Boston EMTs Face Attacks, Injuries

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Boston EMTs Face Attacks, Injuries

David Abel, GLOBE STAFF

The Boston Globe

One had his nose broken four times. Another was attacked with cinder blocks dropped off the roof of a housing project. Others have been stabbed with drug-filled syringes, chased by dogs, and strafed by gunfire after arriving at crime scenes before the shooting stopped.

Boston's emergency medical technicians, who often run red lights and speed through the opposite lane of traffic to save lives, are trained to confront broken bones and cardiac arrest.

But EMTs, who are responding to more calls each year, often become victims themselves as they face Boston's rampant street violence without the guns, mace, and nightsticks that police officers carry.

Last year, 28 percent of the 193 injuries suffered by city EMTs were the result of violence, a figure that has held constant over the past five years, according to Boston Emergency Medical Services. This year EMTs have been injured in 24 attacks.

Since 1994, four EMTs have left the department as a result of injuries from violence.

Nationally, no one tracks the number of EMTs and paramedics - highly trained EMTs - injured in violence on the job, but the National EMS Memorial Service, a volunteer group in Virginia, said 30 EMTs have died because of violence since 1993, 14 of them while responding to the terrorist attacks on Sept. 11, 2001.

"Violence isn't something an EMT should have to deal with," said Richard Serino, chief of Boston EMS, who noted that more than half of last year's total number of injuries left his employees out of work for a day or more. "One EMT injured as a result of an assault is too many."

Last fiscal year, the city's 333 EMTs responded to 99,266 calls and made a record 68,943 trips to hospitals- an increase of about 5,000 since 2002 - without a significant change in staff.

Many EMTs said they are overworked and undertrained for what they confront. They said they are increasingly sent to calls that in the past may have been answered by the police - such as a report of a "man down" or someone drunk in the street - and too often must work without police assistance to subdue hostile patients or others interfering with their care.

When they encounter trouble, they have only a radio to call for help and handcuffs to restrain the attacker. Their radios, they say, aren't much help, because they can't call police directly; they must wait for an EMS dispatcher to e-mail police dispatchers.

James Orsino, who has suffered a broken nose four times during his 23 years as a city EMT, said he has dodged bullets after being caught in the crossfire and been punched more times than he can remember. Like other EMTs, he has also been injured by people not willing to accept his help; he once tore his rotator cuff in a struggle with a man trying to jump off the Massachusetts Avenue Bridge.

"We're in a time when there's a lot more going on in the street, and you can feel it," said Orsino, president of the EMS division of the Boston Police Patrolmen's Association. "With everyone's resources stretched thin, we often arrive on the scene before police. Those are classic cases to get hurt on."

Boston EMS, overseen by the Boston Public Health Commission, dispatches teams of two medical technicians from an office adjacent to police dispatchers at police headquarters. When a 911 call comes in, an operator determines whether to transfer the caller to a specially trained EMT dispatcher.

The department, which has a $37 million budget this fiscal year, offers EMTs the opportunity to take a two-hour self-defense class, but Orsino and others contend it's not enough. He said the city should require EMTs to be certified annually in self-defense, as they are for defensive driving and CPR. He said the department should also outline standard procedures for how to deal with violent patients.

EMTs also worry about fighting back for liability reasons, he said, which is why they don't carry mace.

"When someone is violent in a hospital, six people are used to restrain the person," he said. "In the street, it's you and your partner. There's no one else, nothing to help you out. Whatever comes out of it is what happens, which is why so many people get injured. It's a crazy situation."

Nearly every city EMT has a story about being attacked.

Jim Allen, 33, who has worked as an EMT for 11 years, said it's not uncommon for people to start yelling as his ambulance passes and to "make violent gun gestures."

"I've been bitten by more people than dogs," he said. "It seems every other call they dislike you for something. I think it's because of the badge we wear."

Alcohol and drug abuse are fueling the violence against EMTs. Zach Schiess, 29, who has worked as an EMT for six years, said he was called to a bar in South Boston after a man's arm was twisted in a fight. When he arrived, he said, the man and his girlfriend started swinging at him and his partner, forcing them to lock themselves in their ambulance.

"You can never take for granted what can happen when someone is drunk," he said.

City EMTs receive at least eight months of training, from life support to how to use the radios to how to operate the ambulances. The advanced EMTs, or paramedics, receive two years of training, which includes more advanced life-saving techniques.

Serino said all EMTs are trained to manage aggressive behavior, but he said, "We're always looking for ways to improve our training."

