Paramedics move a stretcher out of an ambulance in Toronto on Dec. 19.
Anecdotes of abuse and threats against paramedics abound. They've been punched and kicked by patients, sworn at and spat on.
The violence got so bad in Calgary a few years ago, the city's then-chief of emergency medical services, Tom Sampson, pleaded with the public to stop the attacks: Paramedics are there to care for the sick and wounded, but not at their peril, he warned.
Until now, there has been scant Canadian research to back up the anecdotes. But a new survey of 1,381 paramedics in Ontario and Nova Scotia suggests violence committed by patients, their families, bystanders or colleagues of emergency responders is widespread.
The study, whose initial findings are being published in the January issue of Prehospital Emergency Care journal, found that slightly more than two-thirds of paramedics experienced verbal abuse within the previous 12 months, most often from patients and their families or friends. Nearly 42 per cent of paramedics reported facing intimidation, while about one-quarter said they've been physically abused.
Sexual harassment and sex assault were also identified as problems, although these incidents occurred less often, at 14 per cent and 3 per cent respectively.
The results of the survey, conducted between January and June of this year, were a "shocker," said lead investigator Blair Bigham, an associate scientist with Rescu, a research group based at St. Michael's Hospital in Toronto.
"I wasn't surprised that paramedics experience violence in the field, but I was very surprised at how many are reporting that violence," said Mr. Bigham, who is also an advanced care flight paramedic for York Region EMS and Ornge. "When you span that out over a 20- or 30-year career, we're looking at a lot of [violent]events happening with these paramedics."
The Canadian findings follow similar studies done in the United States, Australia and Sweden. In Australia, the number of paramedics verbally abused was higher than here, at 82 per cent. More of them also reported being intimidated (55 per cent) and physically abused (38 per cent).
A clearer understanding of the circumstances behind the attacks is needed, Mr. Bigham said. Over the next few years, he and his research partners plan to dig deeper and assess what effect the violence is having on emergency responders. They also want to look at measures that could reduce the abuse and make the job safer.
"There's not a lot of documentation about these violent events. Paramedics pretty much treat this as just part of the job and they don't talk about it. They don't report it," Mr. Bigham said. "We'd like to better understand the long-term impacts on their psychological health and their family life."
Equipment and training geared toward protecting paramedics vary widely in Canada. In Alberta, emergency medical workers receive self-defence training after they're hired. Protective vests are offered to any worker who wants one, said Darren Sandbeck, an executive director of emergency medical services with Alberta Health Services.
These vests aren't offered in Toronto. Paramedics have to pay for one themselves, which is what Geoff MacBride did after responding in 2005 to the Boxing Day shooting of Toronto teen Jane Creba. He feels safer wearing it, but the vest doesn't prevent attacks, of course.
"As a paramedic in the city for the last seven years, I have unfortunately been assaulted many times myself, as have I'm certain every one of my colleagues," said Mr. MacBride, president of Toronto Paramedic Association.
Mr. MacBride was most recently attacked on Halloween, punched in the throat by a patient who was drunk and required rescuing after he fell off a boat and into Lake Ontario. As paramedics carried the young man across a gangplank, he regained consciousness and started swinging his fists. Mr. MacBride was nearly knocked into the water.
In this case, little could have been done to change the outcome aside from restraining the patient before moving him.
"Because of the severity of the patent's condition, expeditious transport was necessary," Mr. MacBride said. "It was quite unexpected, but that's our job, unfortunately."
Training for the expected and unexpected is part of ongoing instruction given to paramedics in Toronto, said Arthur Graham, a commander with Toronto EMS. The city's paramedics are among the busiest in the country, he noted. And when an emergency call appears too dangerous, they, like their counterparts, have the option to wait for police to help ensure they stay safe.