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Emergency department dispositions among 4100 youth injured by violence: a population-based study

Published online by Cambridge University Press:  21 May 2015

Carolyn E. Snider  and
Jacques S. Lee
Carolyn E. Snider*
Affiliation:
Division of Emergency Medicine, University of Toronto, Toronto, Ont.
Jacques S. Lee
Affiliation:
Division of Emergency Medicine, University of Toronto, Toronto, Ont. Sunnybrook Research Institute, University of Toronto, Toronto, Ont.
*
Division of Emergency Medicine, University of Toronto, 2075 Bayview Ave., C716, Toronto ON M4N 3M5; carolynsnider@sympatico.ca

Abstract

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Objective:

Concern about youth violence in Canada is growing. Because victims of violence are more likely to become future violent perpetrators, preventative interventions are often based out of inpatient units; however, the question of how often youth who have been injured due to violence are discharged from emergency departments (EDs), or whether there are opportunities for emergency healthcare workers to deliver violence prevention programs, is not known. The primary objectives of this study were to describe the frequency and patterns of violent injuries among youth, to determine how many injured youth are discharged directly from EDs and to estimate the proportion of injured youth who may benefit from ED-based intervention programs.

Methods:

We conducted an observational study using a population-based database that records information on all ED visits in Ontario. We analyzed age, sex, cause of injury and disposition for all patients aged 12–19 years who presented to Toronto EDs with violent injuries during a 2-year period (April 2002 to March 2004).

Results:

A total of 4100 patients aged 12–19 years visited Toronto EDs with violent injuries during the study period. Assault due to bodily force (in contrast to sharp objects, guns or other) was the most common injury mechanism, accounting for 48.7% of cases (95% confidence interval [CI] 47.1%–50.2%). The majority of patients (89.3%; 95% CI 88.3%–90.2%) were discharged directly from EDs, including 44% of gun-related injuries.

Conclusion:

In Toronto, a large proportion (89.3%) of youth injured in violent incidents are discharged directly from EDs. There are opportunities to develop ED-based youth violence prevention initiatives.

Keywords

youthviolenceemergency medicinepreventionvictim
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 9 , Issue 3 , May 2007 , pp. 164 - 169
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

References

1.EKOS Research Associates, Inc. 2004 March 26. Canadian attitudes toward the prevention of crime. Presented to Justice Canada. Available: http://www4.psepc-sppcc.gc.ca/en/library/publications/research/attitudes/index.html (accessed 2006 Nov 2).Google Scholar
2.Crime Statistics in Canada. Statistics Canada. 2005;26(4):13. Cat no. 85-002 Available: http://www.statcan.ca/english/freepub/85-002-XIE/85-002-XIE2006004.pdf (accessed 2006 Nov 2).Google Scholar
3.Sims, DW, Bivins, BA, Obeid, FN, et al. Urban trauma: a chronic recurrent disease. J Trauma 1989;29:940–6.CrossRefGoogle ScholarPubMed
4.Rivara, FP, Shepherd, JP, Farrington, DP, et al. Victim as offender in youth violence. Ann Emerg Med 1995;26:609–14.Google Scholar
5.Morrison, LJ, Allan, R, Grunfeld, A. Improving the emergency department detection rate of domestic violence using direct questioning. J Emerg Med 2000;19:117–24.CrossRefGoogle ScholarPubMed
6.Mello, MJ, Nirenberg, TD, Longabaugh, R, et al. Emergency department brief motivational interventions for alcohol with motor vehicle crash patients. Ann Emerg Med 2005;45:620–5.Google Scholar
7.Rhodes, KV, Gordon, JA, Lowe, RA. Preventive care in the emergency department, part I: clinical preventive services-are they relevant to emergency medicine? Society for Academic Emergency Medicine Public Health and Education Task Force Preventive Services Work Group. Acad Emerg Med 2000;7:1036–41.Google Scholar
8.Karlson, TA. Injury control and public policy. Crit Rev Environ Control 1992;22:195–241.Google Scholar
9.Baker, SP. Childhood injuries: the community approach to prevention. J Public Health Policy 1981;2:235–46.CrossRefGoogle ScholarPubMed
10.Zun, SZ, Downey, L, Rosen, J. Violence prevention in the ED: linkage of the ED to a social service agency. Am J Emerg Med 2003;21:454–7.CrossRefGoogle ScholarPubMed
11.Zun, SZ, Downey, L, Rosen, J. The effectiveness of an ED-based violence prevention programme. Am J Emerg Med 2006;24:8–13.CrossRefGoogle Scholar
12.Becker, MG, Hall, JS, Ursic, CM, et al. Caught in the crossfire: the effects of a peer-based intervention program for violently injured youth. J Adolesc Health 2004;34:177–83.Google Scholar
13.Youth, Alive. Caught in the crossfire. Available: http://www.youth alive.org/caught.html (accessed 2006 Nov 2).Google Scholar
14.Chan, B, Schull, MJ, Schultz, SE. Emergency department services in Ontario. Institute for Clinical Evaluative Studies Research Atlas. 1st ed. North York (ON): Institute for Clinical Evaluative Sciences, 2001.Google Scholar
15.Totten, M. Youth violence fact sheet. Public Health Agency of Canada. Available: http://www.phac-aspc.gc.ca/ncfv-cnivf/familyviolence/html/nfntsyjviolence_e.html (accessed 2007 Feb 28).Google Scholar
16.Statistics Canada. Age (122) and sex (3) for population, for Canada, Provinces, Territories and Federal Electoral Districts (1996 Representation Order), 2001 Census-100% Data. Census 2001 (95F0300XCB2001003). Available: www.statcan.ca/english/Dli/Data/Ftp/census/2001/tbt/census2001as-tbt.htm (accessed 2006 Nov 2).Google Scholar
17.Sege, RD, Kharasch, S, Perron, C, et al. Pediatric violence-related injuries in Boston. Arch Pediatr Adolesc Med 2002;156:73–6.Google Scholar
18.Gofin, R, Avitzour, M, Haklai, Z, et al. Intentional injuries among the young: presentation to emergency rooms, hospitalization, and death in Israel. J Adolesc Health 2000;27:434–42.Google Scholar
19.Canadian Institute for Health Information. Executive summary: database background and general data limitations documentation National Ambulatory Care Reporting System (NACRS). Available: http://secure.cihi.ca/cihiweb/en/downloads/NACRS_Background_General_Data_Limit_Executive_Summary_2005-2006_e.pdf (accessed 2006 Nov 3).Google Scholar
20.Statistics Canada. Population urban and rural, by province and territory, 2001 Census. Available: www40.statcan.ca/l01/cst01/demo62a.htm (accessed 2006 Nov 3).Google Scholar