51 - domestic abuse

Question 1

role of ER (5)

Answer 1

1. ID prob.
2. assess, support, Tx
3. document
4. plan safety
5. ensure there is follow up

Question 2

suggestive injuries

Answer 2

• bilateral multiple bruises
• patterned injuries
• periorbital hematoma
• nasal fracture or fractured mandible
• arm injuries
• perfed tympanic
• cigarette burns
• abdo during preg
• breasts or genitals
• out of keeping with cause

Question 3

somatic Sx

Answer 3

• chronic and not well defined
• chest pain, palp, SOB
• abdo or pelvic pain
• dizzy, numb
• fatigue

Question 4

3 step if abuse disclosed

Answer 4

1. refer to assault centers
2. be supportive
   - affirm crime
3. assess danger
   - pattern
   - weapons
   - multiple
   - threats
   - alc. or drugs

Question 5

assessment and Tx

Answer 5

• ABC
• ID and Tx injuries
• non-judge support
• ask about sexual assault
• assess risk
• help clarify needs
• review options

Question 6

how to document

Answer 6

• assume as going to court
• be detailed
• police photographer of possible

Question 7

issues in safety planning

Answer 7

• discuss issue of increasing violence
• offer to contact police
• where will stay? - shelter
• advise to prep a safety package
• do not confront batterer

Question 8

follow up

Answer 8

• ensure follow up services
• give written list of local resources
• let them know ED is always available