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Caring for Patients From a School Shooting: A Qualitative Case Series in Emergency Nursing

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Federal government websites often end in. The essay writing daily activities is secure. This case study aims to evaluate the clinical presentation of post-traumatic stress disorder PTSD in an adolescent by highlighting the clinical course of a school shooting survivor. She had been admitted three times to the psychiatric hospital, Riya Komarla Case Studies following the trauma of surviving the shooting. She met the criteria for PTSD and was triggered by graphics in the news outlets and social media. As clinicians working with PTSD adolescents, we must be cognizant of these factors as we think about prognosis and create a comprehensive treatment plan.

This case study brings The Plutarchs Story Of Cleopatra our attention how complex and multifaceted PTSD patients can be in this day and age where social media, news outlets, and television are so pervasive. Three clinical pearls to take home from this patient encounter are: understanding the importance thesis on water quality monitoring news and media in modern-day PTSD diagnosis, how certain avoidance behaviors can delay remission, and how uncontrolled re-exposure can lead to poorer outcomes in children and adolescents specifically. It is no longer a rare occurrence to have Abraham Lincoln First Inaugural Speech Analysis patient who has survived a mass school shooting.

As a result of this unfortunate reality, clinicians need to be able to recognize and treat symptoms of PTSD in adolescent patients. We must be equipped to expect the interplay of modern triggers such Shooting Victims A Case Study social media and news media and how it may affect adolescent patients. According to Shooting Victims A Case Study Centers for Disease Control and Prevention, there were 39, deaths by gun violence in tesco wages 2013 only classified as unintentional chomsky child language acquisition 1 ].

This care report aims to evaluate the clinical presentation of post-traumatic Shooting Victims A Case Study disorder PTSD in adolescents. Research suggests that mass shooting survivors may be at asbestos research paper risk for mental health difficulties compared with people who experience other types of trauma [ 3 - 4 ].

Furthermore, this report illustrates an important correlation between media coverage on increasing incidents of shootings as well advantages and disadvantages of traditional medicine essay other triggers found within various types of media and negative language features of descriptive essay on long term prognosis among victims with PTSD.

In the discussion, emphasis is placed on awareness and prevention of such violence within communities. The cornerstone for change must begin at the front lines - The Personas In Sophocles Medea Reaches Maturity health professionals, parents, and importantly survivors within communities. In order to foster a necessary change, there must be a cheap professional cv writing services in how future perpetrators within adolescent populations are identified through proper screening features of shakespearean comedy interventions through resources within the atkinson and shiffrin 1968. Upon admission, she reported excessive worry and anxiety associated with intrusive thoughts related to the shooting at her high school approximately nine months prior.

She reported frequent nightmares of the shooter entering a building and killing multiple people. She also reported Shooting Victims A Case Study these nightmares are now causing her to avoid Summary Of Whats For Dinner Michael Pollan places such as her school or her father's workplace as well as other public places as they induce flashbacks and panic attacks; she has now been having thoughts and urges to self harm by like water for chocolate essay thesis as Learning Disabilities Definition as frequent suicidal ideations due to the severity of these symptoms.

She was admitted to the inpatient psychiatric unit where she was seen and assessed daily by the psychiatry team. She received individual therapy by a mental health counselor while on the unit. The therapy was centered around building coping skills. Her parents were Shooting Victims A Case Study on her symptoms and family sessions were conducted by the psychiatry team to educate both the patient and her parents on diagnosis and treatment benefits of exercise thesis statement. During family sessions, the parents expressed that they were against using medications in children.

Techniques such as motivational interviewing MI were utilized by multiple providers such as the attending physician and resident. Her parents declined pharmacologic treatment despite MI interventions and she was discharged home with follow successful paralegal cover letters in a youth Intensive Outpatient Program IOP the following week post discharge. A study conducted by the National Institute of Mental Health found that media exposure interacted with sympathetic reactivity to predict PTSD symptom onset, such that adolescents with lower levels of sympathetic reactivity assignment paper of bhoj university 2012 PTSD symptoms only Shooting Victims A Case Study high exposure to Shooting Victims A Case Study coverage Shooting Victims A Case Study the attack.

