent encounter in EMS.........


For instance.......... where do you stand when you knock on a door? Why would it matter?

Have you ever been called "officer" on a medical scene? What are some things we can do to separate ourselves from being perceived as police officers?

Are there "tactics" you already employ for patient care that can be used to "buy a second" to escape should the need arise?

Is there a difference between an uncooperative patient and an "attacker"?

Is there a law that actually covers patient restraint? When am I allowed to apply restraints? Who should actually be applying restraints? What is the NAEMSP's position on it?

If you are ever assaulted........ is there a way to document the event that would help in prosecution? (this helps bring awareness to the problem)

Why have so many states started making LAWS for assaulting EMS if it is not a problem?


But since it never happens.....

http://www.nbcmiami.com/news/local/...ami-Firefighters-With-Knife-120170299.html?dr

http://www.youtube.com/watch?v=y3YMt8GADkw&feature=player_embedded

http://www.youtube.com/watch?v=5e4e7FI9_PM&feature=player_embedded

http://paramedictv.ems1.com/Media/1857-Man-punches-paramedic-in-face/
 
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So, I find you post uber-funny! But then I ask...... so if news reports, studies and surveys are done and there is still no major player with a central database for assaults on EMS.....what do you suggest be done?

Also......... let me ask this.......... (because this is the approach I teach)........

How many surgical cric's have you done in your career? How many people do you uwork with have actually done one?
I ask that very question in state conferences and courses all across the country to make this point.........

Since it is such a rare occurrence in your area.......then you should not practice or prepare for it. The idea being....... you may never be assaulted in YOUR position........ but "if" it happens..the hope is you practice for it.

See.........there is much more than just physical skills involved in training for escaping a violent encounter in EMS.........


For instance.......... where do you stand when you knock on a door? Why would it matter?

Have you ever been called "officer" on a medical scene? What are some things we can do to separate ourselves from being perceived as police officers?

Are there "tactics" you already employ for patient care that can be used to "buy a second" to escape should the need arise?

Is there a difference between an uncooperative patient and an "attacker"?

Is there a law that actually covers patient restraint? When am I allowed to apply restraints? Who should actually be applying restraints? What is the NAEMSP's position on it?

If you are ever assaulted........ is there a way to document the event that would help in prosecution? (this helps bring awareness to the problem)

Why have so many states started making LAWS for assaulting EMS if it is not a problem?


But since it never happens.....

http://www.nbcmiami.com/news/local/...ami-Firefighters-With-Knife-120170299.html?dr

http://www.youtube.com/watch?v=y3YMt8GADkw&feature=player_embedded

http://www.youtube.com/watch?v=5e4e7FI9_PM&feature=player_embedded

http://paramedictv.ems1.com/Media/1857-Man-punches-paramedic-in-face/


and one of the better ones.............. that never happened...............
http://paramedictv.ems1.com/Media/671-Man-attacks-paramedic/
 
so if news reports, studies and surveys are done and there is still no major player with a central database for assaults on EMS.....what do you suggest be done?

The main problem is underreporting and the lack of a cohesive national tracking system combined with the wide variance between jurisdictions. As an example: what's a threat here on the west side of Indianapolis, did not exist where I worked at in rural Illinois. We had practically no minorities, save for the few migrant farm workers in the area (who were all hard working, generous and decent people) and the few blacks we dealt with were professionals working at a local industrial plant. Not exactly your average knife and gun club like you encounter here on the west side due to the black and Hispanic gangs that proliferate the area. We were seldom without county or city LEOs on the scene even for medical calls (one of the three people I most often had as a partner was a deputy sheriff at his other job). The percentage of drug and alcohol related calls were much lower. So trying to compare one to the other to justify training isn't exactly going to work based on current evidence.

Why have so many states started making LAWS for assaulting EMS if it is not a problem?

The same reason why they started putting those "move over" laws into place. Because of a few high profile cases. Why do you think so many of them have someone's name attached to them? To quote Stalin, "One death is a tragedy. A million deaths is a statistic."

How many surgical cric's have you done in your career? How many people do you uwork with have actually done one?
I ask that very question in state conferences and courses all across the country to make this point.........


I think six. I don't keep track of anyone else I currently work with.

