Almost two-thirds of emergency medical services (EMS) workers responding to an international survey said they had been physically attacked on the job, researchers report in a recently published study.1

“These EMS personnel have a rate of occupational fatality comparable to firefighters and police, and a rate of nonfatal injuries that is higher than the rates for police and firefighters and much higher than the national average for all workers,” the authors reported.

Underscoring the international nature of the problem, the researchers are from Australia.

“In Australia, no occupational group has a higher injury or fatality rate than EMS personnel,” they wrote.

In the United States, EMS workers’ risk of violence is 22-times higher than the average risk faced by all workers.

The researchers used an online survey, netting 1,778 EMS respondents from 13 countries. Fifty-five percent described their work location as “urban.”

“The majority of respondents were from the U.S.,” the authors stated, making the findings relevant for employee health professionals stateside.

Overall, 65% of respondents said they had been physically attacked at work.

“In almost 10% of those incidents, the perpetrator used a weapon,” the researchers reported. “Approximately 90% of the perpetrators were patients, and around 5% were patient family members.”

In a related development, a group called the Paramedic Chiefs of Canada (PCC) recently released a position statement saying violence against EMS workers is unacceptable.

“The PCC supports a zero-tolerance position on all forms of violence experienced by paramedics and support staff,” they reported.2 “Each day, as they perform these tasks with compassion and dedication, these same individuals are at high risk of being victims of violence and abuse.”

Workplace violence experienced by EMS has been “linked to psychological injuries in the form of stress, anxiety, and PTSD,” the group stated. “Further, workplace violence has been linked to decreased job satisfaction in paramedics and an intent to leave the profession in healthcare professionals.”

The Canadian group said interventions are needed on several levels including the following:

  • the development of evidence-based training materials on dealing with violent patients and situations that threaten EMS staff;
  • raising public awareness of the human toll and financial impact of the issue;
  • changes in policy and laws to discourage such attacks and follow through with punitive measures against EMS attackers.


  1. Maguire BJ, Browne M, O’Neill BJ, et al. International survey of violence against EMS personnel: physical violence report. Prehosp Disaster Med 2018;33(5):526-531.
  2. PCC. Paramedic Chiefs of Canada Release Position Statement on Violence to Paramedics. Journal of Emergency Medical Services Sept. 18, 2018. Available at: