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EMS Response to Domestic Violence

It has been noted that the family is perhaps more violent than any other American institution or setting. It is important to understand that family violence -- child, spouse, and elder abuse -- is the only category of crime in which the perpetrator frequently voluntarily remains on the scene, expecting no negative consequences and actually perceiving intervention as a violation of his rights. Historically, domestic violence has focused on the victim and the result was a tendency to view domestic violence as a “women’s issue.” The focus of intervention was to determine why she was beaten or why she stayed. As such, the violence against the woman is viewed as her responsibility or fault -- the batterer is not held responsible for his behavior. Despite a recent increased awareness of domestic violence, significant misunderstandings about its nature and extent exist especially within the medical field. Medical response to battered women has been traditionally to focus on the presenting medical problem, not the violence that causes the injury. The following pages are designed to increase awareness among emergency medical personnel that domestic violence is a preventable, public health problem, and provide tools for EMTs to better identify and care for victims of domestic violence.

SCOPE OF PROBLEM

Domestic violence is a significant public health problem. More than 5 million women are battered annually. According to the American Medical Association, nearly one-fourth of the women in the United States (more than 12 million) will be abused by a current or former partner sometime during their life. Over half the women murdered in the U.S. are killed by a current or former partner. The Federal Bureau of Investigation estimates that a woman is battered every 9 seconds in the United States. In 25% of homes where domestic violence occurs, the abuser will use violence against his female partner five or more times each year. Battering against women often increases during pregnancy, increasing the incidence of miscarriage, preterm labor and low birth weight. Battering is so common, that it is now the leading cause of injury to American women. If these statistics seem horrific, even more disturbing is the fact that a National Crime Survey showed that 48% of all incidents of domestic violence against women were never reported to the police. In Alaska, according to the Council on Domestic Violence and Sexual Assault, domestic violence and sexual assault programs throughout the state served 13,057 clients in FY97. Further dividing by services sought:

Crisis intervention 742

Domestic violence 9,860

Incest 536

Sexual assault 1,862

Unknown 57

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