番茄社区

In the first 2 months after a San Diego urban emergency department installed metal detectors this year, the number of confiscated weapons skyrocketed 13-fold, from 15 to 194, when psychiatric patients were screened, a new report revealed.

The weapons included a gun, knives/switchblades, box cutters, blunt instruments, tire irons, a stun gun, and even Sterno, a flammable fuel that's carried by homeless people for cooking purposes and self-protection, said , clinical service chief of Emergency Medicine at the University of California San Diego, who reported the findings at the American College of Emergency Physicians annual meeting.

"Weapons screening can be a very successful intervention," he told 番茄社区.

UCSD Medical Center, a level 1 trauma center with an annual emergency department census of about 45,000 visits a year, added a walk-through magnetometer to the emergency entrance of the central San Diego campus last winter. The move came after a patient stabbed himself with a knife in the waiting room, Vilke said. "This added a lot to the safety concerns of staff."

Now, patients and visitors must go through the metal detector and can only take one personal bag with them. Other bags are stored securely and are inspected with handheld metal detector wands if needed. Any weapons are confiscated and not returned if their owners can't get rid of them by, say, returning them to a vehicle, Vilke said.

Patients who come in by ambulance are screened at the bedside.

During the earlier 8-week period, security staff screened 511 psychiatric patients and confiscated 15 weapons. Over the 8 weeks the metal detectors appeared, 13,149 people were screened and 194 weapons were confiscated. The change in average weapons confiscated per day grew from a mean of 0.26 to 3.46 (P<0.001); the patient censuses were similar during both 8-week periods.

Hospital staff are not required to go through the screening, Vilke noted.

He said the study's findings aren't surprising: "We know people carry stuff in," he said. "Most of the time, it's not an issue. They keep it to their backpacks."

The metal detectors remain in place, Vilke said, adding that he expects future research to explore whether patients actually now feel safer.

"From a staff perspective, there's probably an increased perception of safety," he said. "Another area that needs to be looked into is the immediate effect when you reduce the number of weapons that would otherwise be brought in by patients or visitors."

It's unclear how many U.S. hospitals use metal detectors for security screening. Some local San Diego hospitals do not; a found that a third of hospitals surveyed used metal detectors.

'Security Screening is Steeped in Racial Bias'

However, Carmen Black, MD, a psychiatrist at Yale School of Medicine in New Haven, Connecticut, told 番茄社区 that research like this needs to consider a larger picture: Security screening systems are "steeped in racial bias, because they tend to be prioritized at urban teaching hospitals where predominately white, affluent trainees and faculty serve poorer patients of color," she explained, noting that has failed to link inner-city neighborhoods to more armed violence at hospitals.

"Because racial bias plants policing measures disproportionately at public hospitals serving patients of color, we do not know how many weapons are being brought into predominately white hospitals without detection," Black said. "Yet, found that hospitals with the most Black patients confiscated the fewest weapons, whereas the hospitals with the most white patients confiscated the most."

In addition, she noted, suggests that confiscation of weapons does not lead to fewer hospital assaults.

"Lastly, what is the cost -- both financial and ethical -- behind this dubiously effective yet extremely expensive practice?" Black said. "Hospital dollars are limited. How many hospital assaults could be reduced if faster, more robust service delivery yielded less frustrated, healthier patients?"

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