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Women's health trigger > Lecture 10: Violence COPY > Flashcards

Lecture 10: Violence COPY Flashcards

1
Q

Define human trafficking

A

Use of force, coercion, or fraud to obtain some form of labor or commercial sex act

3rd most profitable transnational crime

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2
Q

What is the MC demographic of a trafficked human?

A

Female minor

55-70% female, 50% are minors

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3
Q

What are the 3 methods traffickers primarily use to ensnare victims?

A
  1. Threats
  2. Manipulation
  3. Control
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4
Q

What are the warning signs of human trafficking? (4)

A
  • Personal behaviors (disconnected, missing school/work)
  • Abuse/Neglect
  • Living situation (unstable, lack of personal items)
  • Suspicious presentation (controlling partner, “coached”)
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5
Q

What should we do if we suspect human trafficking?

A
  • Call the feds: 1-866-347-3423
  • Build rapport
  • Only call local law if immediately life-threatening
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6
Q

What % of domestic violence victims are female?

A

85%

Overall, 21% of violent crime experienced by Females is DV/IPV

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7
Q

How common is IPV occurring per minute?

A

24 people PER MIN

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8
Q

What is the MC form of IPV for males? Females?

A
  • Males: Physical violence
  • Females: Multiple forms
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9
Q

How common is sequelae after IPV/DV for both men and women?

A
  • Women: 27%
  • Men: 12%

Sequelae: PTSD, injury, IBS, mental health

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10
Q

When does victimization often occur by? (age)

A

25

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11
Q

What is the average length of victimization before presentation to healthcare providers or police?

A

4 years

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12
Q

How high is the estimate that an american woman will be physically assaulted by a partner or ex-partner?

A

1/5

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13
Q

What races are considered RFs for DV/IPV?

A
  • AA
  • Indigenous
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14
Q

What is the leading cause of death among pregnant women?

A

Homicide

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15
Q

When is IPV more frequent, severe, and at a high risk for homicide?

A

Pregnancy

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16
Q

What age is the highest risk for DV/IPV?

A

16-24

Prior to age 25

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17
Q

What are the S/S that may increase suspicion for DV/IPV? (6)

A
  • Chronic, vague pelvic pain
  • Sexual dysfunction (decreased libido, dyspareunia, anorgasmia)
  • Chronic/recurrent vaginitis
  • Anxiety/tearfulness prior to pelvic/breast exam
  • Persistent multiple bodily complaints
  • Psychiatric complaints

Essentially, vague complaints

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18
Q

How common is DV during pregnancy?

A

4-9%

More common than preeclampsia, gestational DM<, or placenta previa

19
Q

How accurately do practitioners identify women experiencing DV?

A

1 in 20

20
Q

What are the 4 steps in the cycle of abuse?

A
  1. Tensions building
  2. Incident
  3. Reconciliation
  4. Calm
21
Q

What is the single most important thing a provider can do for a battered woman?

A

Ask about violence

Screen everyone

22
Q

When should non-pregnant women be screened for DV?

A
  • Routine OB/GYN visits
  • Family planning visits
  • Preconception visits
23
Q

When should pregnant women be screened for DV?

A
  • First prenatal visit
  • EVERY TRIMESTER
  • Postpartum checkup
24
Q

How should we approach screening for DV/IPV?

A
  • Establish that screening is universal.
  • Direct questioning
  • Face to face
  • Specific descriptions

Actually ask do you get hit, pushed, etc

25
Q

What are some of the screening tools we can use to assess for DV?

A
  • HITS (Hurt, insult, threaten, screen)
  • WAST (woman abuse screening tool) (scoring)
  • PVS (Partner violence screen)
26
Q

When is mandatory reporting indicated generally?

A

Generally, any injury that seems like it was caused illegally (firearm, stabbing, arson)

State dependent

27
Q

What are some ways we can help prevent DV?

A
  • Offer shelter
  • Pocket cards with suggested safety/exit plans
  • Educational materials and resources
28
Q

When do acquaintance rapes typically occur during?

A

Adolescence

29
Q

What is statutory rape?

A

Sexual intercourse with a female under an age specified by state law

WV is 16 for age of consent.

30
Q

Where is child sexual abuse mandated to be reported?

A

All 50 states.

31
Q

What clinical findings could suggest sexual assault?

A
  • Complaints of being “mugged”
  • Concerns over STDs or AIDS
  • Psych complaints
  • Must obtain a sexual history!!
32
Q

How common are obvious physical findings in sexual assault?

A

only 30-40% have obvious injuries.

Most will be minor.

33
Q

What physical exam sign is MC among sexual assault victims?

A

Vaginal irritation

More likely than any other sign. > 50% of victims.

34
Q

What are the MC nongenital injuries seen in sexual assault?

A

Bruises, cuts, scratches, swelling

35
Q

What is the acute phase of the rape-trauma syndrome + associated symptoms?

A
  • Distortion/paralysis of coping mechanism
  • Complete loss of control to unnatural calm
  • Somatic symptoms: disturbed eating/sleep, GI irritability, MSK soreness, fatigue, etc

Wide range; like they’re in shock/petrified

36
Q

How long does the acute phase of rape-trauma syndrome typically last?

A

Up to 2 weeks.

37
Q

What are some of the common sequelae of delayed phase rape-trauma syndrome?

A
  • PTSD (common long-term)
  • Psychologic distress (mistrust of others, phobias, depression)
  • SI (33-50%)
  • Substance abuse
  • Depression
38
Q

How common is a suicidal attempt for patients that were raped that did not seek tx?

A

1 in 5

39
Q

If a victim presents to you with evidence of sexual assault, what are your responsibilities?

A

You are both medically and legally responsible.

Can request assistance from a sexual assault nurse examiner (SANE)

Need hx, kits, full PE

40
Q

Why are bite marks useful in evidence collection for sexual assault?

A

They can leave DNA evidence.

41
Q

What kind of lubricant is preferred for a speculum during a pelvic exam for sexual assault?

A

Sterile saline

Don’t want to interfere with any DNA collection.

42
Q

How soon do you f/u regarding sexual assault?

A

2 weeks

Recheck PE and collect specimens

43
Q

What tx can we offer for an SA victim?

A
  • Tx any physical injuries as appropriate
  • Emergency contraception
  • STI tx: Rocephin + Metro + Doxy + HPV vaccinations
  • Psych (even if they seem calm at the moment)
44
Q

When is sexual assault awareness month?

A

April

Women's health trigger (23 decks)

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