Violence Prevention and Intervention in Emergency Medical Services Systems

Originally approved April 2019


The American College of Emergency Physicians (ACEP) reaffirms that Emergency Medical Services (EMS) systems provide essential healthcare elements in the health and wellbeing of communities. With innovative, involved physician medical oversight, EMS is capable of serving multiple roles across the spectrum of public health and public safety.

ACEP believes that optimal EMS medical care can only be achieved when patients, EMS professionals, and all other persons in the EMS care environment are protected against violent acts. Such acts constitute a preventable and significant public health problem.

As such, ACEP advocates for specific violence preventions and interventions in EMS, beyond the “awareness level” education that historically has largely constituted EMS violence-related initiatives.

Further, ACEP strongly encourages all states to enact legislation that provides the maximum category of offense and criminal penalty against individuals who consciously commit violence against EMS and all healthcare professionals.

To promote safety and security in the EMS environment, ACEP believes in supporting violence prevention and intervention initiatives that include:

  • Attaining and maintaining an EMS culture of patient and personnel safety, based upon community/system specific risk assessments that include:
    • adequate staffing of professionals on emergency apparatus
    • sufficient training for professionals in violence risk assessment, violence avoidance/de-escalation maneuvers, self-defense tactics, and patient and colleague defense tactics
    • provision, training, and utilization of devices designed as physical barriers against bodily injury
    • provision of other security components deemed essential in collaboration with violence/law enforcement experts
    • periodic assessments to measure compliance and effectiveness of violence-related initiatives
  • Coordinating with applicable law enforcement agencies, to provide rapid response of law enforcement officers to EMS patients and/or EMS professionals in distress related to violence.
  • Developing written operational protocols, with relevant input from EMS professionals, for violent situations occurring in the EMS environment.
  • Developing and enforcing mandatory reporting policies that require EMS professionals to promptly report verbal and/or physical assaults to a clearly defined authority established by applicable law and/or within EMS system policy. Such policies should clearly state that reporting will not result in any adverse action by the EMS system such as termination, threatening to terminate, demoting, suspending, or in any manner discriminating against an EMS professional who reports an assault in good faith.
  • Adopt a zero tolerance policy for violence against EMS professionals, patients, and others in the EMS environment. Educate EMS professionals that any assault is not considered “part of the job.”
  • Provide appropriate post-incident support for EMS professionals involved in violent events including prompt medical treatment, debriefing options, counseling resources, and professional assistance as indicated.
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