title: Violence and general security in the emergency department.
abstract: OBJECTIVE
  To describe cases of violence related to weapons in a university hospital and urban county ED and to provide related recommendations for ED staff security.
  
  
  METHODS
  Descriptive analysis and case examples of weapons-related assaults in one urban ED for the period 1979-1993.
  
  
  RESULTS
  Over a 14-year period, 115 "incidents" of weapons-related violence were identified during the management of approximately 980,000 patients. Examples of ED violence are described.
  
  
  CONCLUSIONS
  Emergency department staff should prepare for the possibility of violence by 1) recognizing the danger, 2) rehearsing response mechanisms, and 3) debriefing after incidents. In particular, plans must be made and practiced for the time when external violence follows the surviving victims of gang activity through the "sacrosanct" hospital doors. Protection of patients and ED personnel must be ensured. In many urban settings, appropriately armed security guards must be immediately accessible to the ED staff. Other suggestions for ED protection are given.
authors.affiliation: King/Drew-UCLA Medical Center, Department of Emergency Medicine, Los Angeles 90059, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Ordog
authors.forename: J
authors.initials: J
authors.lastname: Wasserberger
authors.forename: C
authors.initials: C
authors.lastname: Ordog
authors.forename: G
authors.initials: G
authors.lastname: Ackroyd
authors.forename: S
authors.initials: S
authors.lastname: Atluri
mesh_terms: D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D005389:Firearms / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006785:Hospitals, University; D006786:Hospitals, Urban; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D012449:Safety; D012637:Security Measures / Q000592:standards*; D014754:Violence / Q000517:prevention & control*