Treating Youth with Fight Injuries
It is important to recognize that a youth who is injured in a fight and requires medical attention is at high risk of being injured again. Talk to the patient to find out if the fight is over and the conflict resolved. Some of the following questions may be helpful:
- Is the conflict settled?
- Do you feel safe leaving here?
- Is there a safe place to go while things cool off?
- What plans do you have regarding the other person(s) involved in the fight?
- Are you thinking about revenge?
- Is there an adult who can help mediate the fight? Is there a peer mediation program in your school or community?
Talk with the patient and his/her family about the fight and discuss ways to avoid confrontations in the future. These may include anger management strategies, disassociation from a dangerous peer group, and learning to walk away. Parents may need guidance on limit-setting, monitoring their child's behavior, and effective discipline.
Also assess whether other risk factors are present that increase the youth's risk of violence and re-injury. Talk with the teen about: previous weapon use; alcohol and drug abuse; mental health history; ongoing family violence; life at school; and any criminal history.[1]
When youth are at a heightened risk for re-injury, it is often best to try to connect them with a referral agency before they leave your office, clinic, or hospital. Some youth may require referrals to mental health or social services resources. Programs that teach skills such as conflict resolution, anger management, and sensitivity can also provide valuable tools for youth who have been injured. Other programs, such as those that offer job training, recreation opportunities, and spiritual/religious support, play an important role as well. In many cases, these programs provide links to other services that prove to be influential in preventing youths from being injured again. [2]
For more information, see:
Adolescent Assault Victim Needs: A Review of Issues and a Model Protocol. Policy Statement (1996) - American Academy of Pediatrics
Oppositional and Aggressive Behaviors - Bright Futures in Practice: Mental Health (2002) - Maternal and Child Health Bureau, U.S. Department of Health and Human Services. Provides suggestions for assessment and intervention by primary care health professionals, as well as guidelines for referral.