Several characteristics such as unexplained bruises, multiple visits for falls, bullying, injuries with explanations that do not match, anxiety, depression, or suicidal thoughts could lead a provider to suspect domestic violence. Our facility screens each patient for abuse during the assessment process. If we suspect domestic violence we contact the police. We have a direct line called “the batphone” to the police department. We refer them to local shelters, provide information to area resources, and try to encourage them to seek help. We also discuss safety plans with patients that come in after an assault. Safety plans should include having a bag packed, keeping numbers and addresses of shelters handy, and having emergency cash hidden for the appropriate time (Usta, & Taleb, 2014). If we have a sexual assault case come in, we do not have a SANE nurse at our facility, so we have to transfer them to a hospital an hour away. We had a child abuse case last week where the child died as a result of a head injury from a fall three days prior to being presented for care. The child had multiple bruises to the head at different stages of healing and human adult bite marks on her arms. EMS notified their dispatch and the police met EMS at the hospital. I have been in the ED for six months and in that time we have had two cases where children have died from child abuse and one from child neglect. In two of the three cases there were signs that should have been picked up on and missed opportunities by multiple people that could have prevented their death. In the third case there were no signs.
Usta, J., & Taleb, R. (2014). Addressing domestic violence in primary care: what the physician needs to know. The Libyan journal of medicine, 9, 23527. doi:10.3402/ljm.v9.23527
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