INDIANAPOLIS - A woman twice the size and half the age of a 60-year-old paramedic 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 Linda 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 Emergency Medical Services workers: Facing assaults is as much a part of the job as checking a patient's blood pressure.
Since 2015, more than 60 paramedics and emergency medical technicians here have been injured in patient attacks, according to Indianapolis EMS data.
Nearly 80% of workers who responded to the agency's survey said they felt threatened on a medical call.
The National Association of Emergency Medical Technicians hasn't done a similar survey since 2005, when it found that a bit more than half of its members who responded reported that they had been assaulted by a patient. Now the professional organization gives members access to an online tool to anonymously report safety and other problems.
But from 2008 to 2014, the National Institute for Occupational Safety and Health reported that about 2,000 emergency medical services workers every year were the victims of acts so violent that they required hospital treatment. Other research from Drexel University showed that many assaults by patients aren't reported.
Now Indianapolis EMS is determined to do something about the problem.
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-Mc-Kinney 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."
Attacks on paramedics are nothing new. For years, emergency medical 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," said Indianapolis EMS' safety officer Tammy Mabrey. "People feel like they're told, 'It's just part of your job.' "
Some patients confuse EMS workers with police officers and lash out, Hodge-McKinney said. Some are simply drunk and angry.
Other attacks come from heroin overdose patients who quickly re-orient 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, such as 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
She calls herself one of the lucky ones who never has been attacked, even during six years inside an Indianapolis EMS truck before her promotion last year.
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