5 important tips for domestic violence response

Most cases of domestic violence go unreported, but you may see the signs during medical calls

Updated Sept. 27, 2018

Domestic violence affects our communities in ways that are largely hidden from view. According to CDC reports, one in three women and one in four men experiences domestic violence at some point in their lives. One in three women who are a victim of homicide are murdered by an intimate partner. Violence is the third most common cause of homelessness among families.

More sobering is the fact that most cases of domestic violence are not reported at all. Part of the reason is that most victims do not realize the treatment they receive from their partner fits the legal definition of domestic violence. They may feel that it’s a private matter and don’t want outside friends or agencies to intervene.

Let victims of domestic violence know you are concerned for their safety.
Let victims of domestic violence know you are concerned for their safety. (Photo/courtesy www.state.gov/m/ds/rls/285057.htm)

Relatively few states require EMS providers to report suspected domestic violence situations. Here are some tips to keep in mind when on an EMS call if you suspect intimate partner abuse is occurring:

  1. Be aware of the signs. Domestic violence has many characteristics of other forms of abuse, such as child and dependent adult situations. Pay attention to signs like injury patterns inconsistent with the reported mechanism of injury, a controlling spouse or partner on the scene, or unusual behavior or interactions between the patient and partner.
  2. Scene safety is paramount. You may be stepping into a very volatile situation. Keep all parties in view, and maintain a safe exit out of the environment. Move the patient into a more controlled environment as soon as possible, such as your ambulance.
  3. Ask the patient if they are safe. In private, respectfully but directly ask the patient whether anyone in the home has hit or tried to injure them in any way. If the patient says yes, listen and document what is being said in a nonjudgmental way. If the patient says no, note any unusual or inconsistent findings and quietly transfer that information at the emergency department. 
  4. Preserve any evidence you can. Just as you would with any other crime scene, preserve the evidence.
  5. Have a script. Practice what you will say to possible domestic violence victims. Consider an approach like, “I am concerned for your safety,” “There are people and programs that can provide you with assistance,” and “You do not need to be treated this way.” Remember that your patient may not realize the situation they are in is not normal.

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