Category:Domestic Violence/Abuse/Sexual Assault
We have the highest rate per capita for domestic violence and sexual abuse in the country. That is why we screen for it at each patient encounter. Whether you are doing radio medical traffic, seeing a patient in outpatient clinics, ER or Inpatient, you or the health aide is considered a mandatory reporter at the point of contact.
If you see suspicious bruises, etc., try to ask the patient when they are alone how it happened and if they feel safe. Encourage them to talk to Tundra Women’s Coalition, which is our local domestic violence shelter – 907-543-3444.
If violence occurred while children were present it is mandatory in Alaska to report it. If it occurred in Bethel, report it to Bethel Police Dept 311.
If it occurred in the village, report it to the State Troopers, 543-2294. You must also report it to Office of Children Services (OCS) 543-1411.
If you find that a girl is younger than 17 and had sex with a partner who is 3 years older than her (you will probably discover this on a first prenatal), this is also reportable to Bethel PD or State Troopers and OCS.
If the patient is over the age of 18 and comes to the Emergency Department with obvious signs of injury or sexual assault and DOES NOT wish to involve law enforcement, you are required to notify law enforcement if the patient has been shot, stabbed with a sharp object, burned over 10% BSA, or strangled. If none of these conditions are present, then the patient should be encouraged to report the crime but if she still does not wish to report the crime, then she should be treated like any other ED patient and her injuries should be treated and she should be offered Plan B and STI prophylaxis.
If you suspect child abuse or sexual abuse, use the same reporting system as described above. Please review the pediatric sexual assault guideline and how to proceed. The Children’s Advocacy Center (CAC) at Tundra Women’s Center (TWC) organizes the child’s interview, exam etc– to make it as painless as possible for the child. They tape the interview and do it behind a 1-way mirror to make the child as comfortable as possible.
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