Interpersonal Violence

Who to Screen in the ER

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

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

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

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