Violence Against Paramedics: Protocol for Evaluating 2 Years of Reports Through a Novel, Point-of-Event Reporting Process

Profiling paramedic job tasks, injuries, and physical fitness: A scoping review

INTRODUCTION

The aim of this review was to identify, collect, appraise, and synthesise research profiling paramedic job tasks, injuries sustained, and current fitness levels, to guide optimal workplace performance and enhance injury mitigation efforts.

METHODS

Following the Preferred Reporting Items for Scoping Reviews, four databases (PubMed, SPORTdiscus, CINAHL, and Embase) were searched using key search terms (derivatives of 'paramedic' and 'injury', 'physical fitness' and 'tasks'). Identified records were screened against eligibility criteria with remaining studies critically appraised.

RESULTS

Of 1675 identified records, 33 were retained. Musculoskeletal injuries exhibited the highest mean injury rate, with sprains and strains the predominant nature of injury, and the back the most frequently injured body part. Among paramedics, handling stretchers and equipment posed the most challenging tasks while for Emergency Medical Services patient extraction was the most physically and mentally demanding task. Male paramedics were generally stronger with more muscular endurance, but less flexibility, than female paramedics. Older paramedics displayed lower levels of strength and flexibility.

CONCLUSION

Tasks involving stretcher handling and patient extraction are reported as being most strenuous for paramedics leading to musculoskeletal injuries, particularly sprains, strains, and back injuries.

The extent of physical and psychological workplace violence experienced by prehospital personnel in Denmark: a survey

BACKGROUND

Workplace violence against healthcare workers has been a well-known problem for more than 40 years. This problem is also relevant for prehospital personnel who are at risk of physical and/or psychological violence during work. Violence and threats of violence can have physical and psychological consequences, including personal challenges in their everyday life, use of sick days, reports, and the need for professional help. Therefore, this study aimed to describe the extent of and subsequent reporting of physical and psychological workplace violence toward the prehospital healthcare workers in Denmark in a two-year period. Moreover, we wanted to elucidate any possible effect of workplace violence on the private and professional lives of the prehospital healthcare personnel.

METHODS

A nation-wide survey where a validated anonymised questionnaire was directed to all of the approximately 4500 Danish prehospital healthcare workers.

RESULTS

Out of 584 complete responses we found that 47.4% had experienced psychological violence on the job whereas 25.7% had experienced physical violence on the job within the past two years. The perpetrators were mainly patients or relatives of the patients. Physical violence was mostly reported as punching, pushing, and kicking, while psychological violence included threats of violence and other intimidation. After experiencing violence the respondents reported both physical and psychological harm, which for some prehospital healthcare workers had consequences for their professional and/or personal life. Furthermore, some prehospital healthcare workers reported that the violence had resulted in some patients receiving worse treatment afterwards. We found that violence was rarely reported to either employers or the police, because respondents believed the events were not important enough to merit reporting, or because a report was not considered to make any difference to the healthcare worker. The survey demonstrates that, as a minimum, at least one healthcare worker in 30 and one healthcare worker in 16 has been exposed to episodes of violence and threats of violence within the last two years.

CONCLUSION

We suggest that the prehospital organisations emphasise reporting future episodes of physical and/or psychological violence. Knowing the extent of the problem is a prerequisite for addressing, debriefing, and/or other psychological follow-up.

TRIAL REGISTRATION

N/A.

Sexist, Racist, and Homophobic Violence against Paramedics in a Single Canadian Site

Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between 1 February 2021 and 28 February 2022, two paramedic supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high inter-rater agreement across the dimensions (k = 0.73-0.83), and after resolving discrepant cases, we found that one in four violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience over the course of their work and its potential for psychological harm.

Prevalence and Characteristics of Violence against Paramedics in a Single Canadian Site

Violence against paramedics has been described as a 'serious public health problem' but one that remains 'vastly underreported', owing to an organizational culture that stigmatizes reporting-hindering efforts at risk mitigation in addition to creating a gap in research. Leveraging a novel reporting process developed after extensive stakeholder consultation and embedded within the electronic patient care record, our objective was to provide a descriptive profile of violence against paramedics in a single paramedic service in Ontario, Canada. Between 1 February 2021 and 31 January 2023, a total of 374 paramedics in Peel Region (48% of the workforce) generated 941 violence reports, of which 40% documented physical (n = 364) or sexual (n = 19) assault. The violence was typically perpetrated by patients (78%) and primarily took place at the scene of the 9-1-1 call (47%); however, violent behavior frequently persisted or recurred while in transit to hospital and after arrival. Collectively, mental health, alcohol, or drug use were listed as contributing circumstances in 83% of the violence reports. In all, 81 paramedics were physically harmed because of an assault. On average, our data correspond to a paramedic filing a violence report every 18 h, being physically assaulted every 46 h, and injured every 9 days.