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Pay attention for early warning signs of a potential attack. Sample behavior and physical posturing include:

conspicuous ignoring of questions and statements by you or police;

repetitious questioning;

looking around nervously;

excessive emotional attention;

ceasing all movement;

physical crowding;

assuming a pre-attack posture;

target glance.

These are clues for EMS personnel to heighten awareness and to ensure your own personal safety.

RECOGNIZING AND TREATING VICTIMS OF DOMESTIC VIOLENCE

The odds are very high that most of us, as emergency care providers, have treated victims of domestic violence during our career. Maybe we had no awareness of what we were responding to. Or just maybe, we had a very real suspicion of domestic violence but didn’t know how to deal with the situation. Should we have expressed our concern? What do we say or do? What if the patient denies being abused, what then? While victims of domestic violence may not offer details on their own initiative, they may discuss it if asked simple, direct questions in a non-judgmental way and in a confidential setting. The patient should be interviewed alone. This cannot be emphasized enough: Question the victim directly about battering only if the suspected abuser is not present. Your ambulance may provide a safe environment for the victim of domestic violence to admit to a problem and ask for assistance. Your ambulance may provide the ideal opportunity for an EMS responder to question the patient and uncover any abuse that is occurring. Ask the patient direct, non-threatening questions in an empathetic manner, emphasizing that certain questions are asked of all trauma patients. You may want to think of sample questions ahead of time so that you will be comfortable and ready when the situation arises. Listed below are some sample direct and non-judgmental approaches. Consider practicing or modifying these statements to see which ones feel appropriate for you:

Because domestic violence is so common in today’s world, I’ve begun to ask about it routinely. Has your partner done this to you?

We often see people with injuries such as yours which are caused by someone they know. Could this be happening to you?

You seem frightened and anxious. Has someone hurt you?

Sometimes when others are over-protective and jealous, they react strongly and use physical force. Has this been happened to you?

Are you afraid of anyone in your household?

Has any household member physically hurt you or threatened to hurt you?

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