Emergency Care of the Abused 1st Edition by Fiona E Gallahue ,Laura D Melville ISBN 9780521867078 978-0521867078
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ISBN 10:9780521867078
ISBN 13:978-0521867078
Author:Fiona E.Gallahue ,Laura D.Melville
Emergency Care of the Abused is intended to assist the health care practitioner in managing the acute care of abused patients. This accessible introduction is not intended to be an exhaustive study of each topic, but a quick reference and practical guide for those in the clinical arena who see such patients. The full range of potential abuses that a health care practitioner may see is covered here. Several topics not commonly included in textbooks, such as trafficking, torture, and cultural influence are included. Each chapter has goals and objectives to maximize educational reading on the topic, photographs and tables to assist the clinician, legal aspects of the emergency situation, and quick reference pages to assist the practitioner emergently dealing with an abused patient.
Table of contents:
1 Physical and sexual abuse of children1 Physical and sexual abuse of children
Goals and objectives
Introduction
Epidemiology
Reporting child maltreatment
1. Identification
2. Reporting
3. Mandatory reporters
General history taking
Taking a history and effective triage in child or adolescent abuse
Gather and document pertinent information
Determine the safety and welfare of the child or adolescent
Determine the most appropriate location for evaluation and the most appropriate provider to conduct
Determine whether you are mandated to make a report
Physical abuse
Cutaneous manifestations of abuse
Contusions, lacerations, and abrasions
Bite marks
Burns
Oral injuries
Fractures
Shaken Baby Syndrome (SBS)
Abdominal injuries
Diagnostic imaging
Skeletal survey
Accidents and abuse: How to distinguish
Motor vehicle crashes
Sexual abuse
Presentation
Evaluation of the physical findings
Behavioral signs and symptoms
Statements or disclosures of sexual abuse
Sexual abuse disclosure
TRIAGE: Appropriate level of care
Emergent evaluation
Imminent danger
Medical need
Psychiatric emergency
Medical/legal issues
Urgent evaluation
Documentation of an injury that may resolve
Medical concerns
Supportive evidence
Evaluation scheduled for a later date
Unlikely need for treatment or evidence collection
Need for reassurance
Behavioral concerns
Family issues
The physical examination
Preparation for the examination
Conduct a complete and thorough physical examination
Special consideration for the examination of the female patient
Important key concepts
Anal/rectal examination
Sexually transmitted disease
Home Appendices
Evidence collection
Photography
Diagnostic testing
Child and adolescent sexual offense post-assault testing and treatment
Treatment
Recommendations for PEP assessment of adolescent survivors within 72 hours of sexual assault109
Other diagnostic and treatment considerations
Concluding the visit
Sexual abuse: case examples
Abuse in children with disabilities
Failure to thrive
Medico?legal issues
Documentation
Protective custody
Confidential and privileged communication
Consent by mature or emancipated minors
Releasing information
The judicial system
Hearsay and medical documentation
Testifying as a fact witness
Testifying as an expert
Testifying as an expert
Provider qualifications
The importance of peer review and supervision in child and adolescent sexual abuse evaluations
References
Quick Reference Pages
Child abuse
Treatment for sexual assault: For HIV
Treatment for sexual transmitted infections
2 Intimate partner violence
Goals and objectives
Intimate partner violence as a health issue
Dynamics of intimate partner violence
Clinical presentations of intimate partner violence
Evaluation and management of victims of intimate partner violence
Screening
Examination
Treatment
Documentation
DANGER ASSESSMENT
Referral
References
Quick Reference Pages
Permission to use danger assessment
Danger assessment reference list
3 Sexual assault
Chapter objectives
The sexually assaulted patient
The examiner?s role
Types of victims
Initial approach and ABCs
Consent to treat
Necessary materials
History of events
Drug-facilitated sexual assault (DFSA)
Past medical history
Contents of the rape kit
The drug-facilitated sexual assault kit
Sexual assault forensic examiner programs
Examining the patient
Chain of evidence
General medical care
Laboratory studies
Emergency contraception
Post-exposure Hepatitis B and C
Post-exposure HIV prophylaxis
Completing the encounter
DNA database
Testifying in court
Resources
Quick Reference Pages
References
4 The geriatric patient
Goals and objectives
Introduction and overview
Definitions
Self-neglect
Risk factors
Identification of elder abuse
Specific categories of elder abuse
Physical abuse
Sexual abuse
Financial exploitation
Caregiver neglect
Psychological abuse
Violation of rights
Legal considerations
