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Mitigating the Risks and Impact of Assaults on EMS Responders
Mitigating the risk and impact of assaults on EMS responders
The SAVER checklist helps departments assess and implement training, policies and practices to mitigate assaults on EMS responders.
Posted: Jan. 13, 2020
Many studies have shown that firefighters and emergency medical services (EMS) responders have a high likelihood of experiencing verbal or physical violence at least once in their career. Fire-based paramedics and EMS are at particularly high risk of experiencing an assault since they respond to calls in varied locations, often paired with only one or two colleagues. In these situations, they may come into close contact with people who have mental health issues.
Researchers on the Stress and Violence to Fire-based EMS Responders (SAVER) study found many improvements organizations can make to mitigate the risk and impact of assaults on their responders. High-reliability organizations — those that have fewer than normal accidents, such as the airline and healthcare industries — have mitigated risks through the adoption of systems-level, organizational checklists.
SAVER study researchers wanted to develop a systems-level checklist for violence against fire-based EMS responders using findings from a comprehensive literature review. They also gathered input from subject matter experts at a national stakeholder meeting.
What the research shows
Prevention opportunities exist when we look as far upstream as possible from the likely source of harm. Therefore, it's best to focus on organizational policies that can shape solutions before the problem occurs.
When management and unions can put effective policies in place, responsibility for safety is firmly on the organization rather than on the individual EMS responder. This is important since management organizes training opportunities and establishes standard operating procedures that can minimize the risk.
The final SAVER checklist consists of 174 items organized by six phases of EMS response:
- Traveling to the scene.
- Scene arrival.
- Patient care.
- Assessing readiness to return to service.
The organization, not individual EMS responders, is responsible for nearly all the 174 checklist items. Fire departments and labor unions can use the checklist to accurately assess and implement training, policies and practices that promote the prevention and mitigation of assaults on EMS responders. Organizations can provide training to their personnel to recognize and react appropriately to potentially dangerous situations by using “pause-points” to protect their health and safety while on calls.
While the checklist is organizational in implementation, the result impacts the individual worker.
— SAVER study researchers
Individual-level checklist: pause points
EMS responders focus on a six-item individual-level checklist, also referred to as “pause points.” Department-level training provides EMS responders with the knowledge of how to call a safety “time-out” at one of six specific pause points.
- Traveling to the scene: If you know there has been violence at a location in the past, request and wait for law enforcement backup.
- Scene arrival: Before exiting the ambulance, are all the resources you need in place to safely begin patient care?
- Patient care: Before transport, does your patient require restraint and have they been checked for weapons?
- Assessing readiness to return to service: Are you mentally and physically ready to return to service?
- Post-event (reporting): If you have experienced verbal or physical violence, have you reported it?
- Post-event (resources): Have you sought and received the physical and long-term mental health resources you feel will enable you to return to work whole and ready?
These six individual-level actions give EMS responders the organizational mandate to protect themselves while providing vital patient care. They also put into place a feedback mechanism to management on what might not be working in the field.
More content on the web
- Helping assaulted first responders during legal prosecutions
- Mitigation of Occupational Violence to Firefighters and EMS Responders PDF 2.5 MB
- Violence against EMS responders
This research was supported by a Fire Prevention and Safety Grant (Research and Development) Grant under the Federal Emergency Management Agency's FY2016 Assistance to Firefighters Grant Program (EMW-2016-FP-00277). Learn more about this project.
Learn more about this research
Summary information for this article was provided by the NETC Library. Read the research paper.
Taylor, J. A., Murray, R. M., Davis, A. L., Shepler, L. J., Harrison, C. K., Novinger, N. A., & Allen, J. A. (2019). Creation of a Systems-Level Checklist to Address Stress and Violence in Fire-Based Emergency Medical Services Responders. Occupational Health Science, 3(3), 265–295. doi: 10.1007/s41542-019-00047-z
Autonomous Vehicles Are Coming! Are You Ready?
Autonomous vehicle technology is coming to your jurisdiction. Vehicles with basic autonomous features like automatic collision avoidance are already on the roads you serve, and fully autonomous "self-driving" or "driverless" implementations are not far behind. Are you ready to respond to incidents where the vehicle does the driving? Most agencies are not.
