Violence-related measures against ambulance personnel: a study protocol for a scoping review with multi-framework conceptual mapping

Violence against ambulance personnel is a recognised occupational hazard. Between 57% and 93% of prehospital responders report at least one episode of verbal or physical violence during their career. Despite this exposure, violence-related measures remain insufficiently mapped in the literature, and no review known to the authors has described their distribution across complementary safety science and human factors frameworks.

This scoping review aims to identify and map violence-related measures targeting ambulance personnel as reported in peer-reviewed literature, and to describe their distribution across five conceptual frameworks: levels of prevention, hierarchy of controls, Safety-I/Safety-II, typology of situations, and levels of the sociotechnical system. Sub-objectives address the isolated versus bundled nature of measures, their relation to the mission cycle, the types of violence targeted, and the proportion of measures that are insufficiently described for coding.

The review follows JBI methodology for scoping reviews and will be reported according to PRISMA-ScR guidelines, which is adaption of the PRISMA extension for Scoping Reviews checklist. Eligibility criteria follow a Population - Concept - Context structure. The population is ambulance personnel involved in mission-related work. The concept covers violence-related measures targeting Type II and Type V violence. The context is prehospital ambulance services, including mission-related dispatch interfaces. Searches were conducted in PubMed/MEDLINE, Embase, CINAHL, Web of Science Core Collection and Scopus, covering English-language peer-reviewed sources published between 1 January 2014 and 15 May 2026. Title/abstract screening will be conducted by the principal investigator with calibrated eligibility criteria. Data will be extracted using a piloted charting form and coded according to a predefined codebook. The protocol is registered on the Open Science Framework ( 10.17605/OSF.IO/DYUWC).