Personal Safety of Paramedics Responding to Emergency Calls

Introduction

South African paramedics are without a doubt some of the best in the world. This is not only as a result of training in line with the best international standards but also through their exposure to and experience in dealing with a vast range of emergencies.

Our first responders are well equipped to provide the life-saving emergency response at the scene of road crashes and other trauma.

Unfortunately, many of these scenes are also where criminals target our first responders and threaten their personal safety.

In this section, we would like to share some insights from our first responders to create more awareness on the challenges to their safety they encounter daily! We approached some of our emergency services with the following Q&A:

Do you believe there has been an increased threat recently to the safety of our first responders?

"Over the past 7 years, I have been held hostage, attempted stabbed, attempted hijacked and had my ambulance broken into several times…"  says a paramedic.

• Unfortunately, many of other first responders have also experienced a rise in the number of attacks on their personal safety!
• Sadly, our first responders are soft targets due to the areas they travel to, at all hours of the day and night.
• Paramedics have in recent times heard of many of their colleagues who have been hijacked or killed for no specific reason.
• Reportedly a Paramedic was shot and killed no longer than a week ago in Gauteng. 

What is the nature of these threats to personal safety at the scene responded to? How is this perpetrated?

• Criminals perpetrating these acts are often intoxicated violent individuals, armed suspects and other criminals viewing paramedics as soft targets.
• The nature of these attacks, we believe, is mostly to gain access to the equipment that the first responders carry.
• This would include some of the medical equipment as well as scheduled medication.
• The first responders also carry personal items, including cellphones, wallets and various electronic devices.

Are there specific high- risk areas that EMS services have identified? Do different services in areas share communication and alert some of these threats with other services as well?

• The attacks can occur in any area and at any time. Each and every call has a risk.
• ER24 has found that these crimes commonly occur in the rural areas where there is limited street lighting and the areas are rather secluded.
• ER24 works with various other private and government services. Should one of these attacks occur, we do alert the relevant authorities as well as liaising with the other emergency services.
• Night time is the is the highest risk time, as with most other criminal activities.
• Also, the nature of work and the areas where first responders need to respond to places them at risk. i.e. we going to an area, where someone has already been shot or stabbed.
• There is an increase in communication between EMS, police and respective individuals and organisations, especially at an informal level, with the use of social media groups/ forums.
• Some areas have been highlighted by EMS services as "Red Zones".
• In KZN Kwa Mashu A section is an incredibly high- risk area as well as Umlazi having some high- risk zones.  

Do paramedics in specific areas work together with law enforcement/ police services to escort them to the scene of an emergency response?

• ER24 paramedics do work with various security services and local authorities.
• The most important thing is to call and request a SAPS escort when needed.
• These services are sometimes able to assist or escort EMS services to dangerous situations and locations.
• Unfortunately, they may not always be available due to other responsibilities.

Would the nature of the reported incidents i.e. gang violence, shooting incident or road crash etc. raise specific alarms for those having to respond?

• Absolutely. In violent or dangerous scenarios, we would ask the assistance of local authorities and security forces. Unfortunately, these services are not always able to assist us.
• We can also not refuse to service the emergency just because we feel that it may be an unsafe situation.
• From day one in our training, we are taught about safety, so safety is always on our minds.
• The different dangers from different scenes are always being rehearsed mentally, allowing us to prepare for them and to be weary to the warning signs.
• Obviously, any crime scene is approached with caution. Paramedics need to know if the threat is still in progress or not.
• Motor vehicle accidents are quite common to the operational paramedic. When you receive a call in the nature of gang violence then you need Police to attend to the call for the safety of the Paramedics.

Are there any regulations/ legislation with regards to paramedics being armed? Do you think they should?

• This is a very contentious issue, in South Africa and the world, with several aspects to look at.
• There are no regulations as yet regarding paramedics carrying firearms whilst on duty.
• A major safety risk is that the patient or one of the bystanders could easily disarm the paramedic busy attending to the patient.
• Many of the EMS services have an internal policy with regards to carrying dangerous weapons or internal rules prohibiting concealed carry of weapons.
• Here are some of the issues, without coming to a conclusion on the matter:

- There are several aspects of legislation (i.e. hospital and government buildings that are gun free zones) that would affect paramedics who carry a gun, but as far as I known there none that specifically prevents them, it would be more the ethical imprecations thereof that could come into effect.

