Domestic Violence (Partner and/or Elder Abuse)

Recognition and Reporting
 

 <BACK  TOC  NEXT>
 

Policy: 

 

Domestic violence is physical, sexual or psychological abuse and/or intimidation which attempts to control another person in a current or former family, dating, or household relationship.  The recognition, appropriate reporting, and referral of abuse is a critical step to improving patient safety, providing quality health care, and preventing further abuse.

 

Elder abuse is the physical and/or mental injury, sexual abuse, negligence treatment, or maltreatment of a senior citizen by another person.  Abuse may be at the hand of a caregiver, spouse, neighbor, or adult child of the patient.  The recognition of abuse and the proper reporting is a critical step to improve the health and wellbeing of senior citizens.

 

Purpose:

 

Assessment of an abuse case based upon the following principles:

Ø      Protect the patient from harm, as well as protecting the EMS team from harm and liability

Ø      Suspect that the patient may be a victim of abuse, especially if the injury/illness is not consistent with the reported history

Ø      Respect the privacy of the patient and family

Ø      Collect as much information and evidence as possible and preserve physical evidence

 

Procedure:

 

  1. Assess the/all patient(s) for any psychological characteristics of abuse, including excessive passivity, compliant or fearful behavior, excessive aggression, violent tendencies, excessive crying, behavioral disorders, substance abuse, medical non-compliance, or repeated EMS requests.  This is typically best done in private with the patient.
  2. Assess the patient for any physical signs of abuse, especially any injuries that are inconsistent with the reported mechanism of injury.  The back, chest, abdomen, genitals, arms, legs, face, and scalp are common sites for abusive injuries.  Defensives injuries (e.g. to forearms), and injuries during pregnancy are also suggestive of abuse.  Injuries in different stages of healing may indicate repeated episodes of violence.
  3. Assess all patients for signs and symptoms of neglect, including inappropriate level of clothing for weather, inadequate hygiene, absence of attentive caregiver(s), or physical signs of malnutrition.
  4. Assess all patients for signs of sexual abuse, including torn, stained, or bloody underclothing, unexplained injuries, pregnancy, or sexually transmitted diseases.
  5. Immediate report any suspicious findings to both the receiving hospital (if transported).  If an elder or disabled adult is involved, also contact the Department of Social Services (DSS).  After office hours, the adult social services worker on call can be contacted by the 911 communications center.
  6. EMS personnel should attempt in private to provide the patient with the phone number of the local domestic violence program, or the National Hotline, 1-800-799-SAFE.