Once upon a time, in an earlier, quaint time, it was good enough to simply teach new EMS providers the “safety dance.” You know what I am talking about: You enter a scenario with your hands in the air, wearing imaginary gloves, and saying something like, “I have my BSI precautions on, is the scene safe?” The instructor responds, “the scene is safe.” And other than an hour or so lecture about scene safety, nothing else is taught about scene safety practices — because we felt like that was enough.
Well, it’s not.
The continuing uptick of violence against EMS providers in this country mirrors what is happening in the UK and other parts of the world. True, the vast majority of our patients are cooperative and desire our help. But more and more are becoming resistant to our efforts, even when they desire them. And then there are a few folks who desire to harm anyone who comes through the front door.
We have started efforts to provide the needed education and training to de-escalate aggressive behavior and defend ourselves when retreat is not an option. For the moment, it rests within the realm of continuing education, which is helpful. But, It has to start in the primary EMS education efforts. More time must be devoted to teaching about scene safety practices, and as importantly, rehearsing those practices. Think highway crash scenes, construction sites, potentially violent situations — while each is unique, there are common issues that require a deliberate approach by first responders. This behavior has to be embedded right at the beginning of a career, not learned after a close call or worse, actually being injured or killed unnecessarily.
