Several years ago I was fortunate to be asked to present at a national conference for trainers in the prevention and management of violence and aggression. While I was there, I had the great privilege to hear this talk by “the most violently injured paramedic in the UK” at the time. The speaker was a 15-year veteran of the ambulance service — she loved her job and says “my job is making people feel better.” This is her story of the worst day of her life: September 2005, when her ambulance was called to a young man who was unconscious due to an overdose.
When the paramedic arrived at her call, she noticed a nice house. No signs of danger anywhere. She had spoken to the control room en route to confirm the location and address — there were “no alarm bells.”
You don’t do this job for long before you learn to have 360-panorama vision — I have eyes in the back of my head!
She entered the room. A male was stretched out on the settee in his boxer shorts. She knelt down to initiate contact and begin the opening assessment, and asked the family to leave the room. When she turned around, the patient was now on his feet — naked — and was suddenly punching her in the face.
He continued to assault her for 22 long minutes.
The drug he had taken made him unusually strong — “like three or four guys.” He kicked, punched, bit, tried to smash the TV, and threw tables. The fight mostly took place on the ground. He would surge in energy, then tire quickly and rest for 10–15 seconds before attacking again.
I couldn’t leave — as soon as one of us took any pressure off this guy, he completely overpowered us. If I could have run, I would have. He looked at me and knew I was the smallest of the two.
The team had had no physical skills training at this point. Their natural instinct was to restrain the man on the ground, even though the risk of sudden death with his type of overdose was exceptionally high. At some points she had her knee across his neck — it was the only way to control him and stop him from hurting her.
During the struggle, the paramedic attempted to call her control room three times but was cut off. The control room operators subsequently admitted they could hear what was going on. She had to call the police herself.
What stopped her leaving? Six adults stood in the doorway and hallway and watched the incident unfold — blocking her escape route. Among them was “a howling, screaming granny who was absolutely horrified at her naked grandson behaving in such a manner.” She believes that the public see people in uniform and assume they “are the experts.”
⚠️ When the police finally arrived, it took four officers assisting two paramedics to restrain, cuff, and move the man — who had fought for at least 40 minutes. He was still trying to bite as they took him to the ambulance.
Ironically, the paramedic was provided with obsolete, old-model breakaway and de-escalation training a few weeks after the assault. Colleagues had been given initial training but had received no updates in 6–7 years.
The old-style PMVA training she received was based on “all that ju-jitsu stuff — if they grabbed you by the hair, tap their hand — that kind of stuff.” Five years after the incident, the organisation still hadn’t changed their training programme.
What I learned was that all of that wouldn’t have applied that night. He didn’t actually grab me, pull me, or throw me — it was all punches and kicks. There was no ‘physical’ holding on to me. What he did do was pull his knee back to his chest and put his heel through my shoulder and my chest.
On use of force, the paramedic described the impossible position staff are placed in:
We get told the reasonable force rules at college but then we get told all the horror stories about staff using force and being disciplined. Basically the answer they give you is: run away. We have been told that if we raise our hand, the service will not support us. We get attacked with weapons all the time — you get punched and you get slapped — you defend yourself as best you can.
The paramedic suffered multiple serious injuries and was left unable to move her arm. It was subsequently found that her bicep was severed during the assault. Her own hospital assessment took five hours — and included being told off by the doctors for bringing the violent man into the hospital.
In the weeks after the incident, the service she worked for would not accept that she had been injured. They claimed she was pretending her injuries — that her hand would not work. Two months after the incident, her pay was cut to half-pay. She was still waiting for a call from the welfare officer.
At this point she was unable to do most daily tasks: with broken ribs, she couldn’t use her left arm, couldn’t bend or straighten, and had to be bathed and washed by others. Management’s attitude was to “get a grip,” “accept it,” and “move on.” She was told: “If you can’t work in an ambulance, there is no place for you in this service.”
The control room failed to call the police and failed to understand what was happening. While she waited in the hospital, the control room manager offered an apology — because they had two violence warnings on the job. The control room knew when the job was assigned that the man was violent, that he was alert, that he had just assaulted his mother, and that he was not unconscious.
📊 Despite two violence warnings being visible on screen, the control room sent the paramedic in alone — and the staff responsible were never informed of their mistake. The difference? She would have waited for police escort and never entered the property alone.
The reason that this incident affected me so badly is because the people I trusted to keep me safe failed me. They are my only contact with the outside world. They put me in the danger and then they weren’t even there to get me out of it.
Two years after the incident, a friend took her for coffee. She was not sleeping, not eating. Her friend suggested PTSD — she had disproportionate and extreme responses to situations, had stopped socialising. Eventually, she was referred to a high-end PTSD clinic and spent two years in treatment, during which she still had panic attacks at a perceived lack of ability to respond to emergencies.
The pain in her shoulder was eventually properly recognised and treated. At the time of the talk she had undergone three surgeries to re-attach, adjust, and then again surgically sever and re-attach her bicep. It is likely that she will never be pain-free.
I have lived and re-lived and re-lived that night. I live this. I can’t change it.
The man who attacked her received a three-year sentence and served 18 months in jail.
Even after everything she had been through, the paramedic’s focus remained on her patient. Despite being violently assaulted, her primary concern was his medical condition.
You’ve got to remember — all I was focused on is that what he has taken can ultimately kill him and result in a cardiac arrest. That’s my focus. Believe it or not, or as pathetic as that might sound — that was my focus. This young man might ultimately die and I am becoming aware of the fact that I don’t have an arm to perform CPR with. That was all I could think about — is that we all had to be safe.
Yes, I put his clinical needs first — they took priority. Yes, I did put myself second. Yes, I would go into that house again and yes, I would treat that man again.
Now back at work, another incident occurred. She arrived at an address, assessed a violence risk, and fed warnings into the system — only to discover the hospital already had warnings on the person. She was subsequently sent back to the same address but recognised it. She checked with control, who told her there were no warnings. As she greeted the patient, he said: “Morning bitch, you again?!”
On investigation, she was told there were warning markers on the job. The system had simply failed to communicate them. Again.
What is it actually going to take for this service to go to the control room and say ‘guys, not good enough — do your job!’? Are we going to have to wait for someone to get shot, raped, or murdered? I was told I was being dramatic.
I’m the most severely injured paramedic in the UK. If that isn’t enough to make them follow their own policies and procedures, then what difference will a man in a robe telling them?
💡 Key takeaway: Ambulance staff personal safety isn’t just about physical skills training. It requires reliable violence-warning systems, control room accountability, proper post-incident support, and an organisational culture that protects the people who protect us — not one that blames them for being injured.
Gerard O’Dea provides tailored PMVA training courses for hospital and healthcare services where people are treated with dignity and shown respect, even in their most difficult moments. Combining respectful verbalisation skills with last-resort restraint alternatives for personal safety has been his specialty for over ten years as Director of Training for Dynamis. www.dynamis.training/breakaway
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