Defensive training to deal with abuse now part of job.
INDIANAPOLIS, IN – A woman twice the size and half the age of paramedic Linda Hodge-McKinney, 60, struck out with a fist during a medical run. The woman — screaming and crying, refusing to answer questions — then threw a heavy box of medical supplies and lunged from the ambulance bed at Hodge-McKinney, who was trying to help her.
That 2013 attack, the worst of Hodge-McKinney’s career, is part of a bruising reality confronting Indianapolis EMS ambulance workers: Facing assaults is as much a part of the job as checking a patient’s blood pressure.
Since 2015, more than 60 Indianapolis paramedics and EMTs have been injured by patient attacks, according to Indianapolis EMS data. Nearly 80 percent of workers who responded to an agency survey said they felt threatened on a medical call.
Now Indianapolis EMS is determined to do something about it.
A recent review of workplace injuries is leading to changes that range from lighter medical kits to policies governing the handling of firearms found on patients. Boxes will be mounted in each ambulance to secure guns found during an ambulance ride.
But officials say the most transformative change is training. Paramedics like Hodge-McKinney now receive instruction to prevent or escape assaults, and they welcome the change.
“It was like a big weight was lifted from my shoulders,” Hodge-McKinney said. “That class was a godsend.”
Hodge-McKinney, the “little girl from Brownsburg” who became a paramedic to help those in need, was not prepared for the 2013 attack.
First responders with the fire department had left the young woman in the back of the ambulance with Hodge-McKinney and her former medical partner, whom she described as a “little guy.”
After the woman lunged at Hodge-McKinney, the two wrestled across the ambulance bed, which collapsed to the floor. Hodge-McKinney pinned the woman and was able to call police on her radio. But the woman started ripping outhandfuls of Hodge-McKinney’s hair. She and her partner were able to control the woman, temporarily.
Then a police officer showed up and shouted warnings through the open side door of the ambulance, she said. The officer pulled out a stun gun. Hodge-McKinney and her partner, afraid of being stunned, let go.
The woman leapt through the door and landed on the officer, throwing Hodge-McKinney in the process. Eventually the officer used the stun gun to end the episode, though the threats continued.
After getting checked out, Hodge-McKinney went back to work that day, wearing several bruises, head pounding.
“I don’t know. I do not know what the deal was with her. No idea,” said Hodge-McKinney, a grandmother who has worked in the Garfield Park area for the bulk of her 30-plus-year career.
She’s been bruised by her patients more than once. It’s rarely clear why.
Attacks on paramedics are nothing new. For years, EMS workers were expected to take their punches and then move on to the next scene — a “dirty little secret” of the job, as one paramedic put it.
“You start to feel like nobody cares,” Indianapolis EMS Safety Officer Tammy Mabrey said. “People feel like they’re told it’s just part of your job.”
Some assaults make headlines. A man attacked two Detroit EMTs with a box cutter in 2015, leaving one with paralysis on part of her face. Last month, a New York EMT was killed after being hit by his stolen ambulance.
Indianapolis hasn’t experienced an attack of that magnitude since the 1990s, when a medic was shot and later recovered. Most assaults escape notice: biting or spitting, slapping or scratching, punching or kicking.
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Some patients confuse EMS workers for the police and lash out, Hodge-McKinney said. Some are simply drunk and angry.
Other attacks come from heroin overdose patients who quickly reorient themselves after receiving a dose of naloxone, a medication that creates rapid withdrawal while saving patients’ lives. “They come up swinging,” Hodge-McKinney said.
Synthetic hallucinogens, like Spice or Wet, can be particularly troublesome. Sometimes those patients abruptly become aggressive during an ambulance ride to the hospital.
“This is not the pot your grandparents smoked in the ’60s or ’70s,” said Jessica McGinn, an Indianapolis EMS lieutenant whose district covers much of the south side, including Garfield Park. She calls herself one of the lucky oneswho has never been attacked, even during the six years inside an Indianapolis EMS truck before her promotion last year.
“The drugs now are such a nasty concoction of chemicals that do just incredibly weird things to your brain,” she said.
Ryan Marcoux, Hodge-Mc-Kinney’s new medical partner, pointed to a recent example. The 6-foot-8 EMT needed help from nine others to control a man reacting violently to Spice. The man kicked Marcoux in the face, breaking his glasses.
Marcoux, who has a 5-monthold child at home, was attacked twice that week.
Mabrey, who moved into her safety officer role in 2013, grew concerned while reviewing injury reports. The rate of assaults seemed higher than she expected, and she knew what kind of effect that could have if left unaddressed.
She gathered a small group of EMTs and paramedics to research how to fix the problem.They considered changing their uniform colors (so as not to share the navy blue of Indianapolis Metropolitan Police officers), and adding ballistic vests. But they decided that learning defensive tactics was what they needed most.
The command staff supported the safety initiative.
Workers learned how to calm down hostile patients in a nonthreatening way, and how to deflect blows, evade grapples and escape grips should the situation call for it. They also received situational awareness training, so they can identify potential cover if a patient at an emergency scene decides to draw a gun.
A year ago, Hodge-McKinney and 19 others went through a five-day course to become trainers. By the end of 2016, they trained every EMT and paramedic.
Hodge-McKinney now knows the techniques necessary to stay safe if she faces another assault. And workers say they feel Indianapolis EMS leadership has their backs.
One tactic she learned could have prevented the attack in 2013: Don’t allow a hostile patient into the confines of the ambulance until he or she has calmed down.
“I am not making you go. I am not the police,” Hodge-Mc-Kinney said. “We can do that now.”
✭Call IndyStar reporter Ryan Martin at (317) 444-6294. Follow him on Twitter: @ryanmartin and on Facebook.
“You start to feel like nobody cares. People feel like they’re told it’s just part of your job.”