Since I was a teenager; a bright-eyed, brand new EMT on an ambulance running 911 calls in the County of Los Angeles in the latter 1980s, it was difficult to grasp the notion that someone would want to harm the only people there to help. The veterans all warned me, but it just made no sense.
Now, three decades later, it still defies reason, but the reality of the dangers faced by EMS providers everywhere is crystal clear and as daunting as ever – if not more so.
While the prism through which I see EMS and my contribution to the industry are very different than when I was running calls, my respect and concern for those who do this job are stronger than ever. I was sickened to read about the FDNY EMT who was beaten and significantly injured by a patient in the back of the ambulance on the way to the hospital.
For nearly a dozen years, I have worked to teach EMS providers and agencies about various ways to use the law in their own defense; how to use the law to keep providers – and patients – safe. However, in real life, no law can protect a provider from a perpetrator bent on engaging in violence. Bullets, blades and clenched fists go right through the paper upon which laws are written. Provider safety is a physical and constant endeavor, and vigilance is the only way to ensure it.
Two takeaways from the attack on an FDNY EMT
I wish the injured EMT a speedy and full recovery. I would encourage him to seek the assistance necessary to get back on the ambulance and continue to do the good work of EMS.
At the same time, I would use this incident to remind every provider in every environment to keep your head on a swivel; to always be aware of your surroundings and to hone your skill at reading early cues to danger.
Here are my takeaways for providers and EMS agencies.
1. EMS providers: seek out scene safety training
Facial expressions, body language and vocal changes are all early-warning signs that a situation is about to escalate. Any seasoned provider will tell you – like the old vets tried to tell me when I first started – the best way to handle danger is to avoid it; the safest way to deal with conflict is to prevent it; the only way to confidently avoid danger and prevent conflict is through regular training and practice.
Without casting aspersions on any particular agency, it is widely known that scene safety and mitigating danger are not generally subjects of frequent continuing education in EMS. Unfortunately, for most providers, gaining competence and confidence in this area means finding and attending (and even paying for) the training on your own – or learning the hard way. Yes, it is counterintuitive, but such is life, so just do it.
2. EMS agencies: provide adequate safety training for personnel
This horrific incident should likewise be a wake-up call to provider agencies and training facilities: focus on scene, provider and patient safety. If you do not teach your people how to be safe, they won’t be safe, and that is where the law will rear its ugly head. If you don’t establish, update and maintain meaningful training policies and procedures (and act on them), the agency will have nothing upon which to fall back when the litigation machine comes to life.
I can assure you, whether an agency is in any way responsible for a providers’ injuries incurred on the job is almost irrelevant to the lawyers out there who would love the opportunity to find out.
My final thought is this: EMS is inherently dangerous. If you want to be as safe as possible, you have to make it so with training and practice. If you want your people to be as safe as possible, you have to provide them the training and practice. It is not as difficult as it is important.
[EMS Chief Ernesto M. Rodriguez shared insights from the City of Austin EMS Department Assault Survey with EMS1. Read: A research-based approach to understanding assaults against EMS personnel]