- Traditionally paramedics are taught that if you needing a gun, you as a paramedic shouldn’t be there and should move to a place of safety

- As paramedics we need to be seen as a neutral party/agency, treating victims injuries irrespective of their injuries and or criminal or social standing. 

-.Carrying a firearm could be seen by criminals as changing this neutral status

- Also, as paramedics, we are not supposed to be engaged in law enforcement activates, while on duty as paramedics.

- If it is known that paramedics are carrying guns it could also make us soft and or unsuspecting targets for criminals wanting to steal the firearms.

• Many paramedic teams are now training in TEMS or tactical EMS where there is a combined law enforcement response and EMS response.
• In such an instance we refer to is a “Hot scene” and the tactical cover is provided while paramedics start treatment and remove the patient to a safe area. The paramedic can concentrate on the patient and the law enforcement on providing safety/cover.

Do you believe that paramedics should receive training in self-defense and how to protect themselves?

• ER24 has created a self-defence course which teaches paramedics various skills.
• These skills may include dealing with dangerous situations to general self-defence.
• Most first responders agree that every emergency worker should have some sort of self-defense experience. This will teach them how to identify dangerous situations as well as dealing with these situations.
• An example of such a course is TacMed (TEMS) https://youtu.be/1M1EpamsoeU

Are male and female paramedics under the same threat - Should there be measures in place to add additional protection to female responders?

• Both male and female staff are under the same threat in these situations.
• Most female paramedics will tell you they are there to do the same job as the men and do not want to be treated differently based on their gender.
• However, as a male crewmate, you are obviously cognisant of the threat of your crew being sexually assaulted.
• ER24 has attempted to minimise the risk by placing a male and female staff member on the ambulance.
• Unfortunately, many staff members work alone on the response vehicles, whether male or female. Even having a male and female staff member, paramedics are still at risk.

Is there anything paramedics can do during the response at the scene or treatment to be safe?

• With specialised training, paramedics are not only taught how to deal with dangerous situations but also how to identify these situations and when danger may be present.
• Mitigations that are put in place include situational awareness and standard safety precautions.
• First responders/paramedics are also encouraged not to carry large amounts of cash or expensive electronic devices.
• Private ambulance services can add an additional medic on the PRV with the advanced paramedic, or they have to give the paramedics training on self-defence etc.

Can communities and community structures do more to keep our paramedics safe?

• The community can continue with lobbying against criminal behaviour against paramedics and being vocal, like in the past, when it occurs.
• They can also help police with information when an incident occurs. I remember one incident, which our crews were involved with. the community assisted the police and the criminals were arrested minutes after the event due to them providing info to the police.
• Members of the community are urged to report any situations to the local authorities.
• By reporting unsafe situations, this acts as a deterrent to the criminal.
• In addition, people are urged not to purchase any medical equipment or medical stock sold at second-hand shops or from medical companies, pharmacies or people who are not registered to provide such services.

What do you believe should be done to increase the personal safety of our paramedics?

• Paramedics should attend a self-defense course as to protect themselves in a dangerous situation.
• Emergency workers should also judge the situation accordingly and request the help of security services or local authorities, should they feel they are in danger.
• Harsher penalties need to be imposed on offenders who attack medics.
• To increase the personal safety of Paramedics, train the Paramedics on TEMS and continuously communicate the importance of personal safety to them.

Any thoughts you would like to share with the community?

We are there to help you.. stop killing our paramedics and bringing harm to them!

Communities can continue to support paramedics - Their support and encouragement are greatly appreciated.

When you notice a response car in your rear-view mirror, give the emergency vehicle the right of way.

Don’t stop on an accident without the necessary safety equipment. Rather drive by and call for help. Remember to place your own safety first.

Also view:

Safety on the Road when Responding to an Emergency Call

Safe Driving when Hearing Emergency Sirens

Response Time to Road Crashes

Emergency Response Communications

Sharing Roads Safely with Fire Fighters