• Sahil Gupta, Kenneth Williams, John Matile, Noreen Milne, Orla Smith, Carolyn Snider, and Samuel Vaillancourt.
• Department of Emergency Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada. sahil.gupta2@unityhealth.to.
• CJEM. 2023 Jan 1; 25 (1): 434743-47.

BackgroundSecurity services in most settings are an essential part of emergency department (ED) care, but their role remains poorly understood. We sought to:(1) identify the frequency of security services involvement in ED care;(2) characterise the events security services are called for; and (3) identify temporal trends in use.MethodsWe used a hospital-wide security database at a tertiary care ED in downtown Toronto, Ontario. Data from January 2017 to June 2021 related to the ED, patient or visitor related safety calls were included. We categorised calls by type of event (e.g.: Code White or Restraints). Call numbers were calculated as rates to adjust for visit volumes for each period. Univariate analyses were used to assess association between security services' calls and shift time, day of week, and month of the year.ResultsOver the 4.5-year study period, 20,033 ED-related calls were recorded. On average, we identified 61 calls per 1000 patient visits. On univariate analysis, no increase in security calls were found based on day of week or month, but a disproportionate number of security calls were recorded overnight.ConclusionThis study reveals high security services involvement in the delivery of care in one urban ED. Security databases can inform improvement work and could be augmented by better coding of violent events and linkage with electronic health records when involving patients.© 2022. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).

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