Physician Documentation of Access to Firearms in Suicidal Patients in the Emergency Department
Physician Documentation of Access to Firearms in Suicidal Patients in the Emergency Department
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DOI：
10.5811/westjem.2019.7.42678
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发表时间：
2019-09-01
影响因子：
3.1
通讯作者：
Mueller, Kristen L.
中科院分区：
文献类型：
--
作者：
Naganathan, Sonya;Mueller, Kristen L.
简介：自杀是美国第十大死因。据估计，这些死亡中有50%是由枪支造成的。自杀意念(SI)是急诊科(ED)常见的主诉。尽管有这些事实，但缺乏关于获得致命手段的提供者文档。我们的主要目标是量化向急诊室就诊的主诉为SI的患者获得枪支的记录。方法：这是一项对连续患者的横断面研究，几乎所有患者都在2014年7月期间向一位患有SI的学术、城市ED就诊。我们从电子健康记录中的所有提供者文档中收集数据。评估的主要结果是急诊医生(EP)团队是否记录了获得枪支的途径。次要结果包括人口统计信息、既往精神疾病诊断和性格特征。结果：我们回顾了100例患者的病历。患者的中位年龄为38岁。大多数患者都有精神疾病。EPS只记录了3%的患者使用枪支的情况。结论：EPS没有充分记录SI患者使用枪支的情况。在这个患者队列中，显然需要关于危险因素评估和针对致命性手段的咨询的教育倡议。
Introduction: Suicide is the 10th leading cause of death in the United States. An estimated 50% of these deaths are due to firearms. Suicidal ideation (SI) is a common complaint presenting to the emergency department (ED). Despite these facts, provider documentation on access to lethal means is lacking. Our primary aim was to quantify documentation of access to firearms in patients presenting to the ED with a chief complaint of SI.Methods: This was a cross-sectional study of consecutive patients, nearly all of whom presented to an academic, urban ED with SI during July 2014. We collected data from all provider documentation in the electronic health record. Primary outcome assessed was whether the emergency physician (EP) team documented access to firearms. Secondary outcomes included demographic information, preexisting psychiatric diagnoses, and disposition.Results: We reviewed 100 patient charts. The median age of patients was 38 years. The majority of patients had a psychiatric condition. EPs documented access to firearms in only 3% of patient charts.Conclusion: EPs do not adequately document access to firearms in patients with SI. There is a clear need for educational initiatives regarding risk-factor assessment and counseling against lethal means in this patient cohort.