The personal characteristics of patients who brought weapons to a university hospital-based psychiatric emergency room were examined. During 14 months following implementation of a routine weapon-screening procedure, 37 (4%) of 1012 psychiatric emergency room patients were found to have weapons. These patients did not differ significantly from a randomly selected control group of non-weapon-carrying patients on a variety of demographic and clinical variables often associated with violence potential, although the weapon-carrying patients were more likely to be male and have a history of substance abuse. The heterogeneity of personal characteristics of weapon-carrying patients is likely to make them difficult to distinguish clinically from other patients. The findings have important implications for maintaining safety in the psychiatric emergency room.
[Show abstract][Hide abstract] ABSTRACT: Violence in the emergency department, a not uncommon but complex phenomenon, may become more serious when patients possess weapons. Searches are used frequently to reduce this danger, though guidelines for searches are not well delineated. We examined our practices in order to formalize our guidelines.
Retrospective chart review of patients found to be carrying weapons.
General, university-based emergency department in the Northwest.
Of 39,000 patients seen during the 20-month study period, 500 (1.3%) were searched.
Of all patients seen in the ED, 92% were medical patients (153, 0.4% of whom were searched) and 8% were psychiatric patients (347, 11.1% of whom were searched). Weapons were found on 89 patients (0.2% of all ED patients and 17.8% of all patients searched). Review showed that 24 (15.7%) medical and 60 (17.3%) psychiatric patients carried weapons.
Although various factors contributed to a clear bias toward searching psychiatric patients, we believe that the rate of weapons possession did not support this bias.
Annals of Emergency Medicine 02/1991; 20(1):8-10. DOI:10.1016/S0196-0644(05)81109-6 · 4.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To determine the incidence of battery against emergency department medical staff by patients or visitors.
Prospective descriptive study over a nine-month period.
A university-affiliated ED Level I trauma center with an annual census of approximately 64,000 located in a major metropolitan area.
All staff members who had been punched, kicked, grabbed, pushed, or spat on by a patient or visitor while on duty in the ED.
Questionnaire that was completed after the incident.
During the study period, there were 19 instances of violence against staff by patients. Staff members were punched six times, kicked seven times, grabbed three times, pushed once, and spat on twice. Blows usually were sustained on the face or head (seven) or on the extremities (seven). In only four cases were hospital incident reports filled out, and in no case was there an injury serious enough to require ED treatment or disability leave. The assailant was usually male (15 of 19, 79%) and usually on a psychiatric or substance abuse detainment (15 of 19, 79%).
This study suggests that instances of battery in an urban university hospital ED usually are not serious and are committed by patients on a psychiatric or substance abuse detainment.
Annals of Emergency Medicine 04/1993; 22(3):583-5. DOI:10.1016/S0196-0644(05)81946-8 · 4.68 Impact Factor
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