Statistics needed
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usafmedic45
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http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5208a3.htm
For LODDs, you can use this: http://www.nemsms.org/notices.htm
I'll keep looking for a source of non-fatal, non-ambulance crash injury data. If necessary, I'll call a couple of my friends down at the CDC to see if they have a suggestion.
If you need further help, let me know.
For LODDs, you can use this: http://www.nemsms.org/notices.htm
I'll keep looking for a source of non-fatal, non-ambulance crash injury data. If necessary, I'll call a couple of my friends down at the CDC to see if they have a suggestion.
If you need further help, let me know.
Sandog
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I doubt he picked up on your sardonic tone... I did though. You funny.
usafmedic45
Forum Deputy Chief
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I wasn't being sarcastic. I actually have friends who work at the injury epidemiology section of the CDC. Remember, this sort of thing is what I'm working towards doing for a living so that I can get away from clinical practice. If he can't find the statistics, I'm happy to put him in touch with the people I know that should be able to help him. I will point out that there will likely be a delay in getting the data from them due to their workloads.
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The insurance institute of America keeps some really great data.
DT4EMS
Kip Teitsort, Founder
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Here is one of my articles that covers a lot of different "sources" for you.
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Several years ago an attorney, John Russo, who is a former law enforcement officer, firefighter and EMT shared with me the case of WALKER v. CITY OF NEW YORK, 974 F.2d 293 (2nd Cir. 1992). The case is known as Failure to Train.
I am not an attorney. I am simply sharing the information that was relayed to me and how it may impact EMS/Fire and the healthcare industry. After looking at the Walker case, check out the latest 10 million dollar lawsuit involving the words “fail to train” later in this article. Here are the elements of FTT:
• “First, the plaintiff must show that a policymaker knows "to a moral certainty" that their employees will confront a given situation. Thus, a policymaker does not exhibit deliberate indifference by failing to train employees for rare or unforeseen events
• Second, the plaintiff must show that the situation either presents the employee with a difficult choice of the sort that training or supervision will make less difficult or that there is a history of employees mishandling the situation.
• Third, the plaintiff must show that the wrong choice by the employee will frequently cause the deprivation of a citizen's constitutional rights.
Where the plaintiff establishes all three elements, then we think it can be said with confidence that the policymaker should have known that inadequate training or supervision was "so likely to result in the violation of constitutional rights, that the policymakers of the city can reasonably be said to have been deliberately indifferent to the need."
When you begin to read below, you will see that with regards to assaults on EMS/Fire and the healthcare profession that it may be argued that policy makers should know “to a moral certainty” that employees will confront situations of violence……. And that this violence is NOT rare or unforeseen……. And that training would make the decision process less difficult.
On January 31st, 2009, www.news10now.com , out of Cape Vincent, NY, reported that an EMT was shot and killed by a male patient while attempting to provide medical treatment.
• “Family of slain EMT files Lawsuit”- April 30th, 2010 http://www.watertowndailytimes.com/article/20100430/NEWS03/304309985
– “The family of an emergency medical technician shot and killed while answering a call in Cape Vincent in January 2009 has filed suit against Jefferson County and Thousand Islands Emergency Rescue Service, Inc., blaming him for his death.”
“Mrs. ****inson claims the defendants were negligent by, among other things, failing to properly train personnel and failing to render assistance and emergency medical care to Mr. Davis the night he was shot.”
• According to the study released by the NAEMT in 2005, the number one injury to EMS providers is assault (52%).
• In 1999 Bureau of Labor Statistics estimated that 2,637 nonfatal assaults occurred to hospital workers—that is a rate of 8.3 assaults per 10,000 workers. This rate is significantly higher than the rate of nonfatal assaults for all other private-sector industries, which are 2 per 10,000 workers.
• According to the Bureau of Labor Statistics, a healthcare provider is more likely to be assaulted, while on the job, than a police officer or a prison guard.
