Trauma Guideline Manual - SUNY Upstate Medical University

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136____________ Trauma Guidelines ManualSUNY Upstate Trauma CenterPRACTICE GUIDELINES: DOMESTIC VIOLENCEOBJECTIVE:Identify guidelines for diagnosis, acute management and appropriate referral of domesticviolence.DEFINITIONS:1. Domestic Violence: A pattern of coercive behaviors that involves physical abuse, sexualand/or psychological abuse against former or current intimate partners. This definitionincludes both male and female victims of domestic violence as well as both homosexualand heterosexual relationships.2. Risk factors for domestic violence include:a. Women are at high risk. In the majority of cases of domestic violence, the victim isfemale and the perpetrator is male. About 20% of American women are victims ofdomestic violence at some point in their lives and domestic violence is thought to bethe leading cause of serious injury to women between the ages of 15 and 44.b. Alcohol and drug abuse.c. Emergency Department patients have a high prevalence of domestic violence; 30% ofwomen seen for traumatic injury and 18-24% of women seen for any reason arevictims of domestic violence.GUIDELINES:1. The physician’s responsibility consists of:a. Detection of patients who are victims of domestic violence.b. Treatment of any acute medical problems.c. Refer and follow Administrative Policy V-11, Victims of Violence, Abuse, or Neglecthttp://www.upstate.edu/policies/documents/intra/V-11.pdfd. Referral of the patient to Social Services for further evaluation and counseling.2. Because of its high prevalence among trauma patients, universal screening of all femalepatients for domestic violence is warranted. Men should be screened when they presentwith signs or symptoms of domestic violence.3. Physical indicatorsa. Injury inconsistent with the explanationb. Delay in seeking treatmentc. Multiple injuries in various stages of healingd. Contusion, abrasions, minor laceration, fractures or sprainse. Injuries to the head, neck, chest, breast, abdomen, pelvic organsf. Injuries during pregnancy, i.e., bruising/abrasions to abdomen or pelvic areag. Repeated or chronic injuriesh. Musculoskeletal complaints atypical chest pain chronic headaches4. Behavioral indicatorsa. Partner accompanies patient, insists on staying close, answers all questions directed atthe patientb. Denial or minimizing of violence by patient or partner
Trauma Guideline Manual______________SUNY Upstate Trauma Center137c. Reluctance of partner to speak in front of partnerd. Overly aggressive, overly attentive or overly protective partnere. Frequent visits with vague complaints or symptoms without evidence5. Screening question:a. “Are you currently or have you ever been in a relationship where you were physicallyhurt, threatened or made to feel afraid?”ORb. If the patient has a physical injury say:“Sometimes people come in with injuries like yours and often they are from someonehurting them. Is this what happened to you?”
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Trauma Guideline Manual - SUNY Upstate Medical University

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