Role of Pediatric Emergency Physicians in Identifying Bullying.
BACKGROUND
Bullying is an important public health issue with broad implications. Although this issue has been studied extensively, there is limited emergency medicine literature addressing bullying. The emergency department (ED) physician has a unique opportunity to identify children and adolescents that are victims of bullying, and make a difference in their lives.


OBJECTIVE
Our aim is to discuss the role of the emergency physician (EP) in identifying patients who have been victims of bullying and how to provide effective management as well as referral for further resources.


CONCLUSIONS
This document provides a framework for recognizing, stabilizing, and managing children who have experienced bullying. With the advent of social media, bullying behavior is not limited to in-person situations, and often occurs via electronic communication, further complicating recognition because it may not impart any physical harm to the child. Recognition of bullying requires a high level of suspicion, as patients may not offer this history. After the stabilization of any acute or overt indications of physical injury, along with obtaining a history of the mechanism of injury, the EP has the opportunity to identify the existence of bullying as the cause of the injury, and can address the issue in the ED while collaborating with "physician-extenders," such as social workers, toward identifying local resources for further support.


CONCLUSIONS
The ED is an important arena for the assessment and management of children who have experienced bullying. It is imperative that EPs on the front lines of patient care address this public health epidemic. They have the opportunity to exert a positive impact on the lives of the children and families who are the victims of bullying.
Department of Emergency Medicine and Pediatrics, Lincoln Medical and Mental Health Center, Bronx, New York; St George's University, Grenada, West Indies.
Muhammad
M
Waseem
Department of Pediatric Emergency Medicine, Mount Sinai Hospital, New York, New York.
Audrey
A
Paul
Keesler Air Force Base, Biloxi, Mississippi.
Gerald
G
Schwartz
Department of Emergency Medicine, Albany Medical College, Albany, New York.
Denis
D
Pauzé
Department of Pediatric Emergency Medicine, Kapi'olani Medical Center, Honolulu, Hawaii; Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii.
Paul
P
Eakin
Department of Pediatric Emergency Medicine, North Shore University Hospital, Hofstra Northwell School of Medicine, North Shore-LIJ Medical Group, Manhasset, New York.
Isabel
I
Barata
Pediatric Emergency Services, Summerville, South Carolina.
Doug
D
Holtzman
Emergency Physicians Medical Group, St. Joseph Mercy Ann Arbor, Ann Arbor, Michigan.
Lee S
LS
Benjamin
American Academy of Pediatrics Committee on Pediatric Emergency Medicine, Elk Grove Village, IL.
Joseph L
JL
Wright
Alberti Center for Bullying Abuse Prevention, Graduate School of Education, University at Buffalo, State University of New York, Buffalo, New York.
Amanda B
AB
Nickerson
Departments of Emergency Medicine and Pediatrics, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida.
Madeline
M
Joseph
D000293:Adolescent; D058445:Bullying / Q000517:prevention & control*; D002648:Child; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics; D010819:Physician's Role; D010820:Physicians / Q000331:legislation & jurisprudence*; D015995:Prevalence; D012574:Schools / Q000639:trends*; D000078329:Workforce
bullying; peer violence; victimization