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ROLE OF EMS PROVIDERS
Many EMTs and paramedics are drawn to emergency medical services because of the opportunity to make a dramatic contribution to persons in need. With adrenaline pumping, we respond to the scene and get great satisfaction when the person in critical need receives medical care and improves during transport to the hospital. We become partners with emergency physicians and nurses in a daily struggle to save critically ill or injured patients. But beyond the excitement of the moment is a more sobering reality. As health care providers involved in our community, we must look beyond the occasional dramatic rescue. EMS professionals are often the first or only medical contact with an injured victim of domestic violence. In some rural communities, we may be the most sophisticated medical people available to identify or refer a victim of domestic violence. Emergency pre-hospital care providers may have a unique opportunities for intervention of domestic violence, specifically in the identification of abuse and referral to appropriate resources. Unfortunately, the majority of battered women who are treated by EMS providers are not identified as victims of domestic violence and thus, are offered no assistance or information to deal with a potentially life-threatening problem. In addition, EMS may be the only witness to the home environment. EMS identification of domestic violence can be the first step in interrupting the progression of violence and prevent the development of a variety of other complex problems. To do this, EMS providers need an understanding of the definition, extent, and nature of domestic violence.
Historically, health care providers have dealt with domestic violence by ignoring it. Health care providers may feel intimidated by the batterer and are reluctant to get involved. In a small community, we may know both the victim and perpetrator and feel intrusive if we say anything. We may feel this is a family issue, not a medical one. We may also feel frustration or disgust when we see the victim return to the batterer time and again. We may feel that there is little or no community support and that the health care system is ineffective if the legal system doesn’t back its efforts.
Efforts to address domestic violence will require multi-disciplinary collaboration. Initial steps can be very simple. Individuals can examine their own behavior and educate themselves and their friends on violence-related issues. Careful consideration can be given to the content and messages of movies and television. We can encourage youth to avoid violence as a response and teach young girls that violence against them is unacceptable. We can support shelters that help battered women and refer suspected victims of domestic violence to these support services. We can begin the empowerment of the victim by concluding that, “Domestic violence is such a serious health problem that I ask all my patients: Has someone you know caused these injuries?”
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