To cope with the stresses of the job, one city paramedic is writing about his experiences on a blog, "Other People's Emergencies: Random Thoughts of an Urban Paramedic."

Jay Weaver, a 22-year veteran and the author of urbanparamedic.blogspot.com, has been stuck with a needle by an AIDS patient, confronted people wielding guns and knives, and dragged three blocks by a man who grabbed him through the window of a car.

On his blog, he covers subjects ranging from how EMTs deal with drunken doctors interfering at scenes, how they subdue people trying to commit suicide, and among other things, how they handle grumpy patients and drivers who cut off their ambulances.

At the end of a December entry titled "Danger," the 47-year-old paramedic wrote: "We are forever one misstep away from serious injury or even death. The next time we fly through an intersection, the impact might be more powerful. The next time I get stuck with a needle, it just might contain a lethal virus. The next time I walk through a door in the projects, there might be a lunatic waiting for me on the other side with a handgun or a knife. I'm not going to dwell on any of this. You can't do the job if you're afraid of each call."

On a recent shift, Weaver and his partner weaved through rush-hour traffic. They raced through streets that looked like parking lots for calls that required them to do everything from subduing a large psychiatric patient who began beating his social worker on Boston Common to treating a father who was stabbed while taking his 2-year-old son for a stroll in Charlestown.

At the end of the night, as their radio continued to squawk, Weaver said the key to surviving was expecting the unexpected.

"We have family members screaming in our face and people throwing things at us," he said. "You just don't know what you're going to experience on any call."

[Goose 188]

More or less pretty much the case everywhere. In fact i had a regular intox throw a swing at me the other day. The worst thing about this type of crap, is that we bust our asses for the same people over and over and they just end up drunk to the point of unconsciousness in the street 9 hours later after they get discharged. At what point do you draw the line? Part of me feels that, hell if they want to do this to themselves thats their business and don't bother me. Lord knows i don't want herpagonasyphlAIDs or whatever these people have floating around them if they go to bite me or try to stab me with a sharp. About the only defense i have is staging away which can cause problems or knocking the guy out with a D-Tank (which probably isn't the best move). Maybe this type of crap is better left to police, after all they've got the firepower - lethal and less lethal - but, there are allot more pressing law enforcement matters happening too.

Edited August 31, 2007 by Goose

[Guest]

So is the moral of the story forget patient care, take care of yourself first? Let the cops get there and handle the drunk in the bar with the twisted arm (heck he is hardly hurting too badly anyway drunk as he is). And if people don't want care leave them to it. My instructor did say that you never ever go into a situation where you are in danger. Now I am not an EMT I just did the exams so I have zero experience here (but I'm handy enough in an imaginary situation )

but I really can't understand why EMTS are hated so much. The place is gone to hell in a handbasket. This has turned me off my search for a job to get some experience

[Guest feraldan]

Boston's emergency medical technicians, who often run red lights and speed through the opposite lane of traffic

Anyone else catch that. I'm assuming its a gross exaggeration. I want to believe that's a gross exaggeration.

[SageVigiles 1,194]

Babyheart, the reason EMTs are hated and attacked is easy, its just like why firefighters in big cities get attacked when responding to fires. If you went through all the trouble to set a building on fire, would you want someone coming to screw that up? No. If you went through all the trouble of trying to kill someone, would you want paramedics coming to help the guy NOT die? Absolutely not. Its not exactly helping the would-be killers situation. I'm by no means saying they are right in attacking EMTs/medics, I'm just saying it doesn't take a Doctorate in Psychology to understand why.

[Guest alsfirefighter]

I think its more sensationalizing the story then exaggeration. Other then a poor choice of words..."speed" "run red lights" many of us have to take the opposite lane of traffic when its possible to get anywhere. Particularly during rush hour.

Unfortunately it is a fact of life and you can't rely on PD for every call. There are courses out there that teach scene safety and defensive techniques. They are very informative and effective. If anyone is interested you can PM me.

[Goose 188]

So is the moral of the story forget patient care, take care of yourself first? Let the cops get there and handle the drunk in the bar with the twisted arm (heck he is hardly hurting too badly anyway drunk as he is). And if people don't want care leave them to it. My instructor did say that you never ever go into a situation where you are in danger. Now I am not an EMT I just did the exams so I have zero experience here (but I'm handy enough in an imaginary situation )

but I really can't understand why EMTS are hated so much. The place is gone to hell in a handbasket. This has turned me off my search for a job to get some experience

What are the first two things you said before you began each of your practical scenarios ? BSI and scene safety. Patient care takes a backseat if a scene is dangerous. I'm not here to be a hero, im here to do a job but if i go down who's going to do that job? I don't need to get in the middle of gang violence, domestic assaults, shootings, stabbings. I really could care less why bob shot jim or why john took a bat to Bill's leg - i only want to get in and do what i can to help jim or bill.

