View source for Interpersonal violence

==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 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"
#thank them for sharing such difficult information

==Differential Diagnosis==
{{Psychosocial DDX}}

==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==
*http://www.futureswithoutviolence.org/userfiles/file/HealthCare/mandatory_calif.pdf

==References==
<references/>
*Muelleman RL et al. Battered woman: injury locations and types. Ann Emerg Med. 1996 Nov;28(5):486-92.

[[Category:Trauma]]
[[Category:Misc/General]]