Boston EMTs Face Attacks, Injuries

One had his nose broken four times. Another was attacked with cinder blocks dropped off the roof of a housing project. Others have been stabbed with drug-filled syringes, chased by dogs, and strafed by gunfire after arriving at crime scenes before the shooting stopped.

Boston's emergency medical technicians, who often run red lights and speed through the opposite lane of traffic to save lives, are trained to confront broken bones and cardiac arrest.

But EMTs, who are responding to more calls each year, often become victims themselves as they face Boston's rampant street violence without the guns, mace, and nightsticks that police officers carry.

Last year, 28 percent of the 193 injuries suffered by city EMTs were the result of violence, a figure that has held constant over the past five years, according to Boston Emergency Medical Services. This year EMTs have been injured in 24 attacks.

Since 1994, four EMTs have left the department as a result of injuries from violence.

Nationally, no one tracks the number of EMTs and paramedics - highly trained EMTs - injured in violence on the job, but the National EMS Memorial Service, a volunteer group in Virginia, said 30 EMTs have died because of violence since 1993, 14 of them while responding to the terrorist attacks on Sept. 11, 2001.

"Violence isn't something an EMT should have to deal with," said Richard Serino, chief of Boston EMS, who noted that more than half of last year's total number of injuries left his employees out of work for a day or more. "One EMT injured as a result of an assault is too many."

Last fiscal year, the city's 333 EMTs responded to 99,266 calls and made a record 68,943 trips to hospitals- an increase of about 5,000 since 2002 - without a significant change in staff.

Many EMTs said they are overworked and undertrained for what they confront. They said they are increasingly sent to calls that in the past may have been answered by the police - such as a report of a "man down" or someone drunk in the street - and too often must work without police assistance to subdue hostile patients or others interfering with their care.

When they encounter trouble, they have only a radio to call for help and handcuffs to restrain the attacker. Their radios, they say, aren't much help, because they can't call police directly; they must wait for an EMS dispatcher to e-mail police dispatchers.

James Orsino, who has suffered a broken nose four times during his 23 years as a city EMT, said he has dodged bullets after being caught in the crossfire and been punched more times than he can remember. Like other EMTs, he has also been injured by people not willing to accept his help; he once tore his rotator cuff in a struggle with a man trying to jump off the Massachusetts Avenue Bridge.

"We're in a time when there's a lot more going on in the street, and you can feel it," said Orsino, president of the EMS division of the Boston Police Patrolmen's Association. "With everyone's resources stretched thin, we often arrive on the scene before police. Those are classic cases to get hurt on."

Boston EMS, overseen by the Boston Public Health Commission, dispatches teams of two medical technicians from an office adjacent to police dispatchers at police headquarters. When a 911 call comes in, an operator determines whether to transfer the caller to a specially trained EMT dispatcher.

The department, which has a $37 million budget this fiscal year, offers EMTs the opportunity to take a two-hour self-defense class, but Orsino and others contend it's not enough. He said the city should require EMTs to be certified annually in self-defense, as they are for defensive driving and CPR. He said the department should also outline standard procedures for how to deal with violent patients.

EMTs also worry about fighting back for liability reasons, he said, which is why they don't carry mace.