Violence in the emergency department (ED) has been escalating for decades worldwide. High-stress situations are commonplace in the ED and can lead to intentional and unintentional aggression from patients. Staff must be educated on the signs of violence and escalation to recognize potentially dangerous situations early. Staff must also identify underlying medical conditions as the source of unintentional violence. Both situations would require different approaches to management. ED violence negatively affects patient care and leads to long-term harmful outcomes for staff. Multiple strategies for mitigation and prevention have been explored in the literature. Among those, weapon detection systems, de-escalation training, and violence prevention programs have demonstrated improved staff outcomes and decreased violence. Formalized procedures and policies should clearly assign roles for each staff member in the event of a violent patient. Training programs should be instituted and may include self-defense classes or crisis intervention courses. Emergency medicine residency programs and EDs around the country must address the rising incidence of violence within EDs through interdisciplinary policy, procedure development, and prevention and mitigation programs.

中文翻译：

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保护一线工作人员：预防和减轻急诊室暴力的策略。


几十年来，全球范围内急诊科 (ED) 的暴力事件不断升级。高压力情况在急诊室很常见，可能会导致患者有意或无意的攻击行为。必须对工作人员进行有关暴力和升级迹象的教育，以便及早识别潜在的危险情况。工作人员还必须确定潜在的医疗状况是无意暴力的根源。这两种情况都需要不同的管理方法。急诊室暴力会对患者护理产生负面影响，并对工作人员造成长期有害结果。文献中已经探讨了多种缓解和预防策略。其中，武器检测系统、降级培训和暴力预防计划已证明可以改善工作人员的工作成果并减少暴力。正式的程序和政策应在发生暴力患者事件时明确分配每位工作人员的角色。应制定培训计划，可能包括自卫课程或危机干预课程。全国各地的急诊医学住院医师计划和急诊室必须通过跨学科政策、程序制定以及预防和缓解计划来解决急诊室内不断上升的暴力发生率。