• OSHA has identified a Potential Hazard in relation to the increased risk of violence in the medical setting, and the ineffective training of staff to deal with or identify potential violent problems. There are specific OSHA recommendations for the health care setting.
• The ENA (Emergency Nurses Association) has taken the following position “Health care organizations have a responsibility to provide a safe and secure environment for their employees and the public.” And “emergency nurses have a right to take appropriate measures to protect themselves and their patients from injury due to violent individual.”
• A June 2008 study showed that workers in the healthcare sector are 16 times more likely to be confronted with violence on the job than any other service profession. A study by the Emergency Nurses Association in the spring of 2007 found that more than 1/2 of emergency nurses reported experiencing physical violence on the job.
• 2006 survey conducted as part of a research project for the National Fire Academy’s Executive Officer Program (Source: firefighternation.com)
– 461 respondents
• 410 (88.9%) had been threatened
• 256 (55.5%) had been assaulted
• 41 (8.8%) had carried a weapon on the job for self defense
• 2009 survey of 518 Arizona firefighters (Source: firefighternation.com)
– 442 (85.3%) had been verbally threatened
– 283 (54.6%) had been physically assaulted
– 217 (42.8%) stated that violence is just part of the job
• According to Brian J. Maguire, Dr.PH, MSA, Clinical Associate Professor, University of Maryland, Baltimore County:
“The risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers per year; the national average is about 1.8 cases per 10,000 workers per year. So the relative risk for EMS workers is about 30 times higher than the national average. The relative risk of fatal assaults for EMS workers is about three times higher than the national average.”
That is a lot of studies showing the problem exists. Administrators may have a difficult time in the future explaining “why” they did not train their staff for the realities of the job.
Riddle me this……… What happens if an employee makes a medication error? Does the agency immediately fire the employee? Usually there is remediation. Why the remediation? I was told it was due to showing the employer took steps to correct the problem should they be sued. This would show there was not an “indifference” to the problem. This remedial training could then reduce damages if damages were awarded.
How often do you have to train Blood borne pathogens? Why? Seriously, how many times does it take to understand that if it is wet, sticky and it doesn’t belong to me……… it’s not good? Someone told your employer it should be regular training……that’s why!
What about anti-harassment training? Is that annual training now for you? It is for a lot of employers. Why? It is because their insurance companies make them.
Regardless of how many studies are conducted, there is still the reluctance on the part of Fire/ EMS agencies and hospital administrations to provide training to effectively address workplace violence. Many EMS agencies and hospitals do not want to acknowledge that there is a problem with workplace violence and subsequently do not perceive the need for defensive training for their providers.
Some administrators erroneously perceive “defensive training” as a form of “offensive fighting”. Regardless of the reasons for an agency has for not providing training for staff, it would be difficult for an agency to defend the actions of an employee who uses inappropriate and excessive force to defend him/herself when they refused to supply them with an appropriate alternative.
In every emergency room and ambulance base across the country there are anecdotal stories of assaults. Many times administrators are not aware of these assaults; providers often fail to report assaults to anyone including law enforcement officers and supervisors. Plenty of healthcare provider are embarrassed to report the incidents and assume “its’ just part of the job”.
Being a victim of an assault is not accepted in any other profession, so why should it be accepted in ours? Not only will our Escaping Violent Encounters ( E.V.E.) course provide the necessary training for providers to help protect themselves, but it will also train providers to properly document the events after an assault; preparing them for the prosecutorial process.
Below is a list of possible solutions OSHA has offered as a guide for employers as well as ways in which DT4EMS, LLC can help
• One of the first recommendations for a workplace violence protection program is training for employees. Since 1996, DT4EMS, LLC has been training Fire, EMS, ER and security staff to be liability conscious in any use of force for self-defense. DT4EMS, LLC emphasizes recognition, avoidance, and escape from violent situations. Included in the class are documentation skills, which fully describe the violent encounter and all the variables, surrounding the event.
