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Violence-related injuries in a pediatric emergency department
S J Kharasch1, J Yuknek, R J Vinci
1Division of Pediatric Emergency Medicine, Boston City Hospital, MA 02118, USA.
Insights
Violence-related injuries (VRI) are a significant concern in urban pediatric emergency departments (EDs). Most young children treated for VRI are discharged, with females and younger children being frequent victims.
Area of Science:
- Public Health
- Pediatric Emergency Medicine
- Trauma Research
Background:
- Violence is a major public health issue in the U.S.
- Interpersonal violence impacts young children.
- Pediatric emergency departments (EDs) are key sites for identifying violence-related injuries (VRI).
Purpose of the Study:
- To describe the epidemiology of VRI in an urban pediatric ED.
- To analyze patient demographics and injury characteristics.
- To inform violence prevention strategies.
Main Methods:
- Retrospective chart review of 11,000 patients (≤17 years) over six months.
- Defined VRI as purposefully inflicted injuries.
- Compared characteristics of discharged vs. admitted VRI patients.
Main Results:
- 317 (3%) patients had VRI.
- 83% were discharged; 17% admitted.
- Injuries often resulted from conflict with acquaintances; discharged patients more likely to be younger, female, with blunt instrument injuries. 13% of discharged cases involved firearms or knives.
Conclusions:
- Most VRI patients are discharged from the ED.
- Young children and females are disproportionately represented.
- Identifying these patients enables targeted violence prevention programs.
Background:
Since the 1980s, violence has emerged as a leading public health concern in the United States. Recent studies have begun to address the impact of interpersonal violence specifically on young children. The purpose of this study was to describe the epidemiology of violence-related injuries (VRI) in an urban pediatric emergency department (ED).
Methods:
A six-month retrospective chart review was conducted. The records of 11,000 patients 17 years of age and younger who were seen in an urban pediatric ED were accessed for VRI. VRI were defined as purposefully inflicted with intent to harm. Patients discharged from the ED with VRI were compared to patients admitted with VRI.
Results:
Three hundred seventeen (3%) of patients were categorized as having VRI during the six-month study period. Eighty-three percent were discharged, and 17% were admitted. The majority of injuries was the result of interpersonal conflict with a friend or acquaintance. Patients discharged were more likely to involve: younger children, female victims, and blunt instruments. Thirteen percent of discharged patients, however, involved potentially lethal weapons (knife or firearm).
Conclusions:
The vast majority of patients with VRI are discharged from the ED. Females and young children were frequently evaluated for VRI in the pediatric ED. Identification of these patients can be used to initiate service protocols directed at violence prevention.