Spotlight on Research

As reports of violence against ambulance staff are increasing, this study is interesting. The researchers conducted a simulation-based study to evaluate the responses of emergency medical service (EMS) professionals to patient encounters with threats of violence. A total of 270 EMS professionals participated as individual members of two-person crews in one of four standardised patient care scenarios: a possible overdose, an intoxicated person, domestic violence, and an aggressive family member. Each scenario lasted for 8 minutes and inevitably spiralled to a point where EMS personnel should escape the scene. Trained evaluators recorded the performance using standardised data elements. The primary outcome was escape from the unsafe scene before the scenario ended, while secondary outcomes were related to verbal de-escalation attempts based upon a standard 5-point scale.

Most participants were certified at paramedic level (79%); the rest were evenly split between advanced emergency medical technicians (AEMT) and EMTs. The majority (66%) of participants were male and 45% had 10 or more years of EMS service. There were also 13% with prior military service, 10% with experience in law enforcement and 23% who had received crisis intervention training (CIT).