Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117655

Brendan G. Carr, MD, MA, Department of Emergency Medicine, Firearm & Injury Center at Penn, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, 215.662.6305, brendan.carr@uphs.upenn.edu, Sarah E. Winters, MD, Division of General Pediatrics, Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, Joel Chinitz, MD, MPH, Philadelphia Physicians for Social Responsibility, 704 N. 23rd Street, Philadelphia, PA 19130, and Douglas J. Wiebe, PhD, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 933 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.

Purpose: Emergency Departments (EDs) treat over a million people for non-fatal injuries annually. Most are discharge after treatment and a subset of these will return for treatment of recurrent injury. The potential to develop a screening protocol that will identify patients at risk for recurrent injury depends upon accurate documentation of injuries. Methods: We reviewed records from three EDs over a four week period. Inclusion criteria were age 10-25 years, acute non-MVC injury, and residence within designated zip codes. Charts were abstracted for demographic information, circumstances of the injury, risk factors for injury/re-injury, and disposition of the patient at discharge. Descriptive data are presented. Results: 146 records were reviewed. 41% of injuries were intentional. Injury circumstances were absent in 57% of cases. Rarely was the patient questioned about risk factors including previous intentional injuries (2%), school attendance (1%), previous fights (0%), and drug/alcohol use (5%). 31% were discharged without referral for follow-up. Only one patient received a psychosocial referral and no patient received a community referral. Conclusions: Emergency Physicians are not documenting circumstantial information or known risk factors on injured patients that could be used to identify patients at high risk for future intentional injury. Increased awareness of the need for documentation may improve the ability to develop effective screening tools and/or interventions to prevent recurrent injury.

Learning Objectives:

• Participants will have an improved understanding of the state of documentation of injuries by Emergency Physicians.
• Participants will be able to identify important historical factors of violently injured patients.
• Participants will be able to more effectively screen for risk of repeat injury.

Keywords: Emergency Department/Room, Injury Prevention

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.