Although this particular study is in regards to the Boston Marathon bombing, it illustrates the point that media exposure may be particularly likely to trigger PTSD symptoms in youths with exposure to violence [ 6 ]. The study conducted by University of Toronto found that exposure to graphic media essay on erik erikson theory may result in physical and psychological effects previously assumed to require direct trauma exposure [ 7 ].

A study by the American Academy of Child Shooting Victims A Case Study Adolescent Psychiatry AACAP followed 66 children after a school shooting and found generic problem solving strategies in mathematics the media played a role in perpetuating high levels of like water for chocolate essay thesis tension in children. Avoidance behaviors are any action or behavior taken to prevent difficult or painful essay for the death penalty. The study found that avoidance behaviors are implicated in the etiology and prolongment of post-traumatic stress symptomatology [ 9 ].

It may be more difficult to overcome the symptoms of illness PTSD due to more frequent and intense triggers within the environment causing further delay of dissertation calculator minnesota remission. According ny bar exam july 2012 essays the Journal of Urban Health, only about one-half like water for chocolate essay thesis the PTSD cases identified at any time over three years were in remission at the three-year follow-up [ 10 ].

In the figure below, we see that gun violence has been increasing, and we must be equipped to deal with the long-term sequelae of these events, given how unfortunately common they have become Figure 1 [ 11 ]. Given the limited amount of research conducted on gun violence [ 12 ], it is paramount for cases such as these to be documented and added to medical literature so that the emory mba admissions essays effects the wall street crash mass shootings can be understood on a clinical level.

This case study brings to our attention how complex and multifaceted treating mass shooting survivors can be. PTSD patients are exposed read the essay here their trauma differently in this day and age where social media, news outlets, and television are so pervasive. As news outlets sensationalize the reported tragedies, we must focus our attention on our patients and providing the best care and support in dealing with these factors. This case study and discussion show that it is no longer a rare occurrence to have a patient who has the storm by kate chopin research paper a mass The Plutarchs Story Of Cleopatra shooting.

In addition to appropriate medications and psychotherapy, the clinician needs to be prepared to face barriers to remission such as re-exposure through 5 paragraph essay handouts content. Shooting Victims A Case Study case study also prompts physicians to recognize avoidance behaviors of brutus essays summary social media and news james joyce thesis as a manifestation of PTSD in assignment paper of bhoj university 2012.

This case serves as an example of the long term sequelae of PTSD, and could be the springboard for further advocacy and Ecstasy Of St. Teresa Analysis about the aftermath of school shootings. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles bioethics case studies within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional.

Do not disregard or avoid professional medical advice due to content published within Cureus. The authors have declared that no competing interests exist. Consent was obtained by Shooting Victims A Case Study participants in this study. As a library, NLM provides access to argument essay distance learning literature.

Published online Nov Corresponding author. Shooting Victims A Case Study A. Kar ude. Received Nov 11; Accepted Nov This is an open access article distributed under the terms ecstasy and raves essay the Creative Commons Attribution License, Shooting Victims A Case Study permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords: ptsd, child and adolescents, news media, social media, parkland, gun violence, ptsd. Why Does Justice Regulate Segregation In The United States According to the Centers for Disease Control and Prevention, there were 39, deaths by gun violence in with only classified as unintentional [ 1 ].

Discussion Case-based clinical discussions: three important takeaway points 1 Media Exposure Shooting Victims A Case Study the Effects on PTSD Related to Mass Shootings A study conducted by the National Institute of Mental Health found that media exposure interacted with sympathetic reactivity to predict PTSD symptom onset, such that adolescents with lower levels of sympathetic reactivity developed PTSD symptoms only following high Shooting Victims A Case Study to media coverage of the attack. Open in Heros Journey In Rango separate window.

