It is not enough to simply treat the physical injury of a patient that you suspect to be the victim of violence.  A doctor must recognize that the victim could be in danger of being re-victimized and the trauma associated with the injury could seriously harm an individual’s mental health and negatively influence their behavior.  This is called trauma informed care.

Here are the steps to trauma informed care that every physician should be taking:

1. Detection

  • Look for physical signs of violence victimization
    • Obvious injuries – shooting, stabbing, severe physical trauma
    • Less obvious injuries indicative of violence – broken ribs, facial bruises, burns, other*
    • Multiple injuries in various stages of healing
  • Look for other possible signs of violence victimization or exposure
    • History of violence involvement
    • Serious social or emotional problems

2. Characteristics

  • Setting (home, school, community)
  • Is it ongoing? (home, school, community)
  • Severity & amount

3. Referral for Interruption  (If violence is ongoing)

  • Home – Family support counseling and interventions (child protective services if required)
  • School – Notify school and parents
  • Community – community-based interruption or conflict mediation

4. Referrals for behavioral and mental health support

  • Specific to community

* For more information on injury types and descriptions see AAP guidelines.  

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