Injuries from assaults on paramedics and firefighters in an urban emergency medical services system

To determine the nature and frequency of injuries resulting from assaults on paramedics and firefighters in a large, fire department-based emergency medical services (EMS) system. This was a descriptive study involving retrospective analysis of an occupational injury database. All injury reports involving assaults from 1996 to 1998 were reviewed. Variables examined included the employee's age, sex, work assignment, and activity being performed when assaulted, the time of day and day of the week of the assault, the nature of the injury, whether medical care was sought, and whether time was lost from work. Assaults were classified as "intentional," if the perpetrator intended to harm the victim, or "unintentional," if the injury resulted from a patient's inadvertently striking the victim due to an acute medical condition. There were 1,100 injury reports submitted during the study period, of which 44 (4.0%, 95% CI 0-10.9%) involved an assault. Paramedics were assaulted in 35 (79.5%) of these incidents and firefighters in nine (20.5%). Forty-one assaults (93.2%) occurred during patient care activities. Medical attention was sought in 36 incidents (81.8%), and in 14 (31.8%) the employee lost time from work. Twenty-six assaults (59.1%) were classified as intentional and 17 (38.6%) as unintentional. One (2.3%) could not be classified. In this EMS system, injuries resulting from assaults were uncommon. However, due to their potential impact on the victims and the EMS system as a whole, policies and procedures should be developed to minimize these incidents.