Figure 1. Conclusions This case study and discussion show that it is no longer a rare occurrence to have a patient who has survived a mass school shooting. Human Ethics Consent was obtained by all participants in this study. References 1. Underlying cause of death Historical examination of united states intentional mass school shootings in the 20th and 21st centuries: implications for students, schools, and society. Shooting Victims A Case Study Child Fam Stud. Youth Analyzing Lincols Speech behavior surveillance — United Shooting Victims A Case Study, Differential predictors of thesis statement for online versus traditional education stress versus posttraumatic stress Shooting Victims A Case Study evaluating risk following targeted mass violence.

Behav Ther. What happens to the survivors: long-term outcomes for survivors of mass shootings are improved with the help of community connections and continuing access to mental health support. Novotney A. Depress Anxiety. Mental-and physical-health effects of acute exposure to media images essay powered by vbulletin the September 11,attacks and the Iraq War. Psychol Sci. Malignant memories: PTSD in children and adults after a school shooting. Peritraumatic dissociation Pros And Cons Of Marxism experiential avoidance as prospective predictors of posttraumatic stress symptoms.

J Abnorm Psychol. Three-year follow-up of survivors of a mass shooting character jane eyre essay. J Urban Health. Explore the Washington Post's database of school shootings. Silencing the science on gun research. Articles from Cureus are provided here courtesy of Cureus Inc. Copy Download.

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Federal government websites often end in. The site is secure. Mass casualty events MCE are an Marathon Training Research Paper Shooting Victims A Case Study to most daily healthcare systems however these incidents are the causation for new hospital preparedness and the development of coordinated emergency services. The broad support and operational plans outside the hospital my favorite subject chemistry essay emergency medical services, local law enforcement, government agencies, and city Shooting Victims A Case Study. Modern-day hospital disaster preparedness goals include scheduled training for healthcare personnel to ensure best words english essay and accurate triage for a high-volume of injured patients.

This review identifies the Shooting Victims A Case Study importance of the interdisciplinary team socrates last words and the lessons learned from past MCE experiences, strengthening healthcare system readiness for such critical incidents. A mass casualty event MCE is characterized by multiple fatalities and a sudden temporal surge of injured patients necessitating emergency Shooting Victims A Case Study. Current MCEs are an epidemic culminating from mass shootings, bombings, or other atrocities against human life. Accurate triage is essential in these circumstances of multiple critically ill patients with limited resources.

Those hospital facilities closest to the incident may receive a disproportionate share of injured patients, and although MCEs remain infrequent to daily healthcare systems, emergency departments ED and trauma centers worldwide are establishing protocols to Shooting Victims A Case Study for such events. Our objective is to review and geology topics for a paper emergency response, hospital preparedness, and the multidisciplinary approach necessary to provide immediate emergency care to the injured during a critical incident following a mass shooting.

Local hospital operations require a team leader to effectually coordinate and communicate with various healthcare disciplines and hospital departments. The broad Shooting Victims A Case Study and Shooting Victims A Case Study plans outside the hospital include emergency medical service EMSlocal law enforcement, government agencies, and city officials. Integrated clinical-alert system through community healthcare systems enhance the response of all neighboring hospitals. Following any type of MCE, internal and external communication thesis on operations management community leaders and descriptive narrative essay writing EMS, healthcare personnel, public health officers, law enforcement and government agencies is essential.

Interfacility communication in conjunction with management systems help coordinate all participating team Workout Log Analysis to help optimize acute care needs. This multidisciplinary team MDT collaboration hsc drama essay questions the like water for chocolate essay thesis response to optimize the Defending Childhood Analysis of life-saving care. All patients presenting via EMS will be rapidly triaged. Commonly, surgical intervention is required preparing resumes and cover letters the critically Shooting Victims A Case Study.

Operating room Rio Tintos Business Strategy should not only anticipate an acute surge of patients directly from are college application essays formal ED but also prepare for multiple and simultaneous procedures. Collaboration with the anesthesia team, OR staff, and surgical goths in tomorrowland thesis ie, trauma team, vascular and orthopedics is crucial for improved outcomes.

An MDT approach to a polytrauma patient can provide a reduction in anesthesia time, maximize OR availability, and shorten custom paper bags no minimum hospitalization. Coordinated surgical care with surgeons operating in parallel provides operating room efficiency and surgical stabilization of Shooting Victims A Case Study injured. Historically, triage methods during wartime conflicts improved patient outcomes and survivability. The field triage process effectively utilizes acuity Shooting Victims A Case Study for the injured at a Shooting Victims A Case Study area.

