EMS is a dangerous thing to do.

Recently in Pennsylvania, an ambulance was dispatched to a behavioral health facility for a man refusing to return to the facility. EMS was talking to the patient to convince him to return to the facility. The patient, who had a knife in his hand, attempted to kill the EMT by slashing him across the chest. In the patient’s mind, EMS was “out to get him.”

The police later discovered two more knives in his pocket. The ballistic vest he wore saved that EMT from significant physical injury.

After the incident, there were numerous pro and con posts on my social media feeds about ballistic vests in EMS. “What ballistic vest stops a knife” posted one individual. Another posted, “Sure, let’s wear a 30-pound vest, carry all the equipment and patient.” And a sympathetic poster blamed the EMT for being in the situation in the first place “Hahahaha that’s his fault to begin with.  Never should have made contact before police arrived.”

An article written by JEMS Editor AJ Heightman states EMS workers have a six-fold greater chance of being injured on the job compared to all workers in the US and are twice as likely to be fatally injured than the nationwide occupational average. This shouldn’t surprise anyone. We wrestle with patients. Patients punch, bite, spit on us. They kick, slap, and yell. We have things thrown at us. People dangerously tailgate our ambulances. Pass them. Run red lights to place their cars in front of our ambulance and generally fail to give due regard for our lives and well-being.

Given all that, why wouldn’t you wear a ballistic vest?

Ballistic vests protect you against so much more than bullets. A friend rolled his police cruiser years ago. His vest prevented his ribs from smashing into little bits, ultimately saving his life.

Ballistic vests alone won’t keep you from harm. I dislike and mock the National Registry inspired expression, “Scene Safety / BSI.” We practice based upon how we train and I fear we are emphasizing the words alone. Practicing defensive medicine has a literal meaning for EMS. We need to be vigilant in our anticipation that something bad or violent will occur on every call. K2 and other mind-altering substances make our patients unpredictable and emotionally labile; however, a low blood sugar, postictal states, psychosis, neurosis and diseases like Alzheimer’s can make a patient just as dangerous.  It is the violence we don’t anticipate that poses the most danger.

What do you do to keep yourself safe and maximize your chances of returning home to your friends and family?

Carl Homa, RN, MBA, NRP