VEST First Responder

According to the Occupational Health and Safety Administration (OSHA), about 75% of nearly 25,000 workplace assaults reported annually occur in healthcare and social service settings. While violence against healthcare workers occurs in all environments, hospital emergency departments and inpatient psychiatric facilities are the most common sites. EMS personnel frequently engage with both populations—often in uncontrolled environments like homes, community locations, or the backs of ambulances.

Prehospital Disaster Medicine reports that EMS personnel in the U.S. are 22 times more likely to be injured by workplace violence than those in other occupations. A survey of 221 EMS practitioners in a busy urban New England system found that 80% had experienced a physical assault at some point in their careers. Of those, 40% sought medical care, 49% reported the incident to police, and 68% admitted to fearing for their personal safety while at work.

In 2016 alone, 3,500 EMS workers suffered injuries from workplace violence serious enough to visit an emergency department, according to the CDC’s National Institute for Occupational Safety and Health (NIOSH). These violent incidents made up 16% of all injuries serious enough to seek ED care.

A national survey of approximately 1,800 EMS professionals found that 69% experienced some form of violence in the past year. A third were punched, slapped, or scratched; nearly 30% were spat at; 11% were bitten; and more than two-thirds were verbally abused. Similar studies in Australia and Canada show between 75–88% of emergency responders faced violence within a year.

NIOSH estimates from 2016 put the number of EMS workers hospitalized due to work-related violence at 3,500, though most experts believe the true figure is significantly higher.

Source references: Prehospital Disaster Medicine, CDC NIOSH, NFPA Journal, NAEMT Violence Report (10-02-2019)

The roots of Violent Encounter Survival Training (VEST) trace back to both the classroom and the cage.

I began my professional journey as a high school educator, earning a Bachelor of Science in Secondary Education with Cum Laude honors from the University of Missouri–Columbia. While I taught American history and economics, I was also competing at a high level in mixed martial arts. Eventually, I made the difficult decision to leave the classroom and pursue MMA full-time — a decision that led me across the globe and into the UFC, the sport’s premier organization.

After retiring from professional competition, I returned home to St. Louis and entered the fire/EMS field. It was during my early time in the field that I experienced a defining moment: a violent encounter in which my paramedic preceptor was physically attacked by a patient. Despite my background in physical defense, I quickly realized that many of my colleagues were ill-equipped to manage such incidents — not due to a lack of professionalism, but due to a lack of training.

That experience sparked a simple but important question: What would most firefighters or EMS professionals do in a violent encounter? To find out, I surveyed nearly 200 first responders in the St. Louis area. The responses were alarming — most referenced using equipment like oxygen tanks or laptops as improvised weapons. Not one responder mentioned a structured approach rooted in training, de-escalation, or legal knowledge.

This identified a critical training gap — one that placed both personnel and patients at risk.

From that moment on, I committed myself to addressing the issue head-on. I spent two years researching best practices in de-escalation, crisis intervention, scene tactics, and the legal protections available to healthcare professionals under state laws across the Midwest. I combined this research with my experience as an educator and professional athlete to develop a structured, hands-on curriculum designed specifically for first responders.

That curriculum became VEST — Violent Encounter Survival Training.

VEST is not a self-defense class disguised as a training course. It's a comprehensive, legally-informed, professionally-delivered safety platform built to reduce the risk of violence for EMS providers, firefighters, and healthcare personnel. It emphasizes prevention through communication, safety through tactics, and professionalism through accountability.

To date, nearly all of St. Louis County has implemented VEST training, and participating agencies have reported a measurable decrease in violent incidents and workplace assaults. Departments that invest in this training see safer crews, better patient outcomes, and a stronger culture of preparedness.

If you're a chief, training officer, or hospital administrator seeking a practical solution to an increasingly common threat, VEST offers a proven, regionally tailored course built specifically for professionals like yours.

Let's start the conversation about how we can support your department's safety mission.