More Reaction to Our Show on Violence Against Paramedics

We've had an overwhelmingly positive response to last week's WCBA show on violence against paramedics. Before we focus on Saturday's show, I wanted to share some of your many emails.

"My son almost became a paramedic a few years ago, and, after listening to your show, I'm glad he didn't. To be expected to rush into a situation that is obviously dangerous to your own safety is not part of many job descriptions.
I may have missed this point by coming into the program partway, but I thought it was worth mentioning just in case. Something my son told me is that many paramedics travel solo nowadays which I would hazard a guess at being a "cost-cutting measure". To hear everything your program put forth about venturing into situations that were unknown, and, possibly dangerous to themselves, underscores even greater reason for a solo paramedic to "wait for backup". Thank you for bringing this dilemma to light for the average Canadian. Keep up the good work! From: Gabrielle Garcia, Toronto.

Hello Dr. Brian: Greetings from your fan club in Halifax and Dalhousie! Just heard the show on "Violence and Paramedics" with your interview with Vince Savoia, a good friend and colleague. You struck the issues squarely on target again- how do you do that!- balancing the reality of 'the streets' with the ethical demands of providing health care. Much of my career has been spent trying to convince administrators, political colleagues (yes, I WAS one of those once), other physicians (of various specialty persuasions) and 'da public' of the unique nature of delivering medical care in the uncertain environment of the streets, homes, ditches and such which EHS personnel are required to do. From Ron Stewart, MD, Halifax, NS.

Dr. Goldman, just wanted to take a moment to thank you for your broadcast relating to Paramedic safety and staging. You finally gave us a voice. I felt a huge sense of relief listening to your interviews. This is an issue we have wanted to be addressed for years! Well done. On a related note, safety for hospital staff is becoming an increasing concern. I hope that whatever happens for paramedics in the future, as a result of the Jim Hearst incident, has some positive safety aspects for them as well. Thank you again. I have sent this podcast to everyone I know. From: Ryan Willis, TEMS, Ajax, Ontario.

Dear Dr. Goldman (and staff of WCBA): Thank-you. Thank-you! Thank-you for this week's episode! As a Primary Care Paramedic in Ontario I have been following the issue of staging and of essential service designation closely. Obviously the case in Toronto in June was tragic and I appreciate the way your dove past that specific case to shed some light on the larger issues. Your coverage was fair, balanced and perfectly demonstrated just how gray an area Paramedics operate in, stuck between the conflicting worlds of public safety and health care. I've been a great fan of the show since day one and hope to continue to listen for years to come. Perhaps in the future the next time you do a show on Paramedics, it will be to highlight some of the good things going on in the world of EMS. Until then, keep up the great work. From: Matt Harris, PCP, Peterborough, Ontario.

Hi Doctor Goldman: My name is Gonzo Rocha, and I have been a paramedic (acp) for 17 yrs. I started my career in Texas in 1992. I can honestly say the frequency of violence against paramedics has increased since I started my career. what is even more frightening is way that some of these attacks are being carried out. At times I feel that some of these attackers are just purposely just targeting the most vulnerable of the emergeny community. I guess they figure that if they can not do this with police due to the fact that they carry weapons and well the fire departmeny always show up with at least four to five guys. EMS only shows up with only two medics and have absolutely no weapons and we carry drugs, which sometimes makes us a target. Unfortunately the MOH and the employers do not see our concern for our safety, at our recent cme day with the region that I am employed with our director advised us his priorty was not the medics of the region but rather the people that live in the region and that we service. For years I always thought that my safety was the priority but I guess after the recent events in Toronto that has now changed. I have in the past been dispatched to many 911 unknowns, on one occasion I was chased by a very depressed man with a pair of scissors in his hands, I was able to see him coming at me so I was able to get back to the truck before he was able to hurt me. several times I asked for the police, but like always it seems you are not a priority. It took police 20 minutes befor they showed up to the the location. I was vey upset that they took that long knowing my life was in danger. I confronted my mangement about this particular incident and their respond to me was " you just had to wait your turn ". It's comforting to know that the place you give a 110% everyday does not care about the safety of my life. I just want to say thanks for bringing this issue to light.Perhaps someday the MOH will make some changes that will take inconsideration my safety. From: Gonzo Rocha, Bowmanville,Ontario.

