December 30, 2015 20:58 ET

​Dr. Gregory Brammer -- Discusses Workplace Violence in the Emergency Department

NEW YORK, NY--(Marketwired - December 30, 2015) - Gregory Brammer, Expert Emergency Medicine Specialist and Fellow of the American College of Emergency Physicians, has recently brought awareness to the massive systemic problem of workplace violence in our nation's Emergency Departments (ED). With nearly 50% of all violent workplace assaults in the United States being perpetrated by healthcare patients, it's not surprising that hospital EDs have the highest rate of workplace violence compared to any other setting in the country. Due to the lack of good prospective studies, only an estimate of workplace violence is possible. However, it is important to take into account that health care workers (HCW) self-reporting is grossly underestimated.

"Harassment and physical violence tolerated in the ED setting would often be considered criminal outside the doors of the hospitals and ambulances," says Dr. Gregory Brammer. According to him, HCW are victims of violent assaults at an incidence four times higher than that in any other workplace. "If we stratify HCW strictly to nurses and other direct personal patient care workers that number rises to 12 times that of other workplaces. At a minimum, 67% of ED healthcare aides and nurses, and 50% of ED physicians have been assaulted at least one time in the prior six months. An astonishing 25% of ED nurses reported being physically assaulted more than twenty times in the prior three years. It's estimated that 20% of ED physicians who have been assaulted carry concealed handguns with estimates as high as 70% in larger metropolitan areas."

HCW have always recognized violence and harassment in the ED. Metal detectors, dedicated ED security guards, and the liberal use of law enforcement were once the norm. Currently, the trend among healthcare administrations is to remove metal detectors and dedicated ED Security, citing that they cause a negative impact on the perception of the ED.

Dr. Brammer discussed some recent hospital studies on violence in the ED. "A six-month study using metal detectors in a Detroit ED, revealed 1,234 knives and 33 guns on walk-in patients. In a Los Angeles hospital, ED Security found that 25% of males and 31% of female trauma patients had weapons on their persons when patted down by security personnel."

During Dr. Brammer's residency program at the University of Arizona Medical Center, the hospital employed highly trained German Shepherds in the ED. These dogs protected the HCW by acting as a deterrent, as well as, directly confronting violent patients. "In my opinion, the addition of our canine friends is vital against workplace violence. While dogs are routinely used in bomb and drug detection, in K-9 units and for patient therapy, they presently serve only at a handful of EDs and are grossly underrepresented," argues Dr. Brammer. "The primary role of these dogs is the security of HCW and when on 'guard duty' with their security handlers, the dogs cannot be distracted. However, when the dogs are not at the entrance of a room with a potentially violent patient, they and their handlers strolled throughout the ED as a therapy pet."

According to the 2015 edition of Yorkland and MacAllister's textbook 'Hospital and Healthcare Security', "In the gang community, it may be culturally acceptable of being afraid of the dog, but not necessarily a police officer. Gang members would rather deal with an armed security officer than take a bite from a dog."

Dr. Brammer shared his story where he was dealing with a hostile patient. During a prolonged repair of a facial laceration, the agitated patient pulled a knife on him at close range. Dr. Brammer was certain he'd be killed. Immediately, the ED dog Samuel let out a thundering bark. Following the handler's command, Samuel ran and jumped on the gurney with his jaws engulfing the patient's throat. The patient was unharmed, and Dr. Brammer feels he owes his life to Samuel.

Dr. Gregory Brammer is an expert Board Certified and Board Trained Emergency Medicine Physician and Fellow of the American College of Emergency Physicians with almost 20 years of experience. Dr. Brammer has served an estimated 2.5 million people over his career in medicine. Due to his expertise as an EMS Specialist, Physician, Cardiac Resuscitation Expert and Educator, Dr. Brammer is an international speaker and consultant with works published in the Annals of Emergency Medicine and Veterinary & Human Toxicology. He has spoken and lectured on the subjects of Point-of-Care-Testing, Emergency Medical Services, and other topics related to health and medicine.

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