An Emergency Medicine Approach to Violence throughout the Life Cycle

Muelleman, Robert L.; Reuwer, John; Sanson, Tracy; Gerson, Lowell W.; Woolard, Bert; Yancy, Arthur H.; Bernstein, Edward

doi:10.1111/j.1553-2712.1996.tb03496.x

“…30 Understanding the scope of the problem, we recognize that violence is really the end result of social diseases that many EPs see regularly. If we are to have an effect on the cycle of violence, we can no longer afford to treat physical and psychological trauma without assessing the causes, and the risk and protective factors, that together can help the practitioner identify and offer treatment options to patients in danger.…”

Section: Introductionmentioning

confidence: 99%

Emergency Medicine: Competencies for Youth Violence Prevention and Control

Denninghoff

¹

,

Knox

²

,

Cunningham

³

et al. 2002

Academic Emergency Medicine

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By any standard one wishes to apply, the impact of violence on the health and safety of the public is significant. The expression of violence among children in the United States has increased significantly during the modern era. Homicide and suicide are the second and third leading causes of death in youths 15-24 years of age. The emergency department (ED) is a common site for the care of these victims, and because victims often become assailants, the emergency care provider needs to know the epidemiology, treatment, and methods for prevention of youth violence in order to curtail the cycle. A multidisciplinary task force was convened by the Centers for Disease Control and Prevention (CDC)-funded Southern California Center of Academic Excellence on Youth Violence Prevention and the Keck School of Medicine at the University of Southern California to define competencies for health professionals in youth violence prevention and control. Three levels of competence were identified: the generalist level, which should be obtained by all health professionals; the specialist level, which should be obtained by health professionals such as emergency medicine providers, who frequently work with populations affected by violence; and a third, or scholar level, to be acquired by health professionals who wish to become experts not only in the care, but also in research and advocacy. This article reports the details of this group's efforts and applies them to emergency care provider education. These competencies should shape the development of curricula for the span of emergency medical training from emergency medical services scholastic training to postgraduate continuous medical education. Key words: emergency medicine; violence; adolescence; prevention; competencies. ACADEMIC EMERGENCY MEDICINE 2002; 9:947-956. Youth violence is a serious public health problem in the United States; indeed, homicide is the second leading cause of death for young persons aged 15-24 years. 1 The data on more common nonfatal violent injuries are less available and reliable than the data on homicide, in part because many victims do not seek medical attention. 2 The situations in which fatal and nonfatal adolescent assault injuries occur are similar, 3 and violent injury and death result from altercations between family members and acquaintances more often than from criminal activity. 4 A growing number of reports confirm that children frequently witness violence, 5-8 and exposure to violence and victimization is strongly associated with subsequent acts of violence by the victim. 9-11 There

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“…Emergency physicians can have an impact on violence through medical education, research, surveillance, clinical practice, public education, and advocacy. 30 Understanding the scope of the problem, we recognize that violence is really the end result of social diseases that many EPs see regularly. If we are to have an effect on the cycle of violence, we can no longer afford to treat physical and psychological trauma without assessing the causes, and the risk and protective factors, that together can help the practitioner identify and offer treatment options to patients in danger.…”

Section: Introductionmentioning

confidence: 99%

“…Evaluate implementation and effects of changes. Teach health professionals and students competencies in youth violence prevention 30…”

mentioning

confidence: 99%

Emergency Medicine: Competencies for Youth Violence Prevention and Control

Denninghoff¹,

Knox²,

Cunningham³

et al. 2002

View full text Add to dashboard Cite

By any standard one wishes to apply, the impact of violence on the health and safety of the public is significant. The expression of violence among children in the United States has increased significantly during the modern era. Homicide and suicide are the second and third leading causes of death in youths 15-24 years of age. The emergency department (ED) is a common site for the care of these victims, and because victims often become assailants, the emergency care provider needs to know the epidemiology, treatment, and methods for prevention of youth violence in order to curtail the cycle. A multidisciplinary task force was convened by the Centers for Disease Control and Prevention (CDC)-funded Southern California Center of Academic Excellence on Youth Violence Prevention and the Keck School of Medicine at the University of Southern California to define competencies for health professionals in youth violence prevention and control. Three levels of competence were identified: the generalist level, which should be obtained by all health professionals; the specialist level, which should be obtained by health professionals such as emergency medicine providers, who frequently work with populations affected by violence; and a third, or scholar level, to be acquired by health professionals who wish to become experts not only in the care, but also in research and advocacy. This article reports the details of this group's efforts and applies them to emergency care provider education. These competencies should shape the development of curricula for the span of emergency medical training from emergency medical services scholastic training to postgraduate continuous medical education.

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“…5 National medical organizations, [6][7][8] including the American Academy of Pediatrics, recognize the importance of violence prevention and have identified assault-injured youth as a population requiring urgent attention. [9][10][11] In 2011, .900 000 youth, ages 10 to 24, visited the emergency department (ED) because of violence-related injury. 12 Youth with assault-related injury are at high risk for reinjury.…”

mentioning

confidence: 99%

Firearm Possession Among Adolescents Presenting to an Urban Emergency Department for Assault

2013

PEDIATRICS

3

0

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WHAT'S KNOWN ON THIS SUBJECT: Violence involving firearms is a leading cause of death among US youth ages 14 to 24. The emergency department is the primary medical setting for care of assault-injured youth and an underused but important setting for violence-prevention programs.WHAT THIS STUDY ADDS: Among assault-injured youth seeking emergency department care, firearm possession rates are high, most obtained outside of legal channels. Higher rates of negative retaliatory attitudes and substance use among those youth with firearms increases risk of future lethal violence. abstract BACKGROUND AND OBJECTIVES: Firearm violence is a leading cause of death among youth. The objectives of this study were (1) determine firearm possession rates and associated correlates among youth seeking care for assault in an emergency department (ED); (2) understand differences in risk factors for youth with firearm possession; and (3) identify firearm possession characteristics in this population: type, reason for possession, and source of firearms. METHODS:Youth (14 to 24 years old) presenting to a Level 1 ED with assault were administered a computerized screening survey. Validated instruments were administered, measuring demographics, firearm rates and characteristics, attitudes toward aggression, substance use, and previous violence history. RESULTS:Among 689 assault-injured youth, 23% reported firearm possession in the past 6 months. Only 17% of those reporting firearm possession obtained the gun from a legal source; 22% reported ownership of highly lethal automatic/semiautomatic weapons and 37.1% reported having a firearm for protection. Logistic regression analysis identified significant correlates of firearm possession, including male gender, higher socioeconomic status, illicit drug use, recent serious fight, and retaliatory attitudes.CONCLUSIONS: ED assault-injured youth had high rates of firearm possession (23.1%), most of which were not obtained from legal sources. Youth with firearm possession were more likely to have been in a recent serious fight, and to endorse aggressive attitudes that increase their risk for retaliatory violence. Future prevention efforts should focus on minimizing illegal firearm access among high-risk youth, nonviolent alternatives to retaliatory violence, and substance use prevention. Pediatrics 2013;132:213-221 AUTHORS:

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An Emergency Medicine Approach to Violence throughout the Life Cycle

Cited by 25 publications

References 47 publications

Emergency Medicine: Competencies for Youth Violence Prevention and Control

Emergency Medicine: Competencies for Youth Violence Prevention and Control

Emergency Medicine: Competencies for Youth Violence Prevention and Control

Firearm Possession Among Adolescents Presenting to an Urban Emergency Department for Assault

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