Corbett S W, Grange J T, Thomas T L
Department of Emergency Medicine, Loma Linda University Medical Center, CA 92354, USA.
Prehosp Emerg Care. 1998 Apr-Jun;2(2):127-31. doi: 10.1080/10903129808958856.
To evaluate the experience of prehospital care providers with violence.
A survey addressing experiences with prehospital violence was administered to a convenience sample of emergency medical services (EMS) providers in a southern California metropolitan area. Descriptive statistics are reported.
Of 774 EMS providers surveyed, 522 (67%) returned the questionnaire. Members of law enforcement were excluded because their experience with violence, weapons, and tactics is not typical of most paramedics. This left a sample of 490 for further analysis. These prehospital care providers had a median of ten years' experience on the job. They tended to be male (93%) and white (80%). All together, 61% recounted assault on the job, with 25% reporting injury from the assault. Respondents reported a median of three episodes, and the number of assaults for each individual was unrelated to the number of years of experience on the job (r = 0.068). Of those injured, 37% required medical attention. On the other hand, 35% reported that their company had a specific protocol for managing violent situations and 28% stated ever having received formal training in the management of violent encounters. This limited training notwithstanding, nearly all (95%) providers described restraining patients. Use of protective gear was reported (73%), and some (19%) admitted to ever carrying a weapon on the job.
By their own report, EMS providers encounter a substantial amount of violence and injury due to assault on the job. Formal training and protocols to provide a standardized safe approach for such encounters are lacking. Although the limitations of survey data are recognized, further research characterizing the level of violence and potential interventions seems warranted.
评估院前急救人员遭遇暴力的经历。
对南加州一个大都市地区的紧急医疗服务（EMS）人员进行了一项关于院前暴力经历的调查，样本选取方便抽样。报告描述性统计结果。
在接受调查的774名EMS人员中，522人（67%）返回了问卷。执法人员被排除在外，因为他们在暴力、武器和战术方面的经历并非大多数护理人员所共有。这样就剩下490个样本用于进一步分析。这些院前急救人员在职中位工作经验为十年。他们多为男性（93%），白人（80%）。总计61%的人讲述了工作中遭受攻击的经历，25%的人报告因攻击而受伤。受访者报告的攻击事件中位数为三次，且每个人遭受攻击的次数与工作年限无关（r = 0.068）。在受伤人员中，37%需要医疗救治。另一方面，35%的人报告其公司有处理暴力情况的具体预案，28%的人表示曾接受过处理暴力事件的正规培训。尽管培训有限，但几乎所有（95%）的急救人员都描述过约束患者的情况。报告了使用防护装备的情况（73%），一些人（19%）承认曾在工作中携带武器。
据急救人员自己报告，他们在工作中因遭受攻击而遭遇大量暴力和受伤情况。缺乏为这类事件提供标准化安全应对方法的正规培训和预案。尽管认识到调查数据存在局限性，但对暴力程度和潜在干预措施进行进一步研究似乎是有必要的。