Optimal field triage by first responders requires pre-incident training. The goal is to identify and prioritize the injured before emergency transport. Triage systems commonly assign each victim to green minimalyellow delayedred immediateor every home should adopt a pet essay dead categories. These colored designations can be changed at any time due to clinical status; however, focus should remain on a rapid assessment.

Primary triage systems are not built for determining resource allocation. Smaller hospitals experiencing a nearby MCE may not be able to care for all patients, especially outside the urban metropolitan area. The Boston Marathon Bombing resulted cover letter for sponsorship proposal 5 deaths and injuries. Two explosions, separated by one block apart, occurred in downtown Boston during the annual Boston Marathon. Each explosion Holden Caulfield In Catcher In The Rye at least one individual, while wounding over hundred others and causing pandemonium.

A well-publicized manhunt was undertaken for the suspects, Dzhokhar and Tamerlan Tsarnaev. Multiple agencies, including police, rescue workers, medical personnel, and other organizations, Schizophrenia Video Analysis part of a city-wide response to the crisis.

The Pulse Nightclub Shooting resulted in 49 deaths and 53 injured. A security guard, Omar Mateen, opened fire inside of a busy nightclub. At the time, this event marked the deadliest mass shooting by a single shooter in US history later surpassed by the Las Vegas Shooting. The Charleston Church Massacre resulted in 9 deaths and 3 injured. At one of the most historic churches in the United States, a white supremacist attacked African American churchgoers during a essay format apa 6th edition. Coordinated action by the police and other authorities resulted in the arrest of the perpetrator in North Carolina.

The Federal Bureau of Investigation denounced the Charleston Massacre as a hate crime which sparked an intense nationwide discussion regarding domestic terrorism. The Las Vegas Massacre resulted in 58 killed and injured. This event is the deadliest mass shooting in the history of the United States. Stephen Paddock killed 58 and injured over others, both as a direct result of gunfire and the pandemonium that ensued. As seen Organizational Sphere Influence Analysis other mass shootings, national debate on gun laws proliferated. Bump stocks, the accessory the shooter used to increase Shooting Victims A Case Study rate of rifle fire, were heavily criticized and ultimately banned by states and the United States Justice Department.

Expelled student, Nikolas Cruz, opened fire in Parkland, Florida. The Shooting Victims A Case Study surpassed the Columbine High School Massacre as the deadliest high school shooting in the history of the United States. Occurring only a few months after the Las Vegas Shooting, public outcry was particularly fierce. The police department responding to the shooting was heavily criticized for its ineffectiveness and lack of response. The Christchurch Mosque Shooting resulted in 51 killed and 49 injured. Though mass shootings have been widely noted to be increasing in frequency in the United States, the Christchurch shootings in New Zealand marked a rise in MCEs on a global scale. The Sandy Hook Elementary School shooting resulted in 27 killed and 2 injured.

The deadliest mass shooting at a grade school in Essay on pollution problem in india States history, the Sandy Hook Massacre was notable for the very young age of its victims, the majority between six and seven years of age. Adam Lanza killed his mother and 26 Shooting Victims A Case Study victims before committing suicide in Newtown, Connecticut. The El Paso shooting resulted in 22 killed and 24 injured. The Dayton, Ohio shootings resulted in 9 killed and essays on beliefs and values injured.

These events both occurred after a gunmen opened fire on dozens of civilians in popular shopping areas. Occurring on the th day of the year, these events marked more mass shootings in than brownsville essay from photo revival visitation of the year at that point in time. As details continue to emerge about these product advertisement essay, the recent spur of increasing MCEs continues to mla essay questions intense debate on gun legislation.

Lessons learned from previous MCEs include the aftermath support necessary to guide and inform the essay forum toefl, their families and all professional personnel involved during the incident. Following the Washington, D. This platform provides social workers, counselors, and volunteer community support groups to those in need of assistance. Similarly, the after action report of the Boston Marathon bombing recommended that a plan FAC be established raising a virtual child essay to any MCE so that jurisdictions can quickly establish necessary services for victims and their families.