Obstacles to detection of elder abuse
Abuse in long-term facilities
Management and intervention
Conclusions
References
5 Mentally ill or cognitively impaired patients
Goals and objectives
Abuse of mentally ill and intellectually disabled people
Overview
Abuse of the intellectually disabled
Definition of intellectually disabled
Types of abuse
Connection between violence and disability
Prevalence of abuse among people with ID
Sexual abuse in intellectual disability
Abuse of children with intellectual disabilities
Why people with ID are at increased risk for abuse
Reporting issues
Caregiver abuse
Sequelae of abuse
Recognition of abuse
Reducing risk of abuse
Treatment of abuse
Special population: cognitive impairment in the elderly
Abuse of the mentally ill
Definition of mentally ill
Types of abuse
Connection between violence and mental illness
Prevalence of physical and sexual abuse among people with SMI
Prevalence of neglect among people with mental illness
Special populations and abuse: prisoners
Why people with SMI are at risk for abuse
Reporting issues
Sequelae of abuse
Recognition of abuse
Reducing risk of abuse
Conclusion
References
Mental illness references
Intellectual disability references
6 Immigrants and ethnic minority populations
Goals and objectives
Introduction
Immigrants, ethnic minorities, and the dominant culture
Does abuse occur more commonly in ethnic minority populations?
Reported cases: Just the tip of the iceberg
Hidden barriers to appropriate care
Whose definition is used? Considering context when suspecting abuse
Corporal punishment
Language barriers
Legal requirements
The case of illegal immigrants
Working toward equality for immigrants and cultural minorities
Effecting change: Working toward cultural competence
Conclusion
References
Quick Reference Pages
7 Care of victims of torture
Goals and objectives
The difference between a refugee and an asylum seeker
Current requirements for the medical evaluation of torture victims in the European Union
Medical care for torture victims in Australia and New Zealand
Financial concerns of providing health care to asylum seekers
Types of torture
Evaluation of victims of torture
Medical sequelae of torture
Moreno stresses the need for a formal intake session32
Endemic illnesses
Pediatric considerations
Psychological effects of torture
Special considerations
Professional considerations
References
Quick Reference Pages
8 Trafficking victims
Goals and objectives
Human trafficking
Trafficking: Definitions
The United Nations
United States
Definitions
Human trafficking versus smuggling
Human trafficking is a process, not a single offence
The role of organized crime in trafficking
Who are the recruiters?
Where do victims come from? Where do they work?
The role of globalization and cultural values on trafficking
Role of law enforcement in trafficking
The federal response in the United States
Assisting the trafficked patient
Differences between trafficking victims and victims of other crimes
Language barriers
A victim-centered approach to trafficking: The three R?s
Clues to suspect a patient may be a trafficking victim17
Screening questions to help determine if your patient is a trafficking victim
Ten guiding principles in interviewing a person who has been trafficked
Interview with a trafficked patient
Things to keep in mind during your interview with a trafficking victim
Health concerns for trafficking victims
Trafficking for sexual exploitation
Public health impacts of sex trafficking
The history and physical exam
Getting assistance
Referrals and follow-up
Resources for assisting the trafficking victim
United States
Canada
Europe
Italy
Australia
Ukraine
Israel
Web sites to learn more about trafficking
References
Quick Reference Pages
Clues to suspect a patient may be a trafficking victim*
Screening questions to help determine if your patient is a trafficking victim*
9 Forensic photography
Introduction
Injury documentation
a) Written description
b) Body diagrams
c) Photography
Importance of photography in the acute care setting
Physics of photography: the basics
Lens, aperture, shutter speed, film
Photography in court
Admissibility
Chain of custody
Consent
Exceptions to informed consent
Implied consent
Court order
Technique ? how best to take good images
Background
Scales/measuring device
What injury to photograph?
Medically significant versus forensically significant injuries
Bite mark photography
Equipment
Conventional 35mm single lens reflex (SLR) camera
Polaroid ?instant? cameras
Digital cameras
Adjuncts to injury detection and documentation in sexual assault
Toluidine blue
Colposcopy
History
Forensic versus medical uses
Equipment/physics
Filter selection
Procedure
Colposcopy references
Suggested reading
Forensic photography
Colposcopy
Quick Reference Pages
Forensic photography
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Tags: Fiona E Gallahue, Laura D Melville, Emergency, Care