ED adds 'safety room' in wake of fatal shooting
Machine saves time, conveniences patients
On Sept. 29, 2005, the lives of the ED staff at St. Mary Medical Center in Langhorne, PA, were affected dramatically when a man arrested for DUI pulled a gun and shot an ED technician and two police officers — one fatally.
Harry Myers, the hospital's director of safety, security, and parking, began discussions that very night with police officers and supervisors. Several days of "intense" meetings led to recommendations for the creation of a "public safety room" to keep future DUI patients and others who were potentially violent in a secure area separate from the main ED.
The ED was fortunate in that it had a vacant room, which had previously been used by EMS personnel when they filled out trip sheets. Charles Kunkle, RN, BSN, CEN, BCNA, the ED director, says, "They were now computerized and did not need the room any more."
"The beauty of that room is that it is a collaboration of many efforts — what Harry thought was important, what the local police departments recommended, and what we as an ED thought it should have," he says. "For example, we felt it was important to have an eye-wash machine because there are suspects who get pepper-sprayed."
Myers says he and his staff were open to all ideas and input. "Several of the same recommendations were made by multiple sources and were incorporated into the public safety room," he says. Among the hospital's concerns were that the space to be "sterile," i.e., free of any unnecessary equipment, chairs, or any items that might be used as a weapon; that there be a sufficient number of glass windows for viewing from the outside; seating for patient(s) only that was secured to the floor; and the ability to secure officers' weapons as needed, Myers says.
Near, not in, the ED
The room is not in the ED proper, says Kunkle. "There are doors where the ambulance personnel enter and a second set of doors that leads to the ED itself," he explains. "Before you enter that second set of doors, you make a left to go into the public safety room."
When a DUI suspect is being brought to the hospital, the ED receives a call in advance from the police, says Kunkle. "At that point, security will lock the second set of doors," he notes. When other patients arrive later by ambulance, EMS personnel will individually let each patient through those doors to maintain security.
The cost of renovating the room (estimated to be more than $10,000) did not come out of the ED fund, Kunkle says. "The CEO personally approved 'whatever it would take,'" he says.
Even a small budget of a few thousand dollars will provide basic equipment to outfit a room, notes Myers. The room was completed within a week of the incident.
Adjusting procedures
The new room was not the only thing that changed in the wake of the shootings, says Kunkle. The basic processes for dealing with DUI patients were radically changed as well.
"Previously, all intoxicated patients would come through the main waiting room for their blood draws," he says. "We gave them priority — depending, of course, on what else was going on in the department — as a courtesy to the police officers."
The staff would take an entire intravenous box into the treatment room, which contained "a multitude of sharps," according to Kunkle.
Now, when the patient is brought into the public safety room, the staff ask the police to make sure that the patient is handcuffed to the "security bench." The bench style, explains Myers, was recommended to him by a state police lieutenant. Made by state prisoners, "It is constructed of heavy steel, has room for two persons to sit, and has several points on it for securing both handcuffs and leg irons if needed," he notes. The bench alone weighs about 200 pounds and is bolted to the floor for added safety and security.
"In addition, we only take one IV catheter in with us," Kunkle says. "We do not want any sharps or instruments in there."
For DUI patients who need additional medical attention, another door has been put in the hallway that leads directly to a treatment room, so that patients still never enter the ED.
Myers and Kunkle believe that any hospital that receives or processes detained persons at any level should consider some type of room and procedures to provide the best security and safety possible for everyone, including the patient. "In addition, allocation of the space, about the size of a treatment room at a minimum, is also part of the equation," says Myers.
Kunkle says, "We are in beautiful Bucks County [an affluent Philadelphia suburb]. We only had one locked door and felt very safe. Don't be lulled into a sense of safety just because you live in an area where you feel safe. It can happen anywhere, and you should take steps now before it does happen."
Source
For more information on creating a public safety room, contact:
- Charles Kunkle, RN, BSN, CEN, BCNA, the ED Director, and Harry Myers, Director of Safety, Security, and Parking, St. Mary Medical Center, Langhorne, PA. Phone: (215) 710-2000.
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