摘要:

Recent studies indicate that the emergency department is one of the most concerning areas for the demonstration of violence on hospital grounds. Large numbers of health care facilities have reported problems with emergency department assaults, batteries, and threats with weapons. The increasing incidence of violent events has led to concerns for health care worker safety and security. Security considerations are briefly addressed. Professional responses and resolutions, including those of the American Psychiatric Association, the American Medical Association, the American College of Emergency Physicians, the American Hospital Association, and the Joint Commission on Accreditation of Healthcare Organizations, are described. Legalities and legislative initiatives attempting to address attacks on health care workers are also discussed. A proactive approach to the problem of emergency department violence is advocated.

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Three separate incidences of shootings have occurred in emergency departments of both middle-class community hospitals and teaching hospitals in California. Violence is causing significant physical, emotional, and economic hardships to emergency department personnel. The purpose of this study was to determine the magnitude of the problem of patients presenting to an emergency department carrying concealed weapons.

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Aggressive behavior in the emergency department (ED) is a common problem in urban and rural hospitals alike. Although most ED staff members are taught the causes of patient violence and basic management techniques, few are instructed to recognize the early signs of impending violence. Learning to recognize these signs, such as aggressive body language, attire, and other nonverbal clues, will enable ED personnel to take appropriate measures to reduce or prevent violent behavior.

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Proper procedures for the management of violent patients are important to ensure quality patient care as well as safety for prehospital personnel. The article reviews precautions for dispatchers and on-the-scene prehospital personnel in dealing with violent patients and describes specific immobilization techniques, the use of chemical restraints, and Indications for the use of on-line physician medical command. Guidelines for ensuring safe transfer of the patient from prehospital care to the care of emergency department personnel are presented. Following the presented guidelines and recommendations should result in proper patient care and ensure the safety of prehospital and emergency department personnel in managing violent or potentially violent patients.

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Safe and effective techniques are needed to manage violent patient behavior in the emergency department (ED). Violence should be prevented by controlling access to the ED and screening patients for weapons. Impending violence can also be prevented by early recognition of warning signs of violence and use of verbal techniques to diffuse anger, When these are ineffective, patients should be controlled by chemical and physical means. Neuroleptic agents Induce a dissociative state and are the most common group utilized for rapid tranquilization. Dystonic reactions are the most common side effects, but more serious conditions, such as neuroleptic malignant syndrome, can occur. Although haloperidol is well studied, droperidol may have fewer complications and is approved by the Food and Drug Administration for intravenous use. When used judiciously, restraints optimize patient care.

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The emergency department (ED) management of suicidal patients often requires the staff to enter into complex negotiations to gain the patient's cooperation or even save his or her life on rare occasions. ED personnel must adapt to a changing role under dynamic conditions. The critical role played by the ED requires a significant amount of preparation through policy development and training. Suicidal patients may lash out at the ED staff with extremely violent actions that require the staff to know proper safety techniques, as well as their own limitations. Staff must be trained to recognize the potential for violence and be given the tools to manage the suicidal patient effectively to prevent an escalation of the encounter. ED personnel should also receive training on how to survive a hostage situation and the actions they can take to increase their chances of survival. The ED encounter with the suicidal patient also requires excellent assessment and negotiation skills in addition to the clinical skills normally used with routine patients. Personnel must also have a clear understanding of the institution's use of force policy to detain suicidal patients while limiting the potential for staff injury and liability. With proper planning and training, ED personnel can effectively and safely manage suicidal patients.

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The presence of gang members in the emergency department (ED) presents unique challenges for ED personnel. Gang members are frequent targets of aggression and often require medical care. As gangrelated violence continues to rise, so too will the number of ED visits by gang members. At present, few EDs are prepared to handle the hazards that these groups present. Learning to identify quickly common characteristics associated with gang affiliation as well as how to interact with these groups will lessen one's chances of becoming a victim of gang-related violence.

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Violence directed toward hospital emergency department (ED) staff workers has become more commonplace than in previous years. These acts are becoming Increasingly violent and have resulted in deaths. The precipitating factors have been identified since the 1965 Watts riots but have remained unchanged. These mitigating factors include inaccessible health care, hospital overcrowding, poor education, minimal education opportunities, poverty, and a general denial of social opportunities. Proper education and training of ED staff can serve to mitigate the damage done by the violence. Changes to the physical layout as well as changes in policy and procedures can also serve to mitigate the damage or prevent its occurrence. Such measures include on-site security, lock-down unit status, metal detectors, surveillance cameras, personal alarm systems, preconceived take-down procedures, threat assessment recognition training, the creation of pleasant waiting room conditions, changes to uniform appearance, and a more vigorous reporting of ED-directed violence. EDs can no longer afford to believe that they are protected islands because this type of thinking has already resulted in the deaths of several ED workers. More will result if things are not changed.

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0164-2340    

出版商:OVID    

年代:1994

数据来源: OVID