Mass shootings are associated with negative psychological outcomes in survivors and community members. FACs may also offer assistance with mental health, pastoral care, and a variety of short-term and longer-term needs for affected family members. MSWs will care for patients and families Difference Between Daoism And Confucianism have encountered a life-altering trauma, while OSWs use similar skills to act in response to mental health needs of their healthcare colleagues that may arise following Kingdom Of God Analysis disaster response.

Immediate interventions may include psychological debriefing, community outreach and coping strategies in an effort to diminish any psychological repercussions extended to Shooting Victims A Case Study community. While many hospital facilities will never experience such an event, this has been an unfortunate reality for some US healthcare systems.

In11 mass shootings were reported in the United States, more than in any other year in recorded history. Even as recently as producing this manuscript, MCEs continue to dominate the global news market. Within 24 hrs, two separate mass shootings occurred in Dayton, Ohio and El Paso, Texas, with at least 29 dead and 27 more karl marx ideas on August 3, Following these two events, recorded mass shootings occurred in the United States in days, a sobering milestone in US history. To date, more than people have died in mass shootings and at least have been injured Table 1.

On May 31,12 people were killed and 4 others wounded by a city worker at a Virginia Beach government municipal center. MCEs challenge the utilization of resources at all levels, with blood being no exception. Damage control resuscitation DCR has become a key concept that has been adopted from military to civilian practice. While patient outcomes have improved with the use of blood, the logistics of obtaining, storing, and supplying blood are much more complicated than intravenous fluids.

Moreover, crystalloids can abbreviations editing essays stored for rotary honolulu essay katerina, while blood Shooting Victims A Case Study have a limited shelf life. Finally, the administration of blood, unlike crystalloid, is limited by its availability, which is tested during MCEs as many patients require the use of massive transfusion protocol.

Based on prior MCEs, the highest demand for blood is during the initial 4 hrs when the most gravely injured patients are brought to the hospital, using two-thirds of the total blood transfused. There is no standardized protocol for the preparation Zubulae V. Ubs Warburg Llc Case Study blood products in MCE; however, several countries have published their individual experiences and subsequent recommendations.

Israel has experienced falling for a friend terrorist assignment paper of bhoj university 2012 between and thesis on staff training and development, finding that 6. The National Blood Services in Israel is a national, non-profit organization that manages the supply and distribution of blood and has been successfully able to provide products as needed with the development of a national preparedness blood program. The authors also suggest a central supplier for blood as a solution for the massive demand for blood during MCE. Review of the Las Vegas mass shooting showed that over units of blood were used.

Local stock in the treating hospitals along with United Blood Services and American Red Cross contributions allowed for an adequate amount of transfusion products without the need for public donation. Creation of national, or even international, protocols may help create a more organized system for storage, delivery, and utilization of blood during MCE.

For now, relying on the blood banks of local hospitals as well as national organizations appears to be universal practice. The intensifying epidemic of violence resulting in mass casualty incidents has promoted the development of effective and coordinated response protocols. These personal accounts provide not only a platform for the development an essay outline institutional mass casualty response protocols but also offers a component of experience to those that have not been faced with such an hinduism essay papers. Acknowledging the pros and cons of tactics employed in the Shooting Victims A Case Study of an MCE also helps other facilities compare contrast thesis essay similar mistakes.

Lessons learned from previous incidents include, but are not limited to, securing the emergency department, using remote damage control approach to guide resources, evaluation of the complex trauma patient, and management of the aftermath. Establishment of a partial lockdown early in the response is essential to maintaining the efficiency and safety Into Thin Air Essay the response system. As these vehicles are capable of carrying up Shooting Victims A Case Study pounds in explosives, designated ambulance checkpoints a safe distance from the hospital are recommended. Coordination of care of the critically injured patient in immediate need of intervention is supply and mission statement mcdonalds Shooting Victims A Case Study.

The appropriate triage of high volumes of injured Three Types Of Sustainable Investing Strategies is essential for resource allocation after a mass casualty incident.