Interpersonal violence: Difference between revisions

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[[Category:Misc/General]]
==Who to Screen in the ER==
==Who to Screen in the ER==
* ideally everyone
*ideally everyone
* 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 do not say anything: "your injuries do not 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
 
==Differential Diagnosis==
{{Psychosocial DDX}}


== Mandatory Reporting==
==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
*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?==
==Who is high risk?==
* anyone with a significant injury
*anyone with a significant injury
* threats by their partner to kill them
*threats by their partner to kill them
* strangulation injuries
*strangulation injuries
* suicidal partner
*suicidal partner
* pregnancy
*pregnancy


==Disposition==
==Disposition==
* refer to social services
*refer to social services
* advise them to keep some money separate, notify a friend, and have an escape plan
*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
*if they are in imminent danger you may need to admit them


==Sources==
==External Links==
*http://www.futureswithoutviolence.org/userfiles/file/HealthCare/mandatory_calif.pdf
 
==References==
<references/>
<references/>
Muelleman RL et al. Battered woman: injury locations and types. Ann Emerg Med. 1996 Nov;28(5):486-92.
*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
 
[[Category:Trauma]]
[[Category:Misc/General]]

Latest revision as of 19:41, 2 July 2025

Who to Screen in the ER

  • ideally everyone
  • Institute of Medicine recommends screening women once a year
  • in the ER, screen females with:
  1. reproductive age
  2. signs/symptoms of mental health issues
  3. chronic abdominal pain
  4. any female with any injury
  • especially injuries in a central pattern:
    • head, face, neck, thorax, abdomen

How to Screen

  1. excuse all the family or friends from room
  2. "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"
  3. "I'm going to ask you some questions that I ask all of my patients because violence against women is such an issue."
  4. "Has anyone hit, kicked, or punched you within the past year?"
  5. If they say yes: "how often?", "have they spoken to anyone about it?", "do they feel unsafe at home because of it?"
  6. you should refer them to social work in house or contact 800-799-SAFE
  7. if you're suspicious, but they do not say anything: "your injuries do not seem to fit the story, can you go through how this happened?"
  8. 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"
  9. thank them for sharing such difficult information

Differential Diagnosis

Psychosocial and Related

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

External Links

References

  • Muelleman RL et al. Battered woman: injury locations and types. Ann Emerg Med. 1996 Nov;28(5):486-92.