Since it is such a rare occurrence in your area.......then you should not practice or prepare for it. The idea being....... you may never be assaulted in YOUR position........ but "if" it happens..the hope is you practice for it.

You do realize that you're basically fear-mongering right?

For instance.......... where do you stand when you knock on a door? Why would it matter?

Off to the side in case someone decides to fire through the door. The problem being that a lot of drug houses have realized cops do this and have installed breakaway panels on the sides of the door to allow fire to pass through. ;)

Have you ever been called "officer" on a medical scene? What are some things we can do to separate ourselves from being perceived as police officers?

Stop dressing like cops. I've never had the problem but then again I've never worked anywhere where we were forced to dress like LEOs.

Is there a difference between an uncooperative patient and an "attacker"?

Yeah, one's getting restrained with sux and a sedative and the other with handcuffs and possibly a Tazer.
 
But since it never happens.....

Will you stop arguing that we're saying it "never happens"? It's make you sound like you're either paranoid or just out to make money off your classes. No one is saying that it doesn't happen. We're saying that there's insufficient evidence to say how often it happens.
 
The main problem is underreporting and the lack of a cohesive national tracking system combined with the wide variance between jurisdictions. As an example: what's a threat here on the west side of Indianapolis, did not exist where I worked at in rural Illinois. We had practically no minorities, save for the few migrant farm workers in the area (who were all hard working, generous and decent people) and the few blacks we dealt with were professionals working at a local industrial plant. Not exactly your average knife and gun club like you encounter here on the west side due to the black and Hispanic gangs that proliferate the area. We were seldom without county or city LEOs on the scene even for medical calls (one of the three people I most often had as a partner was a deputy sheriff at his other job). The percentage of drug and alcohol related calls were much lower. So trying to compare one to the other to justify training isn't exactly going to work based on current evidence.



The same reason why they started putting those "move over" laws into place. Because of a few high profile cases. Why do you think so many of them have someone's name attached to them? To quote Stalin, "One death is a tragedy. A million deaths is a statistic."




I think six. I don't keep track of anyone else I currently work with.



You do realize that you're basically fear-mongering right?



Off to the side in case someone decides to fire through the door. The problem being that a lot of drug houses have realized cops do this and have installed breakaway panels on the sides of the door to allow fire to pass through. ;)



Stop dressing like cops. I've never had the problem but then again I've never worked anywhere where we were forced to dress like LEOs.



Yeah, one's getting restrained with sux and a sedative and the other with handcuffs and possibly a Tazer.


"Fear-Mongering" Bwahahahaha! Good one.

Two good points.......... on the side of the door is correct........... but the side with the door knob is what is preferred. Reason............. you can see inside before they can see you.

And uniform is 100% correct. I have been ad advocate for folks wearing non-LEO appearing uniforms for years.


Like I said before.......... you are 100% welcome to come free of charge to see what I do. I will save you a seat in Daytona Beach in March. Then call me a fear-monger...........or tell folks that my message is foolish.......

You are super-smart........... way better at typing/writing than I. But like hundreds of others.........once you actually see what I am sharing........ you will be able to make an informed decision.

See you there?
 
Like I said before.......... you are 100% welcome to come free of charge to see what I do. I will save you a seat in Daytona Beach in March. Then call me a fear-monger...........or tell folks that my message is foolish......

I don't believe it's foolish. I think it should be part of the basic training we get as EMS providers. I just don't agree with the way you're promoting it on here. It's kind of like how a lot of people criticize me for the way I say things even though they agree with the message behind it. "You could word that a little better"....

I may take you up on the offer but I don't think Daytona Beach will work unless my better half (KatGrl2003) OKs it.
 
I look forward to the opportunity for potential assault. Going to take quite a change though. As it stands, most of our patients can't even get out of bed.
 
I don't believe it's foolish. I think it should be part of the basic training we get as EMS providers. I just don't agree with the way you're promoting it on here. It's kind of like how a lot of people criticize me for the way I say things even though they agree with the message behind it. "You could word that a little better"....

I may take you up on the offer but I don't think Daytona Beach will work unless my better half (KatGrl2003) OKs it.

Then I will be your student........... how better to approach it? I have tried every way with the exception of lying and claiming "How to fear no man on earth" or some kill a man in two moves approach.

