Personal protective gear to protect EMS providers from attack

Implementing body-worn cameras and body armor to support EMS safety strategy


The EMS1 Academy features “Downrange EMS – Critical Care When the Scene Isn’t Safe.”     In this video, Dick Fairburn stresses the importance of extra help from downrange EMS in the case of an active-shooter. Fairburn explains the benefits of working together as a team, and the positive effects it can have on the safety of all parties involved. Learn more at the EMS1 Academy.

Early in my career as an EMS provider, circa 1979, my colleagues and I had very few personal safety issues related to our work and interactions with patients and family members in the public.

I’ll never forget one late night response to an area where two people were reported to have been shot. By the time we arrived, a large crowd of maybe 30 people had gathered outside the apartment. As my partner and I approached the building, carrying our gear on the stretcher, a large man with a big voice yelled, “Move aside! Let the ambulance doctors through!”

And just like that, the crowd parted, giving us a clear path to the front door. After we patched up the two patients (both had minor flesh wounds from some horseplay with a couple of .22 caliber handguns – don't see that much anymore!) we departed as unhassled as when we first went in.

EMS ballistic vests are designed to trap the kinetic energy of a projectile and spread the energy over a larger surface area.
EMS ballistic vests are designed to trap the kinetic energy of a projectile and spread the energy over a larger surface area. (Photo/Greg Friese)

Modern-day threats to EMS safety

Much has changed since then, hasn't it? And personal protection for EMS providers means more than just PPE to prevent exposures to blood, body fluids and pathogens during patient care.

Today, there is more than just an increased risk of bodily harm from those same patients, family members, and the general public that used to respect and value “ambulance doctors.” In addition to exposure to infectious disease and the hazards of working on the roadways, EMS providers are also at risk for:

  • Physical threats (e.g., firearms, knives, physical assault)
  • Emotional threats (e.g., verbal abuse, verbal threats of violence)

These threats to EMS safety call for new strategies and equipment to reduce on-duty risk to EMS providers. EMS providers in their organizations need to proactively make personal protection from those identified hazards a priority.

The time to make these transformational changes is not after an EMT or paramedic has been injured or abused after a physical encounter with a patient or family member (who subsequently accuses the EMS provider of striking the first blow). Here’s a look at two protective equipment options that can aid in supporting your organization’s safety strategy.

Measures of protection from BWCs

In 2016, officials in Australia decided to equip paramedics with body-worn cameras (BWCs) after seeing a rapid rise in on-duty assaults toward paramedics. Ambulance Victoria reported that in the previous year, their paramedics experienced 5,000 cases of violence towards them – about 13 incidents a day.

In 2017, one in seven NHS paramedics experienced physical violence from patients or their families, yet only 354 prosecutions were brought against individuals who have subjected ambulance staff to violence. In July 2018, The Telegraph reported that 465 paramedics and their ambulances in Great Britain would initially be given BWCs, with the goal of eventually equipping all EMS providers with BWCs.

In the U.S., during an average year, more than one EMS professional is violently killed on duty, according to the CDC. The CDC reports that 2,000 EMS professionals in the U.S. are injured every year in violence-related incidents, and EMS providers suffer lost-time injuries from violence-related incidents at a rate 22 times higher than the national average for all workers.

BWCs can provide several measures of protection. BWC footage from violent encounters can be a valuable training aid, to help first responders recognize the early warning signs of violence, and how to avoid assault.

BWC recorded visual and audio evidence can also be used after an incident in your defense in the event someone (e.g., patient or family member):

  • Physically attacks you or verbally abuses you
  • Claims that you physically attacked or verbally abused them
  • Claims that you failed to provide appropriate patient care

Some options: The Axon Body 3 from Axon is a one-piece device that’s both a rugged body camera and communications beacon. The Body 3 features enhanced low-light performance, reduced motion blur, and an LTE connection that provides real-time features like live streaming.

The Axon Flex 2, also from Axon, is a two-piece device that gives the user a range of mounting options (e.g., mount the camera on your eyewear and have the receiver in your pocket). This BWC pairs point-of-view video with a rugged design and advanced capabilities like unlimited HD and a 120-degree field of view.

The lightweight Venture 3 in 1 Body Camera’s one-touch record feature lets you begin recording audio and video instantly and it has a digital flash for nighttime photography.

The Venture can also be clipped onto the ambulance visor to work as a dash camera. It can also be used in a flashlight mode (4-LED lamps) and you can record both audio and video while using the flashlight mode.

Read more: How to buy body-worn cameras (eBook)

Protecting EMS vulnerabilities with body armor

The need for EMS body armor has developed along with the changing role and operations of EMS personnel during and after an active shooter/multiple casualty incidents and the shifting of the warm zone.

As EMS1 Editorial Director Greg Friese, MS, NRP noted after attacks against medics in Detroit and San Diego, “Some of the most violent assaults reported on medics are from knives and box cutters, not guns. Body armor that does not provide stab or slash protection leaves medics vulnerable to these close-quarters assault injuries that can happen suddenly.”

Some options: The Concealable Multi-Threat Vest Level iiia from Safe Life Defense, is a soft concealable vest that provides protection from handguns and shotguns, as well as resistance to strikes and slashes. The company’s Concealable Enhanced Multi-Threat Vest Level iiia+ features bullet, strike and slash protection, and it provides National Institute of Justice (NIJ) Level 1 spike protection (up to 36 joules of force). 

The Elite IV (Female) concealable body armor system from Point Blank Body Armor is designed with a more ergonomic fit for women while compliant with NIJ .06 Level II and IIIA standards for ballistic protection systems.

Read more: How to buy body armor for EMS personnel

It’s a rough world out there, for sure, and it appears it’s only getting rougher. But whether you’re operating in the warm zone or providing care to a less-than cooperative patient, protective gear can help in keeping you safe on the job. And who can argue about that?

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