Security in pediatric emergency departments.

With increasing emergency department (ED) violence, security in pediatric EDs is an important concern. The objective of this study was to document current security measures taken in pediatric EDs in the United States. A telephone survey of the security director or designee in the 42 children's hospitals in the United States with over 150 beds was performed. A questionnaire focusing on ED security was administered. Two hospitals declined to participate. In 62.5% of EDs surveyed, a security officer is present in the ED 24 hours/day. Hospital security officers carry firearms in 32.5% of hospitals surveyed. Most (92.5%) EDs have an alarm system or "panic button" which alerts central security; but only 15% have a direct phone from the ED to security. Seven EDs (17.5%) use bullet-resistant glass, and 14 EDs (35%) have controlled access. No ED reported universal metal detector screening. Fourteen directors (35%) reported having had a firearm-related incident in their ED in the past year. In spite of the relatively common nature of ED violence, security measures in pediatric EDs are varied, with most EDs not using all measures recommended by the American College of Emergency Physicians.