PJCGAGNO’S MAR [15-06]:Handling patients with dangerous weapon

Index Title: PJCGAGNO’S MAR [15-06]
MAR Title: Safety First
Period of Observation: June 2015
Tag: Handling patients with dangerous weapon
Category: Professional/Ethical-Reinforcement


It was a busy duty at the emergency room when a 54-year-old male, approximately 5’4” in height, wearing a short pants and a loose t-shirt came to our table. He was holding his stomach with his arms wrapped around on his abdominal area, crouching down, and barely reaching the table. He was asking for help because he felt a sudden onset of abdominal pain.

I immediately attended to the patient and started asking for his history. I eventually extracted from him that he is a known case of nephrolithiasis (stones located at the kidneys). I let him lay down at the examining stretcher to start my physical examination. After asking him to raise his t-shirt in order to expose his abdomen for better physical examination, I noticed an elongated material wrapped with a piece of cloth, securely tied on his short pants. I then asked the patient what was it. At first, he was hesitant to tell but eventually told that it was a knife. I immediately asked the patient to surrender his weapon. At first, he was hesitant to give it but after several times of explaining to the patient that we need to secure the deadly weapon, he eventually followed our advice.

I then inspected the material and it was indeed a 6-inches knife. I immediately informed my nurse and handed the knife over to them. I also informed our security personnel (CSF) about the incident. After securing the material, I then resumed my physical examination and completed the consult.

(Physical, Psychosocial, Professional/Ethical)
(Stimulus, Discovery, Reinforcement)

Before anything else, safety is the top priority, for our patients and to us physicians. Medical care cannot be properly delivered if there is impending danger in the environment that is threat to our patients and to us. Even though he was not showing any violent behaviors, the presence of a dangerous weapon can be considered a threat to himself, to other patients and to the medical team.

With that premise, it is important for us physicians to know how to handle such situations. Though being hesitant is inevitable, we need to have the presence of mind. We have to step up and properly talk to our patients. First, inform them that bringing dangerous weapon in the hospital is not allowed and may pose danger to other patients and to their physicians as well. Unnecessary yelling and discriminatory reprimanding to the patient is inappropriate. Second, we have to disarm the patient by asking them to hand to us their weapon in a nice manner. Given that they have trust to us, they will listen and follow our directions. Third, it is necessary to report to the authorities, such as the nurses and the Central Security Forces (CSF), regarding the situation. However, if the patient is uncooperative and is not willing to surrender the weapon, then immediate reporting to the security personnel is then, needed.

Last but not the least, Medicine does not discriminate. We have to treat patients fairly and without discrimination. As a physician, we should be ready to deliver medical care to our patients from different walks of life. The quality care given to every patient should be equal and justifiable. Given the limited resources of our hospital, which poses limited medical care given, the least we can do is set our attitude in which we treat our patients fair and square whether charity or pay, victim or convict, politicians or voter. We have to set aside our emotions and do our job.

With all these, I recommend to at least have an improvement in the security of our hospital. The security personnel (CSF) should be empowered to screen the patients coming into the hospital. Also, there should be a protocol in the hospital regarding such incidence, in which all medical personnel can report to appropriate authorities. And, we physicians should also be oriented on how to handle such situations.

ROJoson’s Notes (17jan20):

One of the roles of the security force assigned to the Department of Emergency Room is to ensure safety of the staff and patients in the Room.  No firearms and no deadly destructive weapons and materials should be allowed inside the Emergency Room.


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