Category:Domestic Violence/Abuse/Sexual Assault
We have the highest rate per capita for domestic violence and sexual abuse in the country which is why we screen for it at every patient encounter. Whether you are doing radio medical traffic, seeing a patient in outpatient clinics, ER or Inpatient, you or the health aide are considered a mandatory reporter at the point of contact.
If you see suspicious bruises etc., make an effort to question the patient when they are alone so you can ask how it happened and assess for their safety. Encourage them to talk to Tundra Women’s Coalition, which is our local domestic violence shelter (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 a village, report it to the State Troopers (543-2294). You must also report it to Office of Children Services (OCS 543-1411).
If you see a girl younger than 17 years old who has had sex with a partner who is 3 years older than her (you will probably discover this on a first prenatal visit), 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.
In the ED we have a Sexual Abuse Report Team (SART) member who is available to collect evidence and offer support. If you see a patient who has been sexually abused/assaulted that day, or the day before, and they are interested in reporting, you can coordinate with the ED to make that happen. For children with possible abuse, please contact Bethel PD or State Troopers AND OCS.
If you suspect child physical or sexual abuse, use the same reporting system as described above. Please review the pediatric sexual assault guideline and how to proceed.
There is a Children’s Advocacy Center (CAC) at TWC that organizes the child’s interview, exam etc., to make it as painless as possible for the child. They tape the interview behind a one way mirror to make the child as comfortable as possible.
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