Emergency Medicine: Competencies for Youth Violence Prevention and Control

Abstract

By any standard one wishes to apply, the impact of violence on the health and safety of the public is significant. The expression of violence among children in the United States has increased significantly during the modern era. Homicide and suicide are the second and third leading causes of death in youths 15-24 years of age. The emergency department (ED) is a common site for the care of these victims, and because victims often become assailants, the emergency care provider needs to know the epidemiology, treatment, and methods for prevention of youth violence in order to curtail the cycle. A multidisciplinary task force was convened by the Centers for Disease Control and Prevention (CDC)-funded Southern California Center of Academic Excellence on Youth Violence Prevention and the Keck School of Medicine at the University of Southern California to define competencies for health professionals in youth violence prevention and control. Three levels of competence were identified: the generalist level, which should be obtained by all health professionals; the specialist level, which should be obtained by health professionals such as emergency medicine providers, who frequently work with populations affected by violence; and a third, or scholar level, to be acquired by health professionals who wish to become experts not only in the care, but also in research and advocacy. This article reports the details of this group's efforts and applies them to emergency care provider education. These competencies should shape the development of curricula for the span of emergency medical training from emergency medical services scholastic training to postgraduate continuous medical education. Key words: emergency medicine; violence; adolescence; prevention; competencies. ACADEMIC EMERGENCY MEDICINE 2002; 9:947-956. Youth violence is a serious public health problem in the United States; indeed, homicide is the second leading cause of death for young persons aged 15-24 years. 1 The data on more common nonfatal violent injuries are less available and reliable than the data on homicide, in part because many victims do not seek medical attention. 2 The situations in which fatal and nonfatal adolescent assault injuries occur are similar, 3 and violent injury and death result from altercations between family members and acquaintances more often than from criminal activity. 4 A growing number of reports confirm that children frequently witness violence, 5-8 and exposure to violence and victimization is strongly associated with subsequent acts of violence by the victim. 9-11 There

Children Injured by Violence in the United States: Emergency Department Utilization, 2000–2008

“…In fact, several ED‐based interventions have been shown to be effective in this regard 17,18 . Thus, it is important for the pediatric ED care provider to know the epidemiology of youth violence to facilitate the creation and evaluation of prevention programs 19 . To guide these efforts, research priorities for violence prevention in the ED have been elucidated 20 .…”

Creativity and Gangs: Who Joins Gangs and Why? A Critical Review of the Literature

“…They are characterized by their involvement in severe criminal activity [7,8]. Gang violence is an increasing public health problem in the US [7][8][9][10][11]. The Federal Bureau of Investigation [10] reported that there are 1.4 million active gang members in the US.…”

Thinking about violence: do surgeons have a role outside the operating theatre?

“…1 There are therefore many reasons why surgeons should be involved in helping to understand the causes of violence and in its prevention. The second part of this article addresses ways in which surgeons, can -some may argue,should -be involved in roles other than their clinical one in helping humanity deal with the scourge of violence.Drawing on the seven roles defined by the CanMEDS By collaborating with social services, schools and community groups we can help bring the reality of the harm done by violence to those for whom violence is often just a game.We can participate in violence prevention programmes 6,7 and help individuals and communities break out of cycles of violence,working with networks such as the WHO-sponsored Violence Prevention Alliance,the Violence Reduction Unit (Scotland), or Violent Crime Ta sk Groups (England and Wales). By way of example,Warburton and Shepherd described in 2002 how maxillofacial surgeons were becoming involved in the wider issues of violence prevention.…”