Effect of a security system on violent incidents and hidden weapons in the emergency department

To determine the number of weapons confiscated and assaults reported in an urban county emergency department before and after the implementation of a security system.

This is a retrospective review of security records for a 54-month period from 1992 to 1996. We determined the number of weapons and assaults before and after the implementation of a security system consisting of metal detectors, cameras, limited access, and a manned security booth at the ED entrance. We calculated the rates of weapons confiscated and assaults per 10,000 ED patients treated.

Twenty-four weapons were confiscated before the implementation of the security system, and 40 were confiscated after the implementation ( P<. 001). The percentage of weapons confiscated in the patient care area decreased from 92% to 42% after the security system was installed (P<.001). Seven of the 17 weapons (41%) found in the patient care area after implementation were brought in by ambulance patients who bypassed the security booth and metal detector. The reported assaults per 10,000 patients, however, did not change significantly.

The implementation of an ED security system increased the number and percentage of weapons confiscated before patients were placed in patient care areas, but did not decrease the number of assaults. This emphasizes the importance of continued training of ED personnel in the management of violent patients and potentially violent situations.