In this new, free Responder Safety Learning Network program, "Autonomous Vehicles," you will learn the basics of autonomous vehicle technology, the challenges and opportunities it presents for emergency responders, the current state of technology development, and how to begin to prepare for the presence of these vehicles on the roadways you serve.
Don't be caught off-guard when you encounter your first "self-driving" or "driverless" vehicle. Know what to expect and what to watch out for. Take Autonomous Vehicles from the Responder Safety Learning Network today. The program is free and takes less than 30 minutes.
Exciting News from MABAS Division 24 CPAT!
Are you, or someone you know, interested in fitness training in preparation for CPAT? MABAS 24 CPAT is now offering fitness training for those interested in readying themselves for this standard test, which is a gateway into a fire service career.
Sessions are held at the MABAS 24 headquarters building located at 17555 Ashland Avenue, Homewood
Already a firefighter?
Sessions are held at the MABAS 24 headquarters building located at 17555 Ashland Avenue, Homewood
Let's Be Careful Out There
It happens all the time all over America. It has happened again; this time a MABAS Division 24 department has been involved in an accident while on the scene of another incident.Illinois: Markham Fire Apparatus Struck on Interstate 57Saturday, March 09, 2019A civilian passenger died and the driver was critically injured early this morning after the vehicle rear-ended a Markham (Illinois near Chicago) fire apparatus on I-57.The crash happened at 0310 hours while the Markham fire apparatus was stopped on the northbound left shoulder to work the initial crash.The two occupants of the SUV were taken to the hospital, the passenger died later on, this morning, and the driver is in critical condition.A Markham Firefighter was also hospitalized with NLT injuries.
Fortunately, the firefighter injuries in this incident were non-life threatening, but it could have been worse. Daily we face the possibility of wrong place, wrong time.
Across the country civilians are injured or killed in traffic accidents. What is really sad is that firefighters and police officers are sometimes secondary victims of these traffic incidents. We need to start thinking about how we can best protect ourselves at the scene. We equip our vehicles with flashing lights and reflective stripes, we wear reflective vests and our turnout gear carries reflective markings, and yet we are still victims at roadside accidents.
What can be done? Have you and your department recently reviewed SOP’s for traffic management at roadside events? Have you talked about how vehicles should be placed? Have you discussed at morning coffee what can be done to insure that everyone goes home safely at the end of the shift?
There are organizations available to help us. Emergency Responder Safety Institute offers free videos and training materials via their website, www.repsondersafety.com You will also find links to other helpful websites. This organization also offers a You Tube channel Responder Safety.Com You Tube Site
Additionally, the International Association of Fire Chiefs has a Safety, Health and Survival Section www.iafcsafety.org International Association of Firefighters offers Emergency Vehicle and Roadway Safety Scene Safety Program www.iaff.org/hs/EVSP/home.html
Active Shooter and Firefighters
The recent shooting in Aurora reminds us that we all face a potential active shooter situation. If you have a school, church, mall, hospital, business park or other place where groups of people gather in your community, you have the potential for a mass shooting. Are we prepared to safely do what is needed to save lives? While we are thinking about the recent shooting, so close to home, it is a good time to dust off our active shooter response plans, talk about them with each shift and make necessary changes.
Below you will find some resources about this topic:
The IAFC’s Active Shooter Incident Response Toolkit includes a 15-minute video of a presentation by Chief James Schwartz of the Arlington, VA. Fire Department entitled “Responding Under Fire.”
Read more about this important topic:
NFPA 3000™ (PS)Standard for an Active Shooter/Hostile Event Response (ASHER) Program. This standard addresses all aspects of the process, from identifying hazards and assessing vulnerability to planning, resource management, incident management at a command level, competencies for first responders, and recovery.
Training for a firefighter mission shift: Mass casualty incidents
The role of the firefighter is changing as mass shootings, natural disasters and mass casualty events increase in frequency, requiring additional trainingDavid CainFireRescue1Dec 20, 2017
How police, fire and EMS can coordinate active shooter response
Here's how to integrate the NFPA 3000 Active Shooter/Hostile Event Response Program standard into your agency’s training and response plansJames DudleyPoliceone.comMay 7, 2018