More intervention needed to protect paramedics says CQU expert

Australia’s ambulance services should provide more protection, safety training and mental health support to reduce occupational deaths and injuries to its paramedics, according to CQU adjunct professor Dr Brian Maguire.  

Dr Maguire used International Paramedics Day (8 July) to call on the nation’s public health systems to do more to keep their frontline paramedics safe.

According to the 2023 Australian Government Productivity Report into Ambulance Services, during the 2021-22 fiscal year, ambulance services in Australia handled a total of 4,152,014 incidents.

Handling those incidents exposes paramedics to a variety of occupational hazards. In 2014, a landmark paper by Dr Maguire and others, documented that Australian paramedics had the highest rates of occupational fatality and injury compared to all other occupational groups in Australia

“In Australia, 300 cases of serious claims of injury related to assaults, violence, harassment and bullying occurred among ambulance personnel from 2001 to 2014; during that time the annual number of cases of injury secondary to assault tripled from 10 to 30,” Dr Maguire said.

“Preventing occupational injuries and fatalities among paramedics requires a multifaceted approach. The first step is documenting the scope of the problem.

“Just like a paramedic or physician will begin a patient exam by taking a base line set of vital signs, the first step toward preventing occupational risks is to specifically document the risks. That includes not only noting the cases and calculating the rates, but also identifying how risks vary among groups. For example, the risks for women in the ambulance service is different than the risks for men, but little research has been done to determine the reasons for these differences or ways to reduce the risks.”

Dr Maguire said recent studies revealed that most of the paramedic fatalities were transportation related - seven times higher than the national average. Most of the non-fatal injuries were related to lifting and carrying heavy loads, but many cases resulted from falls, vehicle crashes and violence.

“Any successful intervention will come about only after doing pilot studies of potential interventions,” he said.

“For example, there are many possible ways to reduce the risks of violence related injury but each of the possible interventions will have to be tested to document how the intervention reduces risks for all paramedics and for different groups.

“An intervention that reduces the risks for male paramedics might not reduce the risks as much for female paramedics, or one that reduces the risks for 50-year-old paramedics might not work as well for 20-year-old paramedics, or one that works for paramedics working in cities might not be as effective for paramedics in less densely populated areas.”

He added any interventions will only have a chance of being successful if there is support from both the front-line paramedics and the ambulance service managers.

“Only when everyone is committed and working together can there be any hope for significant and long-term success,” he said.

“Multi-faceted interventions include education, engineering, and policy change. Reducing the risks of violence related injury may require, for example, a special education program for paramedics, engineering changes such as the use of new types of protective vests, and policy change that might include, for example, to identify and change the types of calls that should have a police response.”    

He said mental health support for paramedics was vital and should also be a multi-faceted project that is developed, pilot tested, and evaluated prior to large-scale deployment.

Reducing crash-related injuries and death would also require multiple simultaneous interventions, he said.

“They might include new training for paramedics, new safety devices in ambulances, new traffic light management capabilities, public safety messaging for communities, new types of vests for paramedics working on roadsides, and new ways to reduce the speed of vehicles passing paramedics working on busy roads,” he said.

“Finally, the results of any safety initiative must be published. Every ambulance service in Australia has made some effort to improve an aspect of safety for their personnel. However, there is an almost complete lack of published research documenting the outcomes of those projects. Only by publishing the results can other ambulance services learn from the experience and use it to help improve safety for paramedics nationwide and worldwide.

“We depend on paramedics to be there to help us in our most dire moments, we must do more to help mitigate their risks and ensure the safety and well-being of these essential health professionals.”

For more information visit International Paramedics Day.