Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
Emerg Med Australas. 2024 Aug;36(4):616-627. doi: 10.1111/1742-6723.14408. Epub 2024 Apr 22.
People detained in short-term police custody often have complex health conditions that may necessitate emergency care, yet little is known about their management in EDs. The present study aimed to understand ED doctors' experiences and perceptions regarding the appropriateness and management of detainee transfers from police watch-houses to the EDs.
A qualitative descriptive study, using semi-structured interviews undertaken with ED doctors working in five purposively sampled EDs across Queensland, Australia. Data were analysed using inductive content analysis.
Fifteen ED specialists and trainees participated. Participants reported that their overarching approach was to provide equitable care for watch-house detainees, as they would for any patient. This equitable approach needed to be responsive to complicating factors common to this population, including presence of police guards; restraints; complexity (physical/mental/social) of presentation; reliance on police to transport; ED doctors' often limited understanding of the watch-house environment; justice processes and uncertain legal disposition; communication with the watch-house; and detainees misreporting symptoms. Thresholds for assessment and treatment of detainees were contextualised to the needs of the patient, ED environment, and imperatives of other relevant agencies (e.g. police). Participants often relied on existing strategies to deliver quality care despite challenges, but also identified a need for additional strategies, including education for ED staff; improved communication with watch-houses; standardised paperwork; extended models of watch-house healthcare; and integrated medical records.
Providing equitable healthcare to patients transported from watch-houses to the EDs is challenging but essential. Numerous opportunities exist to enhance the delivery of optimal care for this underserved population.
被短期拘留的人通常有复杂的健康状况，可能需要紧急护理，但人们对他们在急症室的管理知之甚少。本研究旨在了解急诊医生对从警察局拘留所转至急症室的被拘留者的适宜性和管理的经验和看法。
这是一项使用半结构式访谈进行的定性描述性研究，访谈对象是在澳大利亚昆士兰州五家有针对性选取的急症室工作的急症医生。数据采用归纳内容分析法进行分析。
15 名急症专家和受训者参与了研究。参与者报告说，他们的总体方法是为拘留所的被拘留者提供公平的护理，就像为任何患者一样。这种公平的方法需要对常见于这一人群的复杂因素做出反应，包括警察看守的存在；限制；表现的复杂性（身体/心理/社会）；依赖警察进行运输；急诊医生对拘留所环境的了解往往有限；司法程序和不确定的法律处置；与拘留所的沟通；以及被拘留者虚报症状。对被拘留者进行评估和治疗的标准是根据患者、急症室环境和其他相关机构（如警察）的需求来确定的。尽管存在挑战，但参与者通常依赖现有的策略来提供高质量的护理，同时也确定了需要额外的策略，包括对急诊室工作人员进行教育；改善与拘留所的沟通；标准化文书工作；扩展拘留所医疗保健模式；以及整合医疗记录。
为从拘留所转至急症室的患者提供公平的医疗保健具有挑战性，但也是必要的。为这个服务不足的人群提供最佳护理有很多机会。