• DT4EMS, LLC provides training, as recommended by OSHA, by a team of individuals who specialize in the field of defensive training. Our Escaping Violent Encounters is not a martial arts type program that teaches offensive fighting skills. E.V.E. is not a law enforcement style-training course that teaches “control” or pain compliance style techniques. It is the belief of the staff of DT4EMS that an Fire/EMS provider or healthcare personnel should learn to recognize a potential threat, learn avoidance skills, and ultimately escape a violent encounter without injury. We do not believe that a Fire/EMS or healthcare provider should try to subdue or arrest a violent individual. That would be the responsibility of security or the police.
• OSHA offered the recommendation of having a staff member on site that would be responsible for a workplace violence program, which would encourage your employees to seek assistance at a much earlier stage. DT4EMS, LLC offers an instructor level (train-the-trainer) course which provides training for a staff member on site to be the “go-to” person for questions regarding situational awareness and scene safety. This person would be responsible for training staff in the mental, physical, verbal, and documentation skills of the E.V.E. curriculum.
In teaching EVE we believe training for verbal de-escalation; verbal skills are as important as the physical skills the providers possess. In an E.V.E. course the provider is trained that “Good Customer Service” can prevent many assaults from taking place. This training is an attempt to remove “machismo” from an EMS/Fire or healthcare scene where “control” seems to be an issue.
Where the question now lies is simple…….. the problem is known to exist, training is available to help deal with the problem, what do you do?
*Hint* Hiding under the covers doesn’t work……… Just because you can’t see the monster, doesn’t mean the monster is not there.
Many members and I of our E.V.E.N.T. (Escaping Violent Encounters National Trainers) are looking forward to hearing from you.
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Several years ago an attorney, John Russo, who is a former law enforcement officer, firefighter and EMT shared with me the case of WALKER v. CITY OF NEW YORK, 974 F.2d 293 (2nd Cir. 1992). The case is known as Failure to Train.
I am not an attorney. I am simply sharing the information that was relayed to me and how it may impact EMS/Fire and the healthcare industry. After looking at the Walker case, check out the latest 10 million dollar lawsuit involving the words “fail to train” later in this article. Here are the elements of FTT:
• “First, the plaintiff must show that a policymaker knows "to a moral certainty" that their employees will confront a given situation. Thus, a policymaker does not exhibit deliberate indifference by failing to train employees for rare or unforeseen events
• Second, the plaintiff must show that the situation either presents the employee with a difficult choice of the sort that training or supervision will make less difficult or that there is a history of employees mishandling the situation.
• Third, the plaintiff must show that the wrong choice by the employee will frequently cause the deprivation of a citizen's constitutional rights.
Where the plaintiff establishes all three elements, then we think it can be said with confidence that the policymaker should have known that inadequate training or supervision was "so likely to result in the violation of constitutional rights, that the policymakers of the city can reasonably be said to have been deliberately indifferent to the need."
When you begin to read below, you will see that with regards to assaults on EMS/Fire and the healthcare profession that it may be argued that policy makers should know “to a moral certainty” that employees will confront situations of violence……. And that this violence is NOT rare or unforeseen……. And that training would make the decision process less difficult.
On January 31st, 2009, www.news10now.com , out of Cape Vincent, NY, reported that an EMT was shot and killed by a male patient while attempting to provide medical treatment.
• “Family of slain EMT files Lawsuit”- April 30th, 2010 http://www.watertowndailytimes.com/article/20100430/NEWS03/304309985
– “The family of an emergency medical technician shot and killed while answering a call in Cape Vincent in January 2009 has filed suit against Jefferson County and Thousand Islands Emergency Rescue Service, Inc., blaming him for his death.”
“Mrs. ****inson claims the defendants were negligent by, among other things, failing to properly train personnel and failing to render assistance and emergency medical care to Mr. Davis the night he was shot.”
• According to the study released by the NAEMT in 2005, the number one injury to EMS providers is assault (52%).
