Erin Smith, La Trobe University and Cameron Anderson, La Trobe University

Paramedics face the threat of violence every day.

Just this past month, two Victorian paramedics were assaulted. One was stabbed and another pregnant paramedic punched after saving a patient’s life.

Authorities warn these incidents are part of an “appalling trend” of escalating violence against paramedics.

And they’re a reminder that violence against paramedics is not a rare or unpredictable event, but a routine occupational risk. And research suggests this risk is rising.

So what makes their job so dangerous? And how can we better protect them?

Research shows paramedics face some of the highest rates of workplace violence of any profession.

One Australian study found nearly 90% of paramedics have experienced workplace violence while delivering care. Verbal abuse is the most common kind, followed by intimidation, physical abuse, sexual harassment and sexual assault.

Paramedics may also be attacked with weapons, including knives and box cutters. Though less common, these acts of violence put paramedics at much greater risk of serious injury or even death.

Paramedics are frequently exposed to other risks, such as dog attacks and car accidents. They are also more likely to be trapped in unsafe private or public spaces, such as when attending domestic violence scenes.

Research suggests violence against paramedics is becoming more common around the world. In Victoria, one paramedic is assaulted every 15 hours on average. And in 2024–25 alone, Ambulance Victoria recorded 1,045 occupational violence incidents — equivalent to almost 17 incidents for every 100 staff.

Research shows female paramedics experience higher rates of occupational violence, particularly sexual harassment and intimidation. Given female paramedics make up just over half of the ambulance workforce, this is an urgent safety issue.

Research suggests there are multiple factors driving the surge in violence against paramedics.

One is the high rate of alcohol and drug abuse. Researchers observe a strong link between substance abuse and violent incidents against paramedics, particularly in overdose and emergency mental health cases.

Another factor is system pressures, such as long ambulance response times and crowded emergency departments. These pressures can make patients, family members and bystanders more agitated, and more likely to lash out at paramedics. Due to workforce shortages in some areas, paramedics may also be forced to treat complex cases or arrive at volatile scenes alone. This leaves them even more vulnerable to assault and other acts of violence.

These violent incidents take an immense psychological toll on paramedics. Research shows workplace violence is a key driver of burnout, anxiety and post traumatic stress disorder among paramedics.

Paramedics are also feeling less safe while on the job. A recent trial required New South Wales paramedics to wear body cameras while delivering care. It found frequent exposure to violence had a significant impact on how safe paramedics felt and how emotionally exhausted they were. Participants were also more likely to consider stepping back from frontline roles, or leaving the workforce altogether.

So protecting paramedics is not just about preventing harm, but also retaining a vital part of our emergency workforce.

To keep our paramedics safe, governments should:

• strengthen legal protections for paramedics, by ensuring assaults carry meaningful, enforceable penalties and intoxication or mental health crises are not routinely used to excuse violence

• train paramedics to de-escalate volatile situations, assess risks and deliver trauma-informed care, and make this training continuous instead of a once-off

• improve communication between paramedics, police and hospitals, to ensure key information gets to ambulance crews before they arrive at a scene

• establish a national database recording the prevalence and patterns of violence against paramedics, including incidents targeting students and early-career staff.

Ambulance services must also:

• provide ambulance services with better lighting, real-time communication systems and security personnel particularly when transferring patients to hospital

• foster a workplace culture where reporting violence is encouraged and taken seriously, not dismissed as “part of the job”.

The public can also help protect our paramedics by:

• staying calm and giving paramedics space to do their job

• following instructions from paramedics

• discouraging aggressive behaviour from others

• calling triple-0 if violence is escalating, so police can be sent in to support paramedics.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

(The Conversation/HG)