A majority of Austin EMS personnel say they've been assaulted while on the job in the last two years, according to an internal survey. Most first-responders also say they don't feel properly trained to address aggressive behavior.

Austin-Travis County Emergency Medical Services hoped to quantify verbal and physical assault among staff fielding calls and emergency medical technicians in the field. Of the 500 staff queried, 210 first-responders and 26 communication staff answered an 18-question internal survey.

First-responders said physical assaults more often than not occurred in the back of ambulances, the department said. Sixty-three percent of those answering the survey said they've been attacked more than once in the last two years; 86% of communications personnel reported being verbally assaulted in that timeframe.

ATCEMS Chief Ernesto Rodriguez, who was a paramedic earlier in his career, says assaults on field personnel have become common and that departments – in Austin and elsewhere – need to do more to prevent them.

"Getting beat up while you're trying to help is a very difficult and trying situation. Back when I was doing it years ago, it was rare," Rodriguez said. "But today, it seems like it happens almost every day."

The number of physical assaults doesn't reflect reality, however, because assault cases are underreported, the department said in a release announcing the survey results. "Only cases involving injuries are reported most commonly," it said.

Austin-Travis County EMS Association President Selena Xie says she's been assaulted multiple times, but hasn't reported it. Xie says she and other field personnel would like to see a more concrete reporting process when medics are assaulted. Anecdotally, she's noticed an uptick, but a better reporting process could provide a clearer picture.

"We have never developed clear reporting mechanisms for how to let the department know that there's an assault, and it's never been very clear as to what the response is supposed to be – or is," Xie said. "And so, I think it's never really been thought about because we've never been tracking it."

The questionnaire also highlighted the need for de-escalation training. Nearly 63% of first-responders said they didn't feel they were properly trained on de-escalation techniques when dealing with aggressive behaviors; 64% said they didn't feel they were trained to escape situations involving aggressive behavior.

ATCEMS said it was also troubled by the acceptance of abuse among those surveyed. Nearly 70% of first-responders said physical assaults were "unavoidable" in their jobs, while 94% of communications staff said verbal assaults were unavoidable.

The department said it was putting together an "improvement team" to address the survey's findings. It said it will focus on better reporting and training – and work with law enforcement to bolster de-escalation training.

Rodriguez says he wants the department and the city to realize that field personnel are, first and foremost, clinicians. He also says he hopes the department will focus more squarely on risk prevention.

Xie says, ultimately, she hopes the survey will inspire action to address that culture and the need for better training and reporting practices, adding that she hopes to see more cases prosecuted under a state law that enhances penalties for attacks on first-responders.

"I think the survey is a first big step," she said.

This post has been updated.

You can read the full survey below.