I listened with interest yesterday to your program on violence in the workplace against paramedics. In British Columbia, not only do paramedics face this same threat, but they face a government who refuses to sit down with them and hammer out a contract. Paramedics have been on strike for over 6 months and are getting nowhere in their negotiations. With the Olympics looming, we all know that the paramedics will be asked to play an important role. But their importance doesn't seem to be on the radar of the premier and the government in Victoria. Paramedics need a contract and they, at least, need parity with police and firefighters. From: Linda Forsythe, Gibsons, BC.

Dr. Goldman, WCBA is a great show. Good demystifying. Staging may protect paramedics, but it not only can cost patients' lives, it wastes resources by making paramedics wait, idle. If done on the basis of "neighbourhood", it can also be race or class discrimination. At the end of today's program, one paramedic mentioned that they might be confused with police because of their uniform. I presume because the uniform is a dark colour. Why don't paramedics wear white? (Including white knife-proof vests if advisable.) Yes, it would show the dirt and blood (police uniforms are dark blue so that spilled blood looks black), and they would have to change often, but white uniforms would 1.) reduce the dangers of infection crossing between calls; and 2.) immediately identify medics as health care personnel, not threats. From: Tom Trottier, Ottawa.

Hi Dr. Goldman: Thanks for the continued good work and particularly the latest show on paramedics. The first responders (police, fire, ambulance) almost always share a common goal, keeping each other safe and taking care of victims/patients. While staging may sound callous responder safety must be paramount not only for moral reasons but to ensure the response be concluded as efficiently as possible. As a rule of thumb any injured person requires three to five rescuers to conduct the response. If a responder is injured an additional 5 rescuers may be required to deal with the situation. These responders may not be available or may have to be pulled from another lower priority response. One item you should be aware of is limited or non-existent communications between responding agencies. Most first responding agencies (police, fire, ambulance) have limited or no ability to communicate directly with responders from other agencies. Introduction of the Incident Command System was supposed to rectify this but a variety of systemic problems have hindered a timely solution. In most cases if a responder from one agency wants to contact another responder from another agency they have to relay messages through several dispatchers. What a recipe for disaster. From: Doug MacLeod, Keremos, BC.

Dr. Goldman: An interviewee on your excellent program on the violence paramedics face in their workplace stated that they aren't an essential service like police and fire departments. For your information, the BC Ambulance Service, a division of the Ministry of Health of the BC Government, and the BC Labor Relations Board consider paramedics in BC to be an essential service. Almost everything BC Ambulance paramedics do is included in an Essential Services Order by the LRB since BCAS paramedics have been on strike beginning over six months ago. From: R. Southcott. Powell River BC.

Hi Dr. Goldman: Just listened to your podcast and would like to say I really enjoyed it. It is nice to see a medical professional take an initiative into the dangers of being a paramedic. I do not believe that the majority of Canadians realize how dangerous the job can be. I hope programs such as this one bring light onto this dangerous matter. From: Scott Martin, Paramedic.

Hey Brian: I liked your show on risks to paramedics on the job. I am a paramedic in BC. I would have liked you to briefly talk about the fact that BC paramedics are currently on strike for a variety of issues including working conditions. Our employer(BC Ambulance Service) denies that we have a dangerous job even though worksafeBC (WCB) did a survey finding paramedics have a 1 in 7 chance of getting hurt on the job. Otherwise good show.
From: Orion Farley, Nelson BC.

Thanks to all of you for your feedback.

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