EMS World

AUG 2018

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EMSWORLD.com | AUGUST 2018 19 the prevention of violent events. Contribut- ing factors included not paying attention to warning signs or not taking appropriate pre- cautions for a patient known to be violent, as well as not paying attention to personal positioning such as standing too close. A recommendation for prevention was better personal awareness of positioning that may make EMS providers vulnerable to attack. 6) Operational environment factors: Law enforcement operations—Some comments indicated better collaboration with law enforcement was necessary to prevent violence against EMS providers. Contribut- ing factors included the speed at which law enforcement took steps to arrest aggressors, and common phrases respondents indicated they'd heard police say to patients that EMS providers identified as triggers of violence (e.g., "Either go with them or go with us!"). A recommendation for prevention was to have law enforcement officers initially manage all drug- or alcohol-related calls and have EMS respond once it can be reasonably assured no threat of violence is present. Firearms One finding the authors noted was that although there's an ongoing conversation regarding the merits of having EMS providers carry firearms on duty, no responses to this survey indicated having a gun would have helped prevent the violent event. The authors also noted the importance of a reliable, comprehensive data-collection system to support reporting of violent events in the EMS workplace. They said assess- ments of other questions on their survey indicated that 44% of assaults against EMS workers went unreported to management. Limitations This study was limited by an inability to ask respondents follow-up questions. There also may have been recall bias if respon- dents didn't recall past events accurately. Also, those who responded may not accu- rately represent the full international EMS community, and the results may not accu- rately reflect themes that arise in single jurisdictions or agencies. Most notably, it does not appear the sur- vey allowed participants to save responses and return to finish later. It's likely that a significant number of individuals simply got tired of answering questions or chose not to begin once they saw that 163 questions were included. The inability to calculate a response rate is also a limitation. Conclusion This was the first survey to ask an interna- tional population of EMS professionals who were victims of workplace violence how these events can be prevented. I commend the authors for giving EMS professionals the opportunity to express how they think they could be safer on duty. I hope you read this manuscript, because there were other interesting aspects we didn't have room to discuss. ABOUT THE AUTHOR Antonio R. Fernandez, PhD, NRP, FAHA, is research director at the EMS Performance Improvement Center and an assistant professor in the Department of Emergency Medicine at the University of North CarolinaÐChapel Hill. For More Information Circle 21 on Reader Service Card

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