创伤急救室中的执法情况：对美国创伤外科学会成员的一项调查
Law enforcement in the trauma bay: a survey of members of the American Academy for the Surgery of Trauma.
作者信息
Kaufman Elinore J, Khatri Utsha, Hall Erin C, Alur Rucha, Song Jamie, Jacoby Sara F
机构信息
Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Department of Emergency Medicine, Mount Sinai School of Medicine, New York, New York, USA.
出版信息
Trauma Surg Acute Care Open. 2023 Mar 13;8(1):e001022. doi: 10.1136/tsaco-2022-001022. eCollection 2023.
BACKGROUND
Trauma patients frequently come into contact with law enforcement officers (LEOs) during the course of their medical care, but little is known about how LEO presence affects processes of care. We surveyed members of the American Association for the Surgery of Trauma (AAST) to assess their perspectives on frequency, circumstances, and implications of LEO presence in trauma bays nationwide.
METHODS
Survey items addressed respondents' experience with the frequency and context of LEO presence and their perspectives on the impact of LEO presence for patients, clinical care, and public safety. Respondent demographics, professional characteristics, and practice setting were collected. The survey was distributed electronically to AAST members in September and October of 2020. Responses were compared by participant age, gender, race, ethnicity, urban versus rural location using χ2 tests.
RESULTS
Of 234 respondents, 189 (80.7%) were attending surgeons, 169 (72.2%) identified as white, and 144 (61.5%) as male. 187 respondents (79.9%) observed LEO presence at least weekly. Respondents found LEO presence was most helpful for public safety, followed by clinical care, and then for patients. Older respondents rated LEO presence as helpful more often than younger respondents regarding the impact on patients, clinical care, and public safety (p<0.001 across all domains). When determining LEO access, respondents assessed severity of the patient's condition, the safety of emergency department staff, the safety of LEOs, and a patient's potential role as a threat to public safety.
CONCLUSIONS
Respondents described a wide range of perspectives on the impact and consequence of LEO in the trauma bay, with little policy to guide interactions. The overlap of law enforcement and healthcare in the trauma bay deserves attention from institutional and professional policymakers to preserve patient safety and autonomy and patient-centered care.
LEVEL OF EVIDENCE
IV, survey study.
背景
创伤患者在接受医疗护理过程中经常与执法人员（LEO）接触，但对于执法人员的在场如何影响护理过程却知之甚少。我们对美国创伤外科协会（AAST）的成员进行了调查，以评估他们对全国创伤病房中执法人员在场的频率、情况及影响的看法。
方法
调查问卷的项目涉及受访者对执法人员在场频率和背景的经历，以及他们对执法人员在场对患者、临床护理和公共安全影响的看法。收集了受访者的人口统计学信息、专业特征和执业环境。该调查于2020年9月和10月以电子方式分发给AAST成员。使用χ²检验按参与者的年龄、性别、种族、民族、城市与农村地点比较了回复情况。
结果
在234名受访者中，189名（80.7%）是主治外科医生，169名（72.2%）为白人，144名（61.5%）为男性。187名受访者（79.9%）观察到执法人员至少每周在场一次。受访者认为执法人员在场对公共安全最有帮助，其次是临床护理，然后才是对患者。在对患者、临床护理和公共安全的影响方面，年长的受访者比年轻的受访者更频繁地认为执法人员在场是有帮助的（所有领域p<0.001）。在确定执法人员进入时，受访者评估了患者病情的严重程度、急诊科工作人员的安全、执法人员的安全以及患者作为对公共安全威胁的潜在作用。
结论
受访者对执法人员在创伤病房中的影响和后果描述了广泛的观点，几乎没有政策来指导互动。创伤病房中执法与医疗的重叠值得机构和专业政策制定者关注，以维护患者安全、自主权和以患者为中心的护理。
证据级别
IV，调查研究。
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