• In 1999 Bureau of Labor Statistics estimated that 2,637 nonfatal assaults occurred to hospital workers—that is a rate of 8.3 assaults per 10,000 workers. This rate is significantly higher than the rate of nonfatal assaults for all other private-sector industries, which are 2 per 10,000 workers.
• According to the Bureau of Labor Statistics, a healthcare provider is more likely to be assaulted, while on the job, than a police officer or a prison guard.
• OSHA has identified a Potential Hazard in relation to the increased risk of violence in the medical setting, and the ineffective training of staff to deal with or identify potential violent problems. There are specific OSHA recommendations for the health care setting.
• The ENA (Emergency Nurses Association) has taken the following position “Health care organizations have a responsibility to provide a safe and secure environment for their employees and the public.” And “emergency nurses have a right to take appropriate measures to protect themselves and their patients from injury due to violent individual.”
• A June 2008 study showed that workers in the healthcare sector are 16 times more likely to be confronted with violence on the job than any other service profession. A study by the Emergency Nurses Association in the spring of 2007 found that more than 1/2 of emergency nurses reported experiencing physical violence on the job.
• 2006 survey conducted as part of a research project for the National Fire Academy’s Executive Officer Program (Source: firefighternation.com)
– 461 respondents
• 410 (88.9%) had been threatened
• 256 (55.5%) had been assaulted
• 41 (8.8%) had carried a weapon on the job for self defense
• 2009 survey of 518 Arizona firefighters (Source: firefighternation.com)
– 442 (85.3%) had been verbally threatened
– 283 (54.6%) had been physically assaulted
– 217 (42.8%) stated that violence is just part of the job
• According to Brian J. Maguire, Dr.PH, MSA, Clinical Associate Professor, University of Maryland, Baltimore County:
“The risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers per year; the national average is about 1.8 cases per 10,000 workers per year. So the relative risk for EMS workers is about 30 times higher than the national average. The relative risk of fatal assaults for EMS workers is about three times higher than the national average.”
That is a lot of studies showing the problem exists. Administrators may have a difficult time in the future explaining “why” they did not train their staff for the realities of the job.
Riddle me this……… What happens if an employee makes a medication error? Does the agency immediately fire the employee? Usually there is remediation. Why the remediation? I was told it was due to showing the employer took steps to correct the problem should they be sued. This would show there was not an “indifference” to the problem. This remedial training could then reduce damages if damages were awarded.
How often do you have to train Blood borne pathogens? Why? Seriously, how many times does it take to understand that if it is wet, sticky and it doesn’t belong to me……… it’s not good? Someone told your employer it should be regular training……that’s why!
What about anti-harassment training? Is that annual training now for you? It is for a lot of employers. Why? It is because their insurance companies make them.
Regardless of how many studies are conducted, there is still the reluctance on the part of Fire/ EMS agencies and hospital administrations to provide training to effectively address workplace violence. Many EMS agencies and hospitals do not want to acknowledge that there is a problem with workplace violence and subsequently do not perceive the need for defensive training for their providers.
Some administrators erroneously perceive “defensive training” as a form of “offensive fighting”. Regardless of the reasons for an agency has for not providing training for staff, it would be difficult for an agency to defend the actions of an employee who uses inappropriate and excessive force to defend him/herself when they refused to supply them with an appropriate alternative.
In every emergency room and ambulance base across the country there are anecdotal stories of assaults. Many times administrators are not aware of these assaults; providers often fail to report assaults to anyone including law enforcement officers and supervisors. Plenty of healthcare provider are embarrassed to report the incidents and assume “its’ just part of the job”.
Being a victim of an assault is not accepted in any other profession, so why should it be accepted in ours? Not only will our Escaping Violent Encounters ( E.V.E.) course provide the necessary training for providers to help protect themselves, but it will also train providers to properly document the events after an assault; preparing them for the prosecutorial process.
