Citation

Revue E, Boyle AA, Chauvin A, Atkinson P. CJEM 2022; 24(2): 107-108.

Copyright

(Copyright © 2022, Canadian Association of Emergency Physicians, Publisher Cambridge University Press)

DOI

10.1007/s43678-021-00216-6

PMID

35258813

Abstract

The World Health Organization (WHO) defines aggressiveness as “every use of physical force or power, threat or real, against oneself, another person or against a group or community that may result in or has a high probability of death, psychological harm, developmental changes or deprivation” [1]. Emergency departments (EDs) are workplaces where violence is encountered. Violence that has motivated the consultation of patients, or violence towards health care personnel. Whatever violence we are talking about, this is a daily problem in EDs [2]. Emergency physicians and nurses the world over will care for victims of violence and run the risk of becoming victims themselves. The pooled incidence suggests there are 36 violent patients for every 10,000 presentations to the ED (95% confidence interval 0.0030–0.0043). The instigators of violence in the ED were family members (52%), patients (27%) and other relatives/friends (21%).

Violent acts presenting to, and occurring in, healthcare settings are substantially under-recorded to the police [3]. Indeed, the American College of Emergency Physicians has stated that while 70% of emergency physicians have reported acts of violence against them, only 3% pressed charges. Nurses are more likely to experience violence while performing their duties. The Canadian Association of Emergency Physicians (CAEP) position statement seeks to address this by promoting mandatory reporting of violent incidents among a series of well reasoned recommendations. The factors contributing to these acts of violence are well described[1]; drugs, alcohol or substance abuse, poverty, acute or chronic diseases (i.e. dementia) play a major part in the escalation of aggressive and violent behaviour and are suspected to be responsible for the majority of violent escalations in the ED. Aggression situations may be associated with behavioural changes, namely psychomotor agitation, dementia, previous trauma and other disorders, psychotic and personality disorders, drug, hospital and service rules rejection, socio-cultural situations, the shortage of space or the organization of inpatient facility ...

Language: en

Keywords

Violence; Intimate partner violence; Emergency medicine