Interpersonal violence: Difference between revisions
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*Institute of Medicine recommends screening women once a year | *Institute of Medicine recommends screening women once a year | ||
*in the ER, screen females with: | *in the ER, screen females with: | ||
# reproductive age | #reproductive age | ||
# signs/symptoms of mental health issues | #signs/symptoms of mental health issues | ||
# chronic abdominal pain | #chronic abdominal pain | ||
# any female with any injury | #any female with any injury | ||
*especially injuries in a central pattern: | *especially injuries in a central pattern: | ||
**head, face, neck, thorax, abdomen | **head, face, neck, thorax, abdomen | ||
==How to Screen== | ==How to Screen== | ||
# excuse all the family or friends from room | #excuse all the family or friends from room | ||
# "I'm going to ask a few quick questions that I ask all of my patients and then I will bring you back in the room to help with the care in a few minutes" | #"I'm going to ask a few quick questions that I ask all of my patients and then I will bring you back in the room to help with the care in a few minutes" | ||
# "I'm going to ask you some questions that I ask all of my patients because violence against women is such an issue." | #"I'm going to ask you some questions that I ask all of my patients because violence against women is such an issue." | ||
# "Has anyone hit, kicked, or punched you within the past year?" | #"Has anyone hit, kicked, or punched you within the past year?" | ||
# If they say yes: "how often?", "have they spoken to anyone about it?", "do they feel unsafe at home because of it?" | #If they say yes: "how often?", "have they spoken to anyone about it?", "do they feel unsafe at home because of it?" | ||
# you should refer them to social work in house or contact 800-799-SAFE | #you should refer them to social work in house or contact 800-799-SAFE | ||
# if you're suspicious, but they don't say anything: "your injuries don't seem to fit the story, can you go through how this happened?" | #if you're suspicious, but they don't say anything: "your injuries don't seem to fit the story, can you go through how this happened?" | ||
# if still not forthcoming: "here are resources we give all patients as this might be an issue for you or a friend at a later time" | #if still not forthcoming: "here are resources we give all patients as this might be an issue for you or a friend at a later time" | ||
# thank them for sharing such difficult information | #thank them for sharing such difficult information | ||
== Mandatory Reporting== | == Mandatory Reporting== | ||
Revision as of 01:54, 6 July 2016
Who to Screen in the ER
- ideally everyone
- Institute of Medicine recommends screening women once a year
- in the ER, screen females with:
- reproductive age
- signs/symptoms of mental health issues
- chronic abdominal pain
- any female with any injury
- especially injuries in a central pattern:
- head, face, neck, thorax, abdomen
How to Screen
- excuse all the family or friends from room
- "I'm going to ask a few quick questions that I ask all of my patients and then I will bring you back in the room to help with the care in a few minutes"
- "I'm going to ask you some questions that I ask all of my patients because violence against women is such an issue."
- "Has anyone hit, kicked, or punched you within the past year?"
- If they say yes: "how often?", "have they spoken to anyone about it?", "do they feel unsafe at home because of it?"
- you should refer them to social work in house or contact 800-799-SAFE
- if you're suspicious, but they don't say anything: "your injuries don't seem to fit the story, can you go through how this happened?"
- if still not forthcoming: "here are resources we give all patients as this might be an issue for you or a friend at a later time"
- thank them for sharing such difficult information
Mandatory Reporting
- in California, physicians are required to make a report if they provide medical services to a patient whom they suspect is suffering from a physical injury due to a firearm or assaultive or abusive conduct
See Also: Mandatory Reporting
Who is high risk?
- anyone with a significant injury
- threats by their partner to kill them
- strangulation injuries
- suicidal partner
- pregnancy
Disposition
- refer to social services
- advise them to keep some money separate, notify a friend, and have an escape plan
- if they are in imminent danger you may need to admit them
References
Muelleman RL et al. Battered woman: injury locations and types. Ann Emerg Med. 1996 Nov;28(5):486-92. http://www.futureswithoutviolence.org/userfiles/file/HealthCare/mandatory_calif.pdf