Below is a list of possible solutions OSHA has offered as a guide for employers as well as ways in which DT4EMS, LLC can help
• One of the first recommendations for a workplace violence protection program is training for employees. Since 1996, DT4EMS, LLC has been training Fire, EMS, ER and security staff to be liability conscious in any use of force for self-defense. DT4EMS, LLC emphasizes recognition, avoidance, and escape from violent situations. Included in the class are documentation skills, which fully describe the violent encounter and all the variables, surrounding the event.
• DT4EMS, LLC provides training, as recommended by OSHA, by a team of individuals who specialize in the field of defensive training. Our Escaping Violent Encounters is not a martial arts type program that teaches offensive fighting skills. E.V.E. is not a law enforcement style-training course that teaches “control” or pain compliance style techniques. It is the belief of the staff of DT4EMS that an Fire/EMS provider or healthcare personnel should learn to recognize a potential threat, learn avoidance skills, and ultimately escape a violent encounter without injury. We do not believe that a Fire/EMS or healthcare provider should try to subdue or arrest a violent individual. That would be the responsibility of security or the police.
• OSHA offered the recommendation of having a staff member on site that would be responsible for a workplace violence program, which would encourage your employees to seek assistance at a much earlier stage. DT4EMS, LLC offers an instructor level (train-the-trainer) course which provides training for a staff member on site to be the “go-to” person for questions regarding situational awareness and scene safety. This person would be responsible for training staff in the mental, physical, verbal, and documentation skills of the E.V.E. curriculum.
In teaching EVE we believe training for verbal de-escalation; verbal skills are as important as the physical skills the providers possess. In an E.V.E. course the provider is trained that “Good Customer Service” can prevent many assaults from taking place. This training is an attempt to remove “machismo” from an EMS/Fire or healthcare scene where “control” seems to be an issue.
Where the question now lies is simple…….. the problem is known to exist, training is available to help deal with the problem, what do you do?
*Hint* Hiding under the covers doesn’t work……… Just because you can’t see the monster, doesn’t mean the monster is not there.
Many members and I of our E.V.E.N.T. (Escaping Violent Encounters National Trainers) are looking forward to hearing from you.
firetender
Community Leader Emeritus
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DT4EMS, you're pretty astute on stats, so I'm wondering, could you point me to a study that actually gives the NUMBERS OF LAW SUITS FILED AGAINST ON-DUTY MEDICS in any one representative year?
So many people modify their field judgments based on fear of litigation. What does that monster REALLY look like?
DT4EMS
Kip Teitsort, Founder
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Firetender those stats are not my gig....... I am a subject matter expert in my specific area. Not all areas.
You may be missing the point........ administrators seemed to be motivated by fear of litigation. Those stats are sourced for you to see that they are not my numbers.
Finding lawsuits is not my cup of tea. I get numbers and access to stats because people email me and tell me about them.
I work a full time 40 hour a week job, spend 4 hours a day....every day working on scene safety stuff somewhere for someone........ so I wish I had time to research other cases...... but I don't. I wish I could find someone.......heck maybe you
to help dig on these things.But no matter what study gets done.......... someone will always argue that the numbers are flawed....... I mean.......crap........look at the cross section of studies that were listed...
I am trying to improve the breed. I observed a problem and rather than complain about it..... I offered a solution. That solution may not be for everyone, but it is better than complaining.
Hi.
Thanks a lot for the tip on the CDC. I went into both links and got good information, more on the CDC than in the other.
An about the assaults on EMS providers i will use that information for another article, its just amazing, here in my country there is no evidence and hence no action taken against that sort of problem. I hope that changes soon.
Thanks a lot. Really
Thanks a lot for the tip on the CDC. I went into both links and got good information, more on the CDC than in the other.
An about the assaults on EMS providers i will use that information for another article, its just amazing, here in my country there is no evidence and hence no action taken against that sort of problem. I hope that changes soon.
Thanks a lot. Really
usafmedic45
Forum Deputy Chief
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You might look into the CDC's WISQARS program. I'm not sure if it will be specifically helpful, but it might hold some useful data.