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Patient and Bystander Aggression: EMS Safety Talk

Many factors play into emergency medical service provider safety. One of those factors is dealing with aggression from the patient or anyone else on the scene. Patients can be under the influence or unable to think clearly and tension can be high during emergencies.  We will look at some areas to keep in mind.

Law Enforcement:

  • When arriving on the scene, always assess the need for law enforcement’s presence
  • Keep calm and scan for any weapons, anxious patients, or bystanders that are agitated
  • If law enforcement is needed, follow company policy for notifying authorities (do not alert the patient to this)

Verbal Communication:

  • When needed, practice verbal de-escalation techniques
  • Give the patient and anyone else on the scene the necessary space to calm down
  • Keep hands open and avoid prolonged direct eye contact with aggressive people
  • Avoid arguing and keep your voice low and calm
  • Explain the steps being taken and why

Control and Restraint:

  • Always avoid physical restraint and leave that to law enforcement
  • Place equipment and supplies in the truck out of reach to patients, in cabinets or drawers
  • Consider placing all patients in a harness or five-point seat belt to restrict movement
  • Constantly monitor for signs of aggression which could include:
    • Sudden movements
    • Tense posture and tight muscles
    • Threatening stare or facial twitching
    • Darting eye movement
    • Raising voice
    • Rapid and heavy breathing
    • Hands in fists

Remember to first, and foremost, always provide the best medical care possible and treat the patient as you would want a loved one to be treated. Acting with compassion and understanding can go a long way in preventing a situation from escalating.


This article is provided solely as a reference tool to be used for information purposes only. The information in this article shall not be construed or interpreted as providing legal or any other advice. The information material does not amend the provisions of any insurance policy issued by CompSource Mutual. It is not a representation that coverage does or does not exist for any particular claim or loss under any such policy. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy provisions, and any applicable law.

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