San Diego County Health - CARES
Healthcare providers – doctors, nurses, medical social workers, EMT’s/paramedics, administration/insurers - play a critical role in assisting domestic violence victims. The healthcare setting can provide an opportunity for early identification and intervention. Your work to support your patient’s wellness and safety matters.
Did you know?
- Nationally, the medical cost burden of intimate partner violence within the first 12 months after victimization, ranges from $2 to $7 billion dollars.
- Victims may suffer injuries during the abuse. Over the short and long-term, they may also experience behavioral health (mental health and substance use) challenges and a number of adverse medical health effects such as headaches, hypertension, chronic neck or back pain, sexually transmitted infections (including HIV/AIDS), chronic pelvic pain, peptic ulcers, digestive issues, asthma, cardiovascular disease, and miscarriage.
- Non-fatal strangulation is an important indicator of future intimate partner homicide.
The CARES Initiative encourages healthcare providers to:
C