One fifth of children with abuse-related fractures are missed during the initial medical visit. In particular, boys who present to a primary care or a general emergency department setting with an extremity fracture are at a particularly high risk for delayed diagnosis.
History and physical examination remains the cornerstone of the evaluation of the crying infant and should drive investigation selection. Afebrile infants in the first few months of life should undergo urine evaluation. Other investigations should be performed on the basis of clinical findings.
Background: Globally, workplace violence toward health care providers is an area of concern. The impact of workplace violence on health care providers is significant. Objectives: The study was conducted to evaluate the prevalence of workplace violence (physical and verbal) among emergency medical services (EMS) workers in Riyadh. Methods: The study used a cross-sectional design that employed a self-administered confidential questionnaire, which was distributed to all emergency medical personnel. A well-structured and validated questionnaire on workplace violence was adopted from the World Health Organization for use in the study. Results: A total of 370 EMS workers responded to the questionnaire. Workplace violence was experienced by 65% of the respondents. Verbal abuse (61%) was the most common type of violence reported. The majority of the attackers were patients' relatives (80%) followed by patients themselves (51%). Respondents younger than 30 reported a higher percentage of violent acts than did older respondents (p = .001, Odds ratio [OR] = 2.5, 95% Confidence Interval [CI] = (1.6, 3.9)). Similarly, those who had fewer years of work experience (≤ 10 years) reported a significantly higher percentage of violent incidents than those who had 10 or more years of experience (p = .001, OR = 3.5, 95% CI = 2.1, 5.6). Only 10% of the victims reported the incident to a higher authority. Common reasons for not reporting the violent acts included feeling that it was useless (56%) and that it was not important (52%). Discussion: The study demonstrates prevalent workplace violence among EMS workers, predominantly in the form of verbal abuse. The rate of workplace violence among EMS personnel is comparable with international figures. Less than half of EMS personnel exhibit knowledge regarding the process of violence reporting. However, workers tend not to report the incidents because they often believe that reporting is useless and/or not important. Recommendation: With a high reported rate of workplace violence among EMS personnel, we recommend national preventive measures and encouragement to professionals to report violent events. We also recommend awareness programs for the identified vulnerable group.
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