NFPA Journal

The following are excerpts from accounts reported to the EMS Voluntary Event Notification Tool, or EVENT. The tool, created by the Center for Leadership, Innovation, and Research in EMS (CLIR), was launched in 2013 as a portal where responders of all types can make anonymous reports of violent attacks they have experienced in the field. “To the best of my knowledge, ours is the only national reporting system out there,” said Gary Wingrove, who manages the EVENT tool as part of his work as the president of The Paramedic Foundation.

While the tool is currently the most widely known voluntary national reporting tool for attacks against EMS personnel in the U.S., to describe it as widely used would be an overstatement. In all of 2017, for example, only 52 reports were entered into the system, and about 20 of those came from Minnesota, where CLIR is based. To put that in perspective, New York City had 87 reported attacks on EMS personnel just through the first six months of 2018, according to FDNY. All of that highlights the need for more widespread reporting so researchers and departments can better understand why and how responders are attacked and develop better operational systems and training to prevent it.

The excerpts are taken from reports filed from mid-2018 to 2014, starting with the most recent incidents.

While attempting to place cot straps on patient she became combative and kicked provider in the head and spit on EMS and police. A spit sock was placed and while provider was attempting to restrain wrist to the stretcher the patient got a hold of providers wrist and dug her nails in, drawing blood.

I turned to get the cot in position and she threw a TV remote at me that struck me on the side of the head on my temple and right ear. We then prepared restraints to the cot and while getting ready to move patient she jumped out of bed, threw herself onto the cot. As she landed on the cot she kicked at me striking me with her foot on the right side of my face. She also swung her fist at my partner but missed.

EMS dispatched to male complaining of chest pain with methamphetamine use. Upon initial contact, patient was verbally combative and uncooperative, threating to physically harm personnel, including killing them. Patient maintained an aggressive posture with clenched fists, heavy breathing, and inability to remain still. Patient assisted to ambulance where he began punching gurney, kicking at the interior walls and cabinets, and pulling on gurney restraint belts.

EMS dispatched for a patient with acute alcohol intoxication, initially found unconscious in wooded area with homeless campsites. After transport to local hospital, crew was removing gurney from ambulance when patient started to unbuckle the gurney belts, sat up, and tried to climb off the gurney while it was still being unloaded. Patient was restrained back down to the gurney cushion to prevent from falling, at which time patient became combative, clawing with fingernails, biting and kicking them. In the process of restraining the patient, the paramedic was bitten several times on hand and forearm, as well as receiving fingernail punctures of the skin on one hand (through exam gloves).

During transport patient threatened to "track down" the EMS providers on the call and "get them" once he is discharged from the hospital. Upon arrival at the hospital, patient attempted to tip the stretcher over by rocking back and forth; [we] had to take immediate action and hold patient down during which patient bit [practitioner's] left hand (palm side) through gloves and scratched [practitioner's] left forearm.

Attacked by patient during a report of possible seizure. Two EMTs were punched and bitten by patient. One EMT suffered a swollen and blacked eye. Law enforcement had single personnel response and officer stood and watched incident unfold. EMTs had to subdue patient and request that officer handcuff patient.

Law enforcement and crew member were walking a handcuffed combative patient to the ambulance when the patient turned to the paramedic and spit in his face.

EMS dispatched to a report of an ill person. Upon finding individual who matched description of caller in parking lot of grocery store, EMS attempted to interview and assess individual who became increasingly agitated with crew. Agitation increased to verbal threats to harm crew members with firearm and to shoot at fire trucks and ambulances. Individual walked off from crew throwing an object through a window of the grocery store, and threw more objects at passing cars on the road. Law enforcement had been notified and EMS was told not to pursue. Individual walked away from line of sight of crew.

Crew member was kicked in the groin by a combative, suicidal patient that was handcuffed. The crew member was assessing the patient's pupils and was standing about three feet in front of the patient.

During assessment of a patient with altered mental status secondary to synthetic cannabinoid use and possibly methamphetamines, the EMS providers needed to cut a layer of clothing to expose patient for examination. Patient became aggressive and took trauma shears away from provider and threatened to harm crew.

Arrived on scene at police request to find subject and officer in a tussle. Subject was trying to get the officer's weapon and medics moved in to assist. The subject was high on methamphetamines and other drugs, was tased two times without effect … paramedic received scratches on the arm from the subject, who was bleeding freely and shared it with all parties. Once the subject was controlled and handcuffed, he expressed he “might” have Hepatitis B or HIV ... he didn't know …

While preparing to RSI the patient due to combativeness and the extent of his injury, the patient stated "if you intubate me I will kill you."

The patient "punched" [paramedic] in the face, and bit down on his finger. After [paramedic] used multiple efforts to dislodge his finger, [paramedic] ended up punching the patient in the face to free his hand. Multiple LE agencies were dispatched to the scene.

While assessing the patient's pain and injury to her hand, the medic was punched without warning or provocation. The police officer & other medic now subdued & handcuffed the patient before transport to the hospital in the ambulance. The patient also began spitting at any provider who came close.

Handcuffed patient threatened to come find me at my home and kill my wife and children. Police were not present in ambulance (had refused to come in ambulance with handcuffed patient). Police did follow ambulance to hospital. Threats were repeated at the hospital, and were overheard by numerous nurses, doctor, police and other staff. At the hospital the arresting officer (from nearby town) said there wasn't anything to do. I called our local police station to check on the history of the patient, and they advised me that he was "all talk" and I shouldn't expect him to show up at my house ...

While moving an unconscious patient from prisoner processing area floor he regained consciousness and punched paramedic in genitals and spat in his face claiming he had AIDS and was Hepatitis C positive. During restraint process patient made attempts to bite and kick EMS and LEO staff. While moving patient on stretcher he kicked EMT personnel. During transport and despite multiple doses of chemical restraint the patient remained combative, made numerous threats to kill providers and their families, and continued to grab and kick at providers …

A 21 y/o male patient punched one crew member in the face after transfer and arrival at the hospital bed & then attempted to escape from the ED. The patient was tackled and held by the other crew member as he tried to exit the ED exam room until security and law enforcement arrived.

While attending to a patient who had supposedly overdosed on Neurontin, the patient brandished a knife, slashing toward the paramedic. Luckily the paramedic was not injured. The patient was subdued by the paramedic, the knife was secured. In the time it took to subdue the patient, he had cut through five straps on the cot and into the mattress of the cot.

The patient grabbed me by my shirt collar and pulled me down toward him with one hand when I was bent over and began to punch me in the face. He hit me six times before I could break free … I had hematoma to the right side of forehead as well as a swelled right eye.