EMS LEGAL TIPS & ADVICE
Legal considerations for violence against EMS providers
By Douglas M. Wolfberg, Esq.
The hazards that come from everyday EMS operations are inherent in the job, but then one must confront the
added risks of terrorism, biological or chemical attacks, patient assaults or random acts of
violence directed against EMS personnel who
are merely going about their jobs. Fortunately,
the overall incidence of serious or deadly force
violence against EMS providers is
Although EMS agencies can’t guard
against every threat of violence their
personnel may encounter, they should
ensure that their employees have the
basic tools they need to address. This
starts with an assessment of all reasonably foreseeable risks.
Agencies in some areas make body
armor available to their personnel,
while other agencies have determined
that this precaution is unwarranted.
There are no fixed rules as to what
an EMS agency’s legal obligations
may be in this regard. If your state’s
EMS regulatory agency mandates the use of
certain protective equipment, then your agency
would be obligated to comply. As of this writing, we’re not aware of any state EMS agency
that requires body armor be issued to their
EMS agencies should ensure that their personnel receive adequate training to address reasonably foreseeable threats of violence they may
encounter on the job. This would include basic
scene size-up and safety, positioning themselves
and their vehicle for maximum protection,
situational awareness, coordination with law
enforcement agencies and other precautions.
Some agencies participate in tactical teams
and provide their personnel with detailed training in tactical EMS operations during violent
incidents, but that’s typically in furtherance
of the development of a specific tactical EMS
team and not training that’s made available to
rank-and-file EMS providers.
EMS agencies should ensure that their personnel also receive basic training in self-defense.
It’s important to remember that “self-defense”
in the practice of EMS may differ from traditional self-defense techniques of martial arts
or weaponry. Specifically, while in our personal
lives we have a right to keep a firearm in our
homes and, in many cases, use deadly force to
protect ourselves from bodily harm, the right
of self-defense is different in the context of
providing healthcare services.
The conduct of an EMS provider is measured by applicable standards of care. The standard of care is not, “How would a jujitsu-trained
EMT have handled the situation?” The relevant question in court would be, “How would
a reasonably prudent EMT (or paramedic)
have acted under similar circumstances?” EMS
standards of care address how to deal with violent patients.
Instead of self-defense with a weapon or
martial arts skills, EMS providers would be
expected to exercise self-defense techniques
consistent with EMS standards of care. This
means techniques such as verbal de-escalation,
retreat, physical restraint or chemical restraint
all might be seen as reasonable conduct. Some
protocols may require consultation with online
medical command, while others may require the
involvement of law enforcement.
Generally, these standards of care or pro-
tocols call for a clinical and/or oper-
ational approach to the management
of violent threats and the use of weap-
ons (which most states prohibit EMS
personnel from carrying).
Specialized police or martial arts
training would ordinarily not figure
in. An EMT might be a skilled former
high school wrestler, but that wouldn’t
mean that the standard of care permits
him or her to put a violent patient in
Provider self-defense in violent situations must be accomplished only with
equipment, supplies and medications
that are called for in the EMS environment. Your state likely has a list of required
items that must be carried in an EMS unit.
Most EMS-required equipment and supply
lists include the necessary tools to permit providers to safely manage violent patients when
the need arises. JEMS
Douglas M. Wolfberg, Esq., is an EMS attor-
ney and founding partner of Page, Wolfberg
& Wirth, which represents EMS agencies
throughout the United States. A former EMT,
Pro Bono is written by the attorneys
at Page, Wolfberg & Wirth, The
National EMS Industry Law Firm. Visit
the firm’s website at www.pwwemslaw.com or find them on
Facebook, Twitter or LinkedIn.
An EMT might be a
skilled former high school
wrestler, but that wouldn’t
mean that the standard
of care permits him
or her to put a violent
patient in a headlock.