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Related Concept Videos

SBAR II: Application of SBAR01:14

SBAR II: Application of SBAR

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SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
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Assessment of apical radial pulse01:25

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Apical-Radial (A-R) Pulse Assessment
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Pre-Procedural Preparation
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A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
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The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
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Aggression01:47

Aggression

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Humans engage in aggression when they seek to cause harm or pain to another person. Aggression takes two forms depending on one’s motives: hostile or instrumental. Hostile aggression is motivated by feelings of anger with intent to cause pain; a fight in a bar with a stranger is an example of hostile aggression. In contrast, instrumental aggression is motivated by achieving a goal and does not necessarily involve intent to cause pain (Berkowitz, 1993); a contract killer who murders for...
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SBAR I: Understanding the Concept01:29

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Effective communication among healthcare professionals during hand-off reporting is essential to delivering safe and continuous patient care. Common professional interactions include reports to healthcare team members, hand-off, and transfer reports. Nurses routinely report information to other healthcare team members and also urgently contact healthcare providers to report changes in patient status.
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The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
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Aggressive Behavior Risk Assessment Tool for Emergency Medical Services.

Son Chae Kim1, Kathie Dunn2, Corey Youells2

  • 1School of Nursing, Point Loma Nazarene University, San Diego, California, USA.

Journal of the American College of Emergency Physicians Open
|April 2, 2025
PubMed
Summary

Emergency medical services (EMS) clinicians can use the new 3-item Aggressive Behavior Risk Assessment Tool for EMS (ABRAT-EMS) to identify patients at risk of violence. This validated tool aids in implementing proactive violence prevention measures during prehospital care.

Keywords:
emergency medical servicesprehospitalrisk assessmentscreeningsensitivityspecificityviolence

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Area of Science:

  • Prehospital Care
  • Emergency Medicine
  • Public Health

Background:

  • Emergency medical services (EMS) clinicians face significant risks of on-the-job violence, often linked to behavioral health emergencies.
  • Existing screening tools are not validated for prehospital settings, leaving clinicians without adequate resources.
  • This gap necessitates the development and validation of a tool to identify patients at risk of violence in the prehospital environment.

Purpose of the Study:

  • To evaluate the modified 7-item Aggressive Behavior Risk Assessment Tool for Emergency Departments (ABRAT-ED) in a prehospital setting.
  • To determine the tool's utility in identifying patients who pose a risk of violence towards EMS clinicians.
  • To develop a concise and effective screening instrument for prehospital violence risk assessment.

Main Methods:

  • A prospective study involving adult and pediatric patients transported by private EMS agencies.
  • EMS clinicians utilized a modified ABRAT-ED before transport and recorded violent events using the Violent Event Severity Tool.
  • Data were analyzed using logistic regression and receiver operating characteristics (ROC) analysis.

Main Results:

  • Out of 9,024 evaluable patients, 1.16% experienced a violent event.
  • A 3-item Aggressive Behavior Risk Assessment Tool for EMS (ABRAT-EMS), comprising agitation, confusion, and aggressive/threatening behaviors, was identified.
  • ROC analysis demonstrated strong performance with an area under the curve of 0.89, achieving 82.9% sensitivity and 88.1% specificity at a cutoff score of 1.

Conclusions:

  • The 3-item ABRAT-EMS is a brief, validated checklist for identifying potentially violent patients during EMS encounters.
  • The tool demonstrates satisfactory sensitivity and specificity, enabling clinicians to proactively manage risks.
  • Implementation of ABRAT-EMS can enhance clinician safety through targeted violence prevention strategies.