A Case for Risk Stratification in Survivors of Firearm and Interpersonal Violence in the Urban Environment.
A Case for Risk Stratification in Survivors of Firearm and Interpersonal Violence in the Urban Environment.
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DOI：
10.5811/westjem.2020.8.45041
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发表时间：
2020-10-16
期刊：
影响因子：
--
通讯作者：
Moore PQ
中科院分区：
文献类型：
--
作者：
Walker GN;Dekker AM;Hampton DA;Akhetuamhen A;Moore PQ
急诊科（ED）是人际暴力受害者的主要护理来源。因此，全国各地的急诊医生都站在最前沿，在动态的医疗环境中为许多高危患者提供护理和确定处置。在大多数情况下，对人际暴力幸存者的治疗和出院是基于伤害的身体影响，而不考虑再次受伤的风险和可能起作用的结构性驱动因素。在设有以医院为基础的暴力干预方案（hvip）的机构中可能存在一些例外。在这些机构，处置决定通常包括考虑病人再次遭受暴力的风险。理想情况下，所有人际暴力的幸存者都可以获得HVIP服务，但目前的各种限制限制了这种服务的可用性。在这里，我们对HVIP的范围进行了回顾，并就风险分层如何帮助急诊医生确定哪些患者将从HVIP服务中获益最多，并有可能减少人际暴力导致的再伤害提供了我们的观点。
The emergency department (ED) serves as the main source of care for patients who are victims of interpersonal violence. As a result, emergency physicians across the nation are at the forefront of delivering care and determining dispositions for many at-risk patients in a dynamic healthcare environment. In the majority of cases, survivors of interpersonal violence are treated and discharged based on the physical implications of the injury without consideration for risk of reinjury and the structural drivers that may be at play. Some exceptions may exist at institutions with hospital-based violence intervention programs (HVIPs). At these institutions, disposition decisions often include consideration of a patient’s risk for repeat exposure to violence. Ideally, HVIP services would be available to all survivors of interpersonal violence, but a variety of current constraints limit availability. Here we offer a scoping review of HVIPs and our perspective on how risk-stratification could help emergency physicians determine which patients will benefit most from HVIP services and potentially reduce re-injury secondary to interpersonal violence.
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