UMEM Educational Pearls

 

IPV can occur once or over years by a current or former romantic partner.  Types of IPV include: Physical and/or Sexual violence, Stalking, and Psychological/Financial aggression (the use of verbal and non-verbal communication to harm mentally or emotionally and to exert control over another partner). 

IPV is more prevalent that Aortic Dissection and Pulmonary Embolism combined.   Think about how risky it is to NOT recognize IPV.

1:4 women and 1:10 men have been victims of IPV during their lifetime.

1:5 homicide victims are killed by an intimate partner.

Over 50% of female homicide victims are killed by a current or former intimate partner.  Patients who have been strangled are 4 times more likely to be killed within a year.

Your Spidey Sense should go off when:

  1. Stories Change
  2. History doesn’t match up with injuries
  3. Injuries in areas that are concealed, multiple injuries of varying ages, defensive wounds
  4. Major delays in seeking care
  5. Non-specific complaints - headache, gastric issues
  6. Multiple ED visits at odd hours
  7. Refusing the use of an interpreter by partner (why we always use an official interpreter)

 

Once patient is identified as a victim:

  1. Place victim in a safe, inaccessible by visitors, and hidden area
  2. Treat all medical issues
  3. Contact Social Work/SAFE/SANE examiner (some institutions will have IPV specific resources)
  4. Contact police if patient is willing to report
  5. Safe disposition
  6. If unable to ensure a safe disposition, be very careful about documentation provided in discharge paperwork and language used

 

 

References

  1. Choo EK, Houry DE. Managing intimate partner violence in the emergency department. Ann Emerg Med. 2015 Apr;65(4):447-451.e1. doi: 10.1016/j.annemergmed.2014.11.004. Epub 2014 Dec 20. PMID: 25533139; PMCID: PMC4393790.
  2. 06_105344_IPV_SVBooklet_knuth.indd (cdc.gov)
  3. Rabin RF, Jennings JM, Campbell JC, Bair-Merritt MH. Intimate partner violence screening tools: a systematic review. Am J Prev Med. 2009 May;36(5):439-445.e4. doi: 10.1016/j.amepre.2009.01.024. PMID: 19362697; PMCID: PMC2688958.
  4. Intimate Partner Violence |Violence Prevention|Injury Center|CDC