When I first started in EMS back in the late 1970s there were dangers on the job. Patients were sometimes violent due to alcohol, other drugs, psychiatric problems, or just because they were violent assholes.

Back then most of the EMTs and paramedics were men, some were used to fighting, some were veterans who had hand to hand combat training. Most of us were in our early to mid 20s and in reasonable shape. After all, we needed some amount of strength to carry patients down and up stairs, lift the stretchers in and our of ambulances, and perform other tasks.

We had police on scene for calls with active or potential violence, in dangerous areas, and any other call the dispatchers thought needed police. Also, it was only a few years from when the police were the emergency ambulance in Sort of Big City. As a result, the police liked EMS workers because we had taken over one of the jobs that they hated more than just about any other that they did.

We were also allowed, although not encouraged, to defend ourselves from violence by patients or others on scene. Sometimes family members were mad because they thought we moved too slowly or took to long to get there, leave, or “do something.”

It was very rare for a patient to have a handgun, which was fortunate. It was NOT rare for people to be armed with knives of various types. Homeless people seemed to favor steak knives for some reason but “Buck Knives” and other types were not uncommon. At one time during particularly difficult negotiations with our municipal employer the union officers put together a “knife board” that displayed various weapons that we had removed from patients. That did not go over well with management, but we made our point.

Unlike other systems, ours actively discouraged family members from riding the patient compartment unless the patient was a smaller child or there was some other reason that it was beneficial to have a family member or friend ride in the back.

It was not unusual to restrain patients in the back of the ambulance or even on scene before we put them in the ambulance. We were allowed to use handcuffs and even received sporadic training in their application. We also had different types of “soft” restraints to use.

If a crew called for immediate assistance not only would the police come, but the next nearest ambulance would also respond. Sometimes more than one additional ambulance would respond. And a supervisor as well if one was available.

Things changed over the years. First, we were told that we had to limit or avoid physically stopping patients from attacking us. One boss suggested that providers jump out of ambulances if a patient or other person started to be violent.

Okay, then.

A few years after I retired, handcuffs were forbidden by management. We were still allowed to use soft restraints and ALS crews could use chemical restraints. The problem being that mostly patients had to be restrained before medication could be administered.

The composition of EMS providers has also changed. There are more women now, and also smaller statured people of both sexes. In and of itself that’s not a bad thing as long as they can perform the necessary functions. In general, the younger generation doesn’t fight as much as that sort of thing is discouraged. “Use your words, not your hands.” seems to be a common refrain.

Which, after 554 words brings me to today’s story. Which actually happened last month, but is still current.

NYC EMS worker was trying to calm patient before he screamed ‘f–k you’ and stabbed her: prosecutors

The EMS worker stabbed by a disturbed man last month was just trying to calm him down before he yelled, “F–k you!” whipped out a kitchen knife from his boot and attacked, Manhattan prosecutors said Monday.

I’m not criticizing the young lady because that’s how she was trained. Use “verbal descalation” techniques is the phrase. Which is a fancy way of saying “Use your words…” Only it didn’t work and result in serious injuries to the young EMT.

There is no information here about what went on at the scene or if the police were present. For us way back then it was common to search or ask the police to search a person who was agitated for weapons before we put them in the ambulance. When a person is verbally agitated and threatening, it’s prudent to put them in restraints and have a police officer ride in the back of the ambulance. That’s IF a police officer is on scene. Which from what I’m reading elsewhere is often a problem in NYC because there are not enough police to cover the city and respond to calls.

The alleged assailant stabbed Fatum six times in the chest, thigh and arm with the knife during the July 19 attack.

She suffered “significant” blood loss and nerve damage in her thigh which required two surgeries, authorities said.

Fortunately the young EMT was not murdered by this, shall we say, career criminal.

Oh, and of course he was out on bail at the time of the attack from a previous arrest for carrying a knife also stashed in his sock.

At least this time he is being held and not released back onto the street to try and kill someone else.

If I were to be asked, which I won’t be, I’d add situational awareness and risk assessment to EMS training. What they do now is clearly insufficient.

I recommend reading the entire article and watching the video which is fairly graphic.

I won’t be one bit surprised if this young lady opts to find another career path because she’s definitely not getting paid for the amount of risk she is facing.