Aggression and violence against staff of ambulance services

Introduction

Aggression and violence in the workplace have increasingly become topical for various professions in the past years. Studies, however, are mostly published for the areas of psychiatry and education. The first part of the study investigates the question of how emergency services in general deal with aggressive assaults against their staff. In the second part, the monitoring system for aggression incidents of the Vienna Ambulance Service will be presented and evaluated.

Methods

By the means of an email questionnaire, 35 emergency medical services and EMS training facilities were interrogated about their procedures in case of aggression incidents. The monitoring system of the Vienna Ambulance Service, which is based on the SOAS-R questionnaire, was statistically evaluated.

Results

Emergency medical services survey: 21 of the 35 included organizations returned the questionnaire with usable answers. For 80% of the responding organizations, aggression against their staff is an issue; 50% installed a staff reporting system and 58% offer de-escalation courses to their staff. Vienna Ambulance Service: during the analysis period of 2 years, 203 aggressive and/or violent assaults were reported within the Vienna Ambulance Service. In relation to the total number of 268,528 treated patients, the rate of incident is 0.08%. Males committed, with 71.7%, most of these aggressions. With regard to diagnoses, the diagnostic group of alcohol-related incidents was most frequent with 59 cases. Most events took place on weekends and in the evening hours. Verbal aggression was with 86.2% predominant; however, more than 20% of the incidents lead to physical injuries of the medical personnel.

Conclusions

Aggression against emergency medical service staff is brought up for discussion in many organizations. Despite several approaches in different states of development, standardized reporting systems are the exception. The aggression incident reporting formula of the Vienna Ambulance Service was proved to be practical for recording aggression events as well as for evaluation of de-escalation education. The study showed that aggression is a serious problem in emergency medical services and appropriate precautions need to be institutionalized.