Expecting the unexpected: A mixed methods study of violence to EMS responders in an urban fire department

Am J Ind Med. 2016 Feb;59(2):150-63. doi: 10.1002/ajim.22550. Epub 2016 Jan 4.

Abstract

Background: Struck by injuries experienced by females were observed to be higher compared to males in an urban fire department. The disparity was investigated while gaining a grounded understanding of EMS responder experiences from patient-initiated violence.

Methods: A convergent parallel mixed methods design was employed. Using a linked injury dataset, patient-initiated violence estimates were calculated comparing genders. Semi-structured interviews and a focus group were conducted with injured EMS responders.

Results: Paramedics had significantly higher odds for patient-initiated violence injuries than firefighters (OR 14.4, 95%CI: 9.2-22.2, P < 0.001). Females reported increased odds of patient-initiated violence injuries compared to males (OR = 6.25, 95%CI 3.8-10.2), but this relationship was entirely mediated through occupation (AOR = 1.64, 95%CI 0.94-2.85). Qualitative data illuminated the impact of patient-initiated violence and highlighted important organizational opportunities for intervention.

Conclusions: Mixed methods greatly enhanced the assessment of EMS responder patient-initiated violence prevention.

Keywords: assaults; emergency medical services; firefighter; paramedics; prehospital violence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Emergency Responders / psychology
  • Emergency Responders / statistics & numerical data*
  • Female
  • Firefighters / psychology
  • Firefighters / statistics & numerical data
  • Focus Groups
  • Health Status Disparities
  • Humans
  • Male
  • Middle Aged
  • Occupational Injuries / epidemiology*
  • Occupational Injuries / etiology
  • Occupational Injuries / prevention & control
  • Patients / psychology
  • Research Design
  • Sex Factors
  • United States / epidemiology
  • Urban Population
  • Workplace Violence / prevention & control
  • Workplace Violence / psychology
  • Workplace Violence / statistics & numerical data*