Weapons Detection at Two Urban Hospitals

Simon, Harold K.; Khan, Naghma S.; Delgado, C Alfredo

doi:10.1097/01.pec.0000086236.54586.db

Cited by 10 publications

(4 citation statements)

References 9 publications

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“…Some ED managers and personnel are concerned that they may undermine the public image of EDs or constitute an invasion of privacy. 24,25 However, studies indicate that most visitors and patients look favorably upon metal detectors and feel they contribute to a safer enviroment. 25-27 …”

Section: Discussionmentioning

confidence: 99%

A Survey of Workplace Violence Across 65 U.S. Emergency Departments

Kansagra

Rao

Sullivan

et al. 2008

Academic Emergency Medicine

129

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Objectives Workplace violence is a concerning issue. Healthcare workers represent a significant portion of the victims, especially those who work in the emergency department (ED). The objective of this study was to examine ED workplace violence and staff perceptions of physical safety. Methods Data were obtained from the National Emergency Department Safety Study (NEDSS), which surveyed staff across 69 U.S. EDs including physicians, residents, nurses, nurse practitioners, and physician assistants. The authors also conducted surveys of key informants (one from each site) including ED chairs, medical directors, nurse managers, and administrators. The main outcome measures included physical attacks against staff, frequency of guns or knives in the ED, and staff perceptions of physical safety. Results A total of 5,695 staff surveys were distributed, and 3,518 surveys from 65 sites were included in the final analysis. One-fourth of surveyed ED staff reported feeling safe sometimes, rarely, or never. Key informants at the sampled EDs reported a total of 3,461 physical attacks (median of 11 attacks per ED) over the 5-year period. Key informants at 20% of EDs reported that guns or knives were brought to the ED on a daily or weekly basis. In multivariate analysis, nurses were less likely to feel safe “most of the time” or “always” when compared to other surveyed staff. Conclusions This study showed that violence and weapons in the ED are common, and nurses were less likely to feel safe than other ED staff.

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Section: Discussionmentioning

confidence: 99%

A Survey of Workplace Violence Across 65 U.S. Emergency Departments

Kansagra

Rao

Sullivan

et al. 2008

Academic Emergency Medicine

129

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“…They have been used to find metallic objects in wounds, 10 11 to detect bullets after death, 12 and to disclose concealed weapons at airports and hospitals. 13 They have been used to detect orthopaedic implants 6 and to screen for ingested metallic foreign bodies. 14 The use of hand held metal detectors to screen bodies for pacemakers before cremation may not be new.…”

Section: Discussionmentioning

confidence: 99%

A migrating pacemaker

Gale¹,

Mulley

2005

Postgraduate Medical Journal

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A deceased 79 year old man with a permanent cardiac pacemaker was due to be cremated, but the pacemaker generator was not detectable by palpation. A hand held metal detector to locate the device so that it could be extracted before cremation.A bout half of all crematoriums in the UK have experienced pacemaker explosions. These may cause structural damage and injury. 1 In an attempt to prevent pacemaker explosions in UK crematoriums, statutory questions on the cremation form ask the attending physician if the deceased had an artificial cardiac pacemaker and if so, whether it has been removed. 2Despite these questions, some pacemakers are not removed before cremation. There are several possible explanations for this. Firstly, the doctor signing the form may mistakenly report that there is no pacemaker in the body. Secondly, cremation forms may not be completed adequately (in one survey, nearly 50% of forms presented to a crematorium were completed insufficiently for the staff to proceed without further inquiry, 3 in another study, 6% of cremation forms had incorrect or incomplete details of pacemaker or radioactive implants, with over 25% of forms being unsatisfactorily completed 4 ). Thirdly, the coroner's form E does not contain the questions about pacemakers. With the coroner's certificate now accounting for up to a third of disposals, 5 it may be that omission of the statutory questions result in some pacemakers remaining in situ. Fourthly, it is possible that only one pacemaker is removed from a body that contains two or more devices, although this is unusual. CASE REPORTAnother reason for non-removal of a pacemaker became apparent when a body of a man in our hospital mortuary was being prepared for cremation. The 79 year old man had died of a type II respiratory failure. The medical notes stated that the body contained a VVI cardiac pacemaker, inserted in 2003 for symptomatic bradycardia. Despite a thorough external examination of the body, we failed to identify the characteristic mass of the pacemaker box. The medical notes were re-examined and a recent electrocardiogram showed an intermittent left bundle branch block pattern following ventricular pacing spikes.We used a commercially available MD-3003 hand held metal detector (J W Electronics, Dolgellau)-similar to those used at airports 6 to scan the thorax of the body-which was placed on a non-metallic surface (fig 1). We ensured that the detector was kept close to the skin to minimise the chance of a false negative result. It produced a signal over the left sixth intercostal space in the mid-axillary line. On superficial dissection, we found the pacemaker box in this site. The migrated box was removed uneventfully, the cremation form completed, and the body released for cremation. DISCUSSIONPacemakers may migrate in the subcutaneous tissue, making detection by palpation difficult. This may explain why some pacemakers remain in bodies that are cremated. Pacemakers may also be placed in the epigastric region at the time of cardiac surgery and will not be i...

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“…Metal detectors rarely are used presently, despite the frequency of violent incidents in some communities, and especially more frequently now at the ED. 30,31 Given these facts, it may be that many hospitals' plans are not adequate to deal with a direct attack.…”

Section: Reportmentioning

confidence: 99%

Hospitals: Soft Target for Terrorism?

Cauwer¹,

Somville

Sabbé

et al. 2016

Prehosp. Disaster med.

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In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning. De Cauwer H , Somville F , Sabbe M , Mortelmans LJ . Hospitals: soft target for terrorism? Prehosp Disaster Med. 2017;32(1):94-100.

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Weapons Detection at Two Urban Hospitals

Cited by 10 publications

References 9 publications

A Survey of Workplace Violence Across 65 U.S. Emergency Departments

A Survey of Workplace Violence Across 65 U.S. Emergency Departments

A migrating pacemaker

Hospitals: Soft Target for Terrorism?

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