Policy 18 — Neglect/Abuse Reporting

What population groups does this suspected abuse/neglect reporting policy specifically apply to?

Persons over the age of 65, children, and adults with disabilities

During history-taking for suspected abuse, what safety-related step must be completed regarding law enforcement?

Ensure police or the appropriate agency is notified and enroute

What age and injury combination is a possible sign of abuse in a child?

A child under 2 years of age with hot water burns or fractures

What injury locations are possible signs of abuse?

Mouth, facial, or genital injuries

What injury pattern regarding symmetry is a possible sign of abuse?

Bilateral or symmetrical injuries

What finding regarding injury timing is a possible sign of abuse?

Injuries of different ages (new and healing injuries)

What general condition findings are possible signs of neglect?

Poor nutrition, care, or hygiene

What care-seeking behavior is a possible sign of abuse or neglect?

Delay in seeking treatment

What historical inconsistency is a possible sign of abuse?

A vague, inconsistent, or changing history

What critical presentation in a child is listed as a possible sign of abuse?

Child comatose, in shock, or in cardiac arrest

What situational finding regarding an elder or child is a possible sign of neglect?

An abandoned elder or child, unable to care for self

If abuse is suspected, who should a provider convey their suspicions to, and who should they otherwise keep them from?

Convey impressions to law enforcement and hospital staff; otherwise keep suspicions to yourself

When abuse is suspected, what should EMS avoid doing in their documentation?

Do NOT make a diagnosis of abuse; simply describe findings in detail

Why is the written report especially important in suspected abuse cases?

It will likely become a legal document

When sexual abuse/assault is suspected, how should EMS protect evidence on the patient?

Wrap the patient in a sheet that maintains any evidence present on the patient and clothing

When sexual abuse/assault is suspected, what should the victim be encouraged NOT to do, for evidence preservation?

Change clothes or bathe

When sexual abuse/assault is suspected, what provider characteristic may the victim prefer while enroute?

A medic of the same sex

Where should a patient be treated when possible, following a suspected abuse incident?

In the county in which the event occurred

Who is responsible for reporting suspected abuse to the State Protective Service Agencies?

EMS personnel