We open our classes with the it may never happen approach.......but if we don't train people what is appropriate (reasonable) they respond like a caveman they end up unemployed and possibly prosecuted themselves (Medic in Denver sentenced to 12 years in prison last year).

See my mission is to prevent assaults......be it to a provider or the patient.

Now........... this is why I do what I do.......... ( and it has never been about the money )

If you ever wondered "Why" DT4EMS exists.......... well here is why.

For years I would work with EMS partners who knew was a martial artist and a police officer. I would be asked about techniques. They would ask "Hey, how would you get out of this hold or stop this type of attack. I would show them an escape technique or a skill to evade a specific attack.

Then after a while it dawned on me; I need to show more than just the technique, how to not be there in the first place. Hence the first DT4EMS class was formed. I really created it simply as a hobby.

My hobby became a passion one morning working on a rural ambulance.

It was a cool fall morning. The sun had not come up yet. My partner and I were dispatched to a report of a patient who had a “pacemaker malfunction”.

We arrived on scene, treated the patient and began our transport to a hospital that was about 40 miles away in Jefferson City. The patient was in her late 70’s and her daughter, who was in her 40’s, accompanied us (she rode in the front passenger seat).

En route, dispatch advised us of a “body in a ditch” and asked if we could check on it.
In a very rural setting, that type of request was not all that uncommon at the time. My patient was stable and I advised my partner he could stop and check on the “body” and relay the information back to dispatch.

I recall sitting on the bench seat and looking up and through the windshield as I felt the ambulance slow down. I could see a man wearing a white t-shirt and blue jeans, prone on the grass near the road.

My partner made a U-turn and pulled onto what little shoulder there was. We were now facing south on the northbound shoulder. I began to apologize to my patient and her daughter for the delay and explained we would be moving again shortly.

Suddenly the back door of the ambulance opened. Immediately I could smell a strong odor of an intoxicating beverage fill the back of the ambulance. Rather than allowing the “subject” to get into the back of the ambulance. I told my partner to have the guy sit on the bumper and to “call him a ride”. I said it in a tone to signal my partner to call the police.

The back door shut and what seemed like only seconds passed when I heard the door chime. I then watched in disbelief as a black arm put the ambulance in drive. My partner was not African-American. As the ambulance began to pull forward, I lunged through the crawl space between the patient compartment and the cab of the ambulance.
I was in an outstretched position on my knees. I grabbed the gearshift with my right hand and shoved it into park. It made the most God-awful grinding noise.

Then the guy punched me in the left side of my face. I remember thinking “man….he hit like a girl”. Wanting to stop the threat…. while in a kneeling position I attempted to chop his neck with my hand. The strike proved worthless because I was kneeling and he was sitting up in a drivers’ seat. He simply raised his shoulder to block the blow. So……. I did the next best thing…… with his hand over the top of mine on the gearshift, me trying t keep it in park, him trying to pull it down as he floored the accelerator, I placed my left hand in his face. I began to yell at the daughter who was seated in the passenger seat to take the keys from the ignition.

It was obvious her fear had frozen her. She was praying out loud. Suddenly the passenger side door opened. It was my partner. I yelled to him to take the keys from the ignition. He started to climb over the daughter ….then went to the other side.

Once he opened the driver’s door, he turned off the ignition. I was still pushing the guys face as a distraction when I yelled to my partner “jerk this mother-f***er out-a here!”. My partner grabbed the guy by his feet and pulled. I watched as the guy bounced off the floor then off of the running board.

I went out the door after him. I remember being so angry. I was a full-time police officer working part time on the ambulance…… I never, ever wanted to injure anyone. But this guy……. Wow…… the feeling of anger was so much I stepped forward toward him and just before I did something stupid…… “Force Options/Continuum” went flashing through my head. I knew if I struck him…… I would be the aggressor.

When the officer arrived and took custody I told him the story. I later found out the guy was charged with DWI and simple assault. I was enraged because I could only imagine what would have happened if that would have occurred while I was in a PD uniform.

Not only would have officers and the courts treated him differently………but it would have made the national news. It was then I decided to take this “hobby” of DT4EMS and make it a passion.
 
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