Working in Harm’s Way: Mitigating Occupational Violence to Firefighters and EMS Responders

People call 9-1-1 for many different emergencies, and the first people on the scene are usually EMS [Emergency Medical Services] responders and/or firefighters.  As an EMS responder, the first assessment made upon arrival is: Is the scene safe?  Often, the scene poses no danger to the responder, but in other instances, a natural disaster, a man-made hazard, or the threat of violence means that the scene is not safe for EMS personnel or firefighters.  In conjunction with the U.S. Fire Administration, the Federal Emergency Management Agency [FEMA] released a report in June 2017 that seeks to, “document the causes and risk factors of violence and mitigation opportunities,” in order to, “reduce and prevent violence to EMS responders.”  The report, titled Mitigation of Occupational Violence to Firefighters and EMS Responders, is now available in the Homeland Security Digital Library.

The report indicates that “violence against EMS responders has been recognized as an occupational hazard since the early 1970s,” and that increased attention has been paid to the problem over the years, but that there has been little cohesion with regard to how to predict risk factors and how to minimize the impact of such violence on EMS responders.  The report characterizes itself as a literature review, which seeks to provide “an assessment of existing literature and publicly available information on the issue of violence against firefighters and EMS responders.”

The report is broken into a few primary sections, including: Specific Project Aims, Project Methods, Literature Review Key Findings, and Best Practices.  The Specific Project Aims section identifies the concrete goals of the report, which are “to define the issue of violence experienced by EMS professionals; to identify the risk factors of violence associated with the EMS profession; [and] to identify best practices and intervention opportunities.”  The Project Methods section simply outlines and justifies the steps taken to produce the report, while the Best Practices section “inventories” best practices and intervention opportunities.  The Literature Review Key Findings section is the core of the report, and discusses the common characteristics of patients/perpetrators of violence, the psychosocial impact of such violence, and the EMS responder risk factors, among other topics.

The report concludes that, “predicting risk factors associated with violence are difficult to confirm due to the contradictory nature of study findings. Variation in study design, lack of a standardized definition of violence, and under-reporting all contribute to the limited understanding of the issue of violence against EMS responders.”   Perhaps more importantly, however, it indicates that, “alarming information regarding the psychological impact from experiencing violence was uncovered,” and suggests that further research based on “nationally representative data” is needed in order to sufficiently characterize the problem, so that, “targeted interventions can be developed and organizational, educational and policy reform can be implemented to better protect the safety and well-being of the EMS community.”

For more information on EMS responders and firefighters and the work they do, check out these resources from the Homeland Security Digital Library.