EVE4HP (In-Hospital)

There is a widely recognized but little acknowledged problem threatening healthcare personnel; injury through assault. The frequency of assault on our healthcare, and hospital staff is alarming. Many healthcare professionals have anecdotal stories of how they were attacked by a violent patient, an angry bystander or upset family member. While most attacks are not life threatening, the risk of serious injury is evident and unpredictable. Healthcare providers need an effective and reasonable plan on how to avoid an attack, and also know how to defend themselves once attacked. Your medical services staff requires a reasonable, liability-conscious, effective means of preventing and avoiding assault by patients, their family or bystanders. Our E.V.E. courses are not based on law enforcement “pain compliance/control” techniques, the use of non-violent course content for use with “violent people”, nor a martial arts class that teaches “fighting” skills.

The Hazards:

  • The health care industry leads all other sectors in the incidence of nonfatal workplace assaults, and the emergency department is a particularly vulnerable setting. Workplace violence is a significant occupational hazard facing emergency nurses”– ENA
  • “According to Bureau of Labor Statistics, an assault on a healthcare worker is the most common source of nonfatal injury or illness requiring days off from work in the healthcare and social assistance industry.” –Source


The Costs:

  • McGovern et al. (2000) found 344 nonfatal assaults cost employers in Minnesota an estimated $5,885,448; costs included medical expenditures, lost wages, legal fees, insurance administrative costs, lost fringe benefits, and household production costs. The cost per case for assaults to registered nurses was $31,643 and $17,585 for licensed practical nurses.
  • Speroni et al. (2014) Annual workplace violence charges for the 2.1% of nurses reporting injuries were $94,156 ($78,924 for treatment and $15,232 for indemnity)
  • Oceanside nurse awarded almost $5M in damages over attack – Source

 Our Solution:

Target Audience:  All levels of the in-hospital/home-health patient care setting (RN,LPN,MD,Techs,CNA)

Length: 8-hours

Focus: Violence Prevention Customer service as the first step to preventing violent encounters

Every participant, upon successful completion of the course, will receive  special online access to the student area containing review material that can be accessed 24/7.

Hospital staff across the country rave about EVE4HP based upon our training for tactics, techniques and skills for staff recognition, avoidance, de-escalation and escaping if needed, the violent encounter on-the-job in emergency medicine.

 Download Informational PDF

Real-World Application


Our Escaping Violent Encounters for Healthcare Providers (EVE4HP) courses give the Healthcare Provider the options needed to recognize a developing threat of assault, deflect it if possible, escape if practicable, and to defend if necessary.  This non-violent system of prevention and avoidance takes a realistic approach to the subject, eschewing “idealistic” training concepts and methods providing your practitioner with concepts that work in the classroom with cooperative subjects following a script.

While “easy-to-sell, feel-good” classes may appeal to many, these systems fail conclusively in the real-world where crisis creates rage, diabetic reaction overcomes reason, the mentally disabled act upon their delusions, those under the influence act with superhuman strength, and the career criminal lashes out at first responders and ER personnel even as they are engaged in life-saving efforts.

The inevitable failures of the non-realistic, idealistic training system puts careers at risk and creates liability when your employee attempts the trained-for methods but founders, leaving no alternative other than to go “primitive” in a bid to survive uninjured.  The common advice to many nurses in the ED to “medicate and intubate” someone who is simply being “a jerk” is something that our training will help to prevent.


  • EVE4HP is a potent, effective, and ultimately practical combination of many different disciplines brought into one comprehensive training course. The curriculum is applicable in every medical setting. Rather than take a “multi-member team approach, EVE4HP provides training in individual skills that every healthcare provider should know to personally avoid assault–especially when that Healthcare Provider is working in a remote location, or patient’s room with no other staff member present. This course provides training where oral and physical deflection skills are simple and easy to remember and apply. Why?


  • EVE4HP is Practical. Our system of assault avoidance and response is designed to be relevant to every member of your staff–big or small, strong or less so, male or female, trained in defense skills or not. We not only avoid fancy techniques that are forgotten before they leave the class, we just don’t teach them at all. Instead, we teach your personnel, who are some of the finest “problem-solvers” in our society, to problem-solve the situation confronting them through universal concepts of conflictresolution, deflection and recognition, and physical avoidance and escape that are available to everyone.


  • EVE4HP is Defensible. Your personnel face the daily prospect of assault and injury. Without training, they WILL resort to improvised methods of defense and restraint. Their improvisation may later be found to be unreasonable, and sometimes even have criminal liability. Additionally, as their employer, your agency or company may be subject to huge civil liability exposure as a result of their actions. E.V.E.-4-Healthcare Providers™ provides “Assault Response Guidelines” for those instances when prevention and avoidance are just not enough.


  • EVE4HP is Designed to be Liability Conscious. Beyond receiving training in the limits to force and restraint by healthcare personnel, participants are trained in articulation and documentation skills that will hold up to any scrutiny in any legal or ethical venue. Sound decisions in the face of a dangerous assault by a patient, and the articulation skills to prove the reasonableness of those responses will reduce the liability exposure in any situation.

EVE4HP is an 8-hour course covering the basic skills required by any healthcare provider when facing possible, or even imminent assault. The course content consists of:

  • Before you enter the room or home. (Pre-Planning)
  • Verbal skills to diffuse potentially violent encounters.
  • Entrance/exit plan
  • Recognize the difference between a patient and an attacker/aggressor.
  • Pre-assault indicators. (bystanders, body language, situational survey)
  • The 6 D’s (Drugged, Domestic, Diabetic, Deranged, Drunk and Desperate) and what to look for in each.
  • Legal aspects of self-defense.
  • Legal aspects of patient restraint.
  • Mental Preparation (Survival Mindset, Understanding stress and its effects)
  • Documentation Skills (Using the DT4EMS Assault Response Form)
  • Courtroom Demeanor
  • Good Customer Service
  • Assault Response Guidelines. (levels of force)
  • Critical Thinking Problem-Solving.
  • Escapes from various grabs/holds
  • Easy to learn and retain “drills” to reinforce reaction timing
  • Training in the 4 specific areas of self-defense

Since 1997 DT4EMS has trained thousands of EMTs, Paramedics, Nurses and Firefighters across the country. Many agencies (hospitals, fire departments, EMS agencies, training entities) have made DT4EMS’ Escaping Violent Encounters (EVE) mandatory for all ED and pre-hospital staff.

  •  Almost daily your Emergency Department  staff are threatened, yelled at or physically assaulted by a patient, upset family member or bystander.
  • You understand, according to several studies, injuries from assaults are a leading cause for lost work hours in the fields of emergency medicine.
  • We understand you are concerned about the response you or your provider would use in these particularly  stressful incidents.


DT4EMS’ Escaping Violent Encounters (EVE) provides superior training, affording staff the critical thinking skills to protect patients, staff and the agency.