Policy 18-Neglect Abuse Reporting

Which patient populations does this abuse/neglect reporting policy cover?

Persons over age 65, children, and adults with disabilities.

What should you evaluate as part of present/past history when abuse is a concern?

Scene safety, that police/appropriate agency is notified and en route, the mechanism of injury/abuse, and medications or allergies.

Name possible signs of abuse in a child under 2 years old.

Hot water burns or fractures.

Name possible signs of abuse related to injury patterns.

Mouth/facial/genital injuries, bilateral or symmetrical injuries, or injuries of different ages (new and healing together).

Name possible signs of neglect.

Poor nutrition, care, or hygiene; delay in seeking treatment; an abandoned elder or child unable to care for themselves.

Name a possible sign of abuse related to the history given.

A vague, inconsistent, or changing history.

If abuse is suspected, what should you NOT do in your documentation?

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

What else should you do if abuse is suspected?

Keep suspicions to yourself, protect the patient, convey impressions to law enforcement and hospital staff, and write a detailed report (it may become a legal document).

What extra steps apply if sexual abuse/assault is suspected?

Take the history from a medical standpoint, act neutral and professional, protect the patient and evidence (e.g., wrap in a sheet to preserve evidence), and encourage the victim NOT to change clothes or bathe.

What should you consider about the sex of the transporting medic in a suspected sexual assault case?

The victim may prefer a medic of the same sex while en route.

Where should the patient be transported, and who is responsible for reporting the abuse?

Transport to the nearest, most appropriate facility (preferably in the county where the event occurred); EMS personnel are responsible for reporting to the respective State Protective Service Agencies.