Waseem Muhammad, Paul Audrey, Schwartz Gerald, Pauzé Denis, Eakin Paul, Barata Isabel, Holtzman Doug, Benjamin Lee S, Wright Joseph L, Nickerson Amanda B, Joseph Madeline
Department of Emergency Medicine and Pediatrics, Lincoln Medical and Mental Health Center, Bronx, New York; St George's University, Grenada, West Indies.
Department of Pediatric Emergency Medicine, Mount Sinai Hospital, New York, New York.
J Emerg Med. 2017 Feb;52(2):246-252. doi: 10.1016/j.jemermed.2016.07.107. Epub 2016 Sep 29.
Bullying is an important public health issue with broad implications. Although this issue has been studied extensively, there is limited emergency medicine literature addressing bullying. The emergency department (ED) physician has a unique opportunity to identify children and adolescents that are victims of bullying, and make a difference in their lives.
Our aim is to discuss the role of the emergency physician (EP) in identifying patients who have been victims of bullying and how to provide effective management as well as referral for further resources.
This document provides a framework for recognizing, stabilizing, and managing children who have experienced bullying. With the advent of social media, bullying behavior is not limited to in-person situations, and often occurs via electronic communication, further complicating recognition because it may not impart any physical harm to the child. Recognition of bullying requires a high level of suspicion, as patients may not offer this history. After the stabilization of any acute or overt indications of physical injury, along with obtaining a history of the mechanism of injury, the EP has the opportunity to identify the existence of bullying as the cause of the injury, and can address the issue in the ED while collaborating with "physician-extenders," such as social workers, toward identifying local resources for further support.
The ED is an important arena for the assessment and management of children who have experienced bullying. It is imperative that EPs on the front lines of patient care address this public health epidemic. They have the opportunity to exert a positive impact on the lives of the children and families who are the victims of bullying.
欺凌是一个具有广泛影响的重要公共卫生问题。尽管这一问题已得到广泛研究,但涉及欺凌的急诊医学文献有限。急诊科医生有独特的机会识别遭受欺凌的儿童和青少年,并改变他们的生活。
我们的目的是讨论急诊医生在识别欺凌受害者患者方面的作用,以及如何提供有效的管理和转介以获取更多资源。
本文档提供了一个识别、稳定和管理遭受欺凌儿童的框架。随着社交媒体的出现,欺凌行为不仅限于面对面的情况,还经常通过电子通信发生,这使得识别更加复杂,因为它可能不会对孩子造成任何身体伤害。识别欺凌需要高度的怀疑,因为患者可能不会主动说出这段经历。在稳定任何身体损伤的急性或明显迹象后,以及获取损伤机制的病史后,急诊医生有机会识别出欺凌是损伤的原因,并可以在急诊科处理这个问题,同时与社会工作者等“医生助理”合作,以确定当地的进一步支持资源。
急诊科是评估和管理遭受欺凌儿童的重要场所。在患者护理一线的急诊医生必须应对这一公共卫生流行病。他们有机会对遭受欺凌的儿童和家庭的生活产生积极影响。