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External Violence Against Paramedics

Program to promote awareness, advocate for changes, and implement strategies to help prevent violence against paramedics.

In 2019, Peel Regional Paramedic Services launched an External Violence Against Paramedics workgroup. Now a program embedded within the organization, it continues to promote awareness, advocate for change, and implement strategies to help prevent violence against paramedics.

External Violence Against Paramedics is defined by Peel Regional Paramedic Services as violence under these categories:

Other information

Paramedics should not tolerate violence while at work. Peel Regional Paramedic Services has zero tolerance for paramedics being subjected to violence from the public, and any incident of violence happening to one of our employees is unacceptable.

If a paramedic is a victim of violence they are instructed to:

  • Contact police and exit the scene if it is unsafe.
  • Report the incident to their supervisor. They may request their supervisor attend the scene.
  • Ensure the incident is documented.
  • Ask for support. Being subjected to violence can be emotionally impactful and, the effects can be cumulative. Paramedics deserve care.

If a supervisor is alerted of a violent incident:

When alerted of a violent incident and that their presence is required, supervisors will attend the scene, stand up for paramedics and set boundaries with perpetrators of violence.

  • They may contact police.
  • They will provide paramedics with emotional support and ensure they receive medical care if required.
  • They will support and ensure the completion of necessary documentation.

We are committed to providing paramedics with a workplace that is safe, to preventing violence, and to supporting paramedics following all violent incidents. No one should ever be subjected to violence while at work.

  • Zero tolerance signage in ambulances.
  • Personal protective equipment to prevent physical assault, spitting, or striking.
  • Zero Tolerance for Violence from the Public Policy.
  • Development and use of the External Violence Incident Report.
  • Collaboration with Peel Regional Police.
  • Public awareness campaigns.
  • Research and peer-reviewed publishing on the topic of violence in paramedicine.
  • Advocacy for legislative changes to increase protection of paramedics within the Canadian Criminal Code.
  • Conflict avoidance and threat management training for staff.

Between February 1, 2021, and January 31, 2022, 941 external violence incident reports were filed by 377 paramedics.

That means that 48% of our paramedics were exposed to some or multiple forms of violence within the past two years. Despite efforts to encourage reporting, many violent incidents go unreported.

36% of cases involved more than one type of violence.

Sexual assault

  • 40% of incidents included physical or sexual assault.
  • 180 Peel paramedics were physically assaulted, 10 were sexually assaulted.

Verbal abuse

  • 39% of reported cases involved verbal abuse.
  • 368 Peel paramedics were verbally abused.

Threats or intimidation

  • 4% of cases involved threats or intimidation.
  • 39 Peel paramedics were threatened to be beaten, raped, or killed.

Sexual harassment

  • 2% of cases involved sexual harassment.
  • 20 Peel paramedics were sexually harassed.

In just one year, hundreds of reports included racism, sexism, and homophobia. These are protected grounds under the Ontario Human Rights Code.

  • 17% described violence on the basis of the paramedic's gender.
  • 9% contained racist slurs or insults.
  • 2% contained homophobic slurs.

Expressed as a rate, the data corresponds to a paramedic in Peel Region reporting violence every 18 hours, being physically assaulted every 36 hours, and physically harmed by violence every 9 days.

Despite the array of accomplishments achieved through the External Violence Against Paramedics program, it's clear that Peel paramedics continue to experience violence while providing essential care to the community.

If a paramedic is worried about their physical safety, they can't focus on patient care, no matter how much they want to.

We must protect paramedics so they can care for the rest of us.

Bigham BL, Jensen JL, Tavares W, Drennan IR, Saleem H, Dainty KN, Munro G. (2014), "Paramedic self-reported exposure to violence in the emergency medical services (EMS) workplace: a mixed-methods cross-sectional survey." Prehosp Emerg Care. 2014 Oct-Dec;18(4):489-94

Mausz, J. & Johnston, M. (2019). "Violence, in fact, is not part of the job" A qualitative study of paramedic experiences with workplace violence. Peel Regional Paramedic Services, Regional Municipality of Peel, Brampton, Ontario, Canada

Mausz, J., Johnston, M. and Donnelly, E.A. (2022), "The role of organizational culture in normalizing paramedic exposure to violence", Journal of Aggression, Conflict and Peace Research, Vol. 14 No. 2, pp. 112-122.

JUSTIN MAUSZ,, ACP, PHD(C); MANDY JOHNSTON, ACP; AND ELIZABETH DONNELLY, NREMT, LICSW, PHD, “Development of a Reporting Process for Violence Against Paramedics”, Canadian Paramedicine 2020.

Mausz, J., Tavares, W., Johnston, M., Batt, A. M., & Donnelly, E. (2023, May 26). "Violence Against Paramedics: Findings from a Mixed Methods Research Program."

Mausz, J.; Johnston, M.; Arseneau-Bruneau, D.; Batt, A.M.;Donnelly, E.A. Prevalence and Characteristics of Violence against Paramedics in a Single Canadian Site. Int. J. Environ. Res. Public Health 2023, 20, 6644.

2023
"I realized I was not alone": Peel paramedic works to end violence plaguing first responders - The Pointer (September 2023)
$1.25 million pledged to prepare paramedics for situations of assault and abuse in Mississauga and Brampton - InSauga (August 2023)
"No one should be subjected to violence at work": Peel paramedics fight culture that accepts harassment as "part of the job" - The Pointer (July 2023)
Region of Peel pledges $1.25M for paramedic training for violent situations - Brampton Guardian (July 2023)

2021

Following up: "It's at a boiling point": Local paramedics join study on workplace violence - Thunder Bay News Watch (November 2021)
VIDEO: Local EMS officials eager to contribute to study on violence against paramedics - Thunder Bay News Watch (November 2021)
"It's not normal": Violence against paramedics in Brampton, Mississauga and Caledon a big problem - Brampton Guardian (June 2021)
Is getting punched part of your job? Campaign hopes to curb violence against paramedics - The Pointer (April 2021)

2020

Peel paramedics to launch a first-of-its-kind violence reporting system to protect first responders; advocates want national strategy - The Pointer (November 2020)
Threats, abuse, sexual harassment by the public: Paramedics on the dark side of the job - CBC Radio (January 2020)

2019

Violence against paramedics is never acceptable: Changing the culture of tolerance - Mississauga News (December 2019)
80 percent of Peel paramedics experience physical assault on the job - The Pointer (November 2019)