Expecting the unexpected: A mixed methods study of violence to EMS responders in an urban fire department

Background Struck by injuries experienced by females were observed to be higher compared to males in an urban fire department. The disparity was investigated while gaining a grounded understanding of EMS responder experiences from patient-initiated violence. Methods A convergent parallel mixed methods design was employed. Using a linked injury dataset, patient-initiated violence estimates were calculated comparing genders. Semi-structured interviews and a focus group were conducted with injured EMS responders. Results Paramedics had significantly higher odds for patient-initiated violence injuries than firefighters (OR 14.4, 95%CI: 9.2-22.2, P<0.001). Females reported increased odds of patient-initiated violence injuries compared to males (OR=6.25, 95%CI 3.8-10.2), but this relationship was entirely mediated through occupation (AOR=1.64, 95%CI 0.94-2.85). Qualitative data illuminated the impact of patient-initiated violence and highlighted important organizational opportunities for intervention. Conclusions Mixed methods greatly enhanced the assessment of EMS responder patient-initiated violence prevention. Am. J. Ind. Med. 59:150-163, 2016. (c) 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.