You have to figure 9 out of 10 drunks or whoever don't call 911 themselves, you've got the passersby who calls b/c they are out cold in their driveway, on the sidewalk or in the street. Trust me, take the same guy to the ER a few dozen times for the same self inflicted crap and itll frustrate the hell outta you

I've been fortunate i haven't been in too many shady situations, most people don't mind EMS where i work. However, i think more generally, people see EMS as part of the establishment. We have similar uniforms and we could be easily mistaken for Police. Additionally, they know that Fire and EMS both work pretty closely with PD so anything they do or say will get back to the police eventually. But, god forbid they have a hole the size of a coffee can in their chest, they'll be crying for EMS.

Don't be discouraged. It's just life bro. If your willing and can afford to deal with that for 9 bucks/hour then by all means do it!

Edited August 31, 2007 by Goose

[Guest]

9 bucks an hour! Sign me up - I'll figure it out as I go right?

And Sage now I am no eejit I do know there are lunatics out there running amok but I will never, ever for the life of me (hopefully not that literally anyday...) understand them or their insane actions. You can't rationalise or justify that garbage (which is why I have no intention of getting my doctorate in Psychology).

[RescueKujo 130]

Babyheart,

You can be on the most serene scene and have it go sideways in a heartbeat. As was said before, expect the unexpected. It is ultimately up to you to watch out for yourself. Now that I'm in dispatch, I can't tell you how many times I've been asked by the crews why I didn't tell them to standback/stage. There are certain things that are an absolute standback/stage for Sheriff or PD, but after a while the crews should have enough street sense to know when to do that.

[Guest]

Hiya Kujo - thanks for the reminder. Things can change in an instant so be prepared always. Like I said I am a total newcomer and aside from a couple of civvie incidents have no experience at all. I hope to learn from you lot!

And most of the time I can be a bit sarcastic. I know, I know, lowest form of wit and all that but if I offend anybody I really am sorry. You guys all seem to post so seriously I'm thinking I don't fit in here.

[RescueKujo 130]

Hiya Kujo - thanks for the reminder. Things can change in an instant so be prepared always. Like I said I am a total newcomer and aside from a couple of civvie incidents have no experience at all. I hope to learn from you lot!

And most of the time I can be a bit sarcastic. I know, I know, lowest form of wit and all that but if I offend anybody I really am sorry. You guys all seem to post so seriously I'm thinking I don't fit in here.

Baby,

Don't worry about the sarcasm. That and the gallows humor are how most of us get by. Everyone gets cynical after a period of time in this profession after dealing with the "noble citizens" that we tend to see.

[Guest partyrock]

One of the biggest problems with Boston EMS is that they look like cops. There is violence against EMS everywhere, but Boston is definitely a more dangerous job than NYC. It has nothing to do with the make up of the cities either. From what I understand Boston also doesn't have the police presence that NYC has. We're rarely on scene for long if at all before PD shows up to most serious calls. FDNY EMT's and Medics go through great lengths to make sure people know that they are not the police and it pays off. I wish I got half the love from the neighborhood when I'm with supression than I get when I'm riding a bus.

[Guest paramedico987]

Nothin' says lovin' like an oxygen tank to the groin!

[ny10570 745]

There's a difference between a dangerous job and a dangerous location. Outside of the occasional violent drunk it is extremely rare for our patients to come after us. Even when the drunk does start swinging how often are they throwing quality swings that you can't see coming from a mile away? Every time I've been caught by one of these clowns I wasn't paying attention where I should have.

Our environment is where we are exposing ourselves to risk. Operating on highways, at various hazardous incidents and just going to work everyday in a crap neighborhood. Take for example the gents down at Battalion 55 in south Bronx. Several of their members were chatting outside the station when gunfire erupted right in front of them. There was no anger towards EMS, but the average jackass slinging led in the Bronx isn't to concerned with collateral damage. To their credit before securing themselves inside their facility they managed to get the lone civilian casualty inside. Luckily everyone was ok and the civilian was stable. Would anyone on this forum have left that patient outside the front door or not gone back to work the next day? All emergency services workers take on a certain level of risk to help others and will continue to do. These risks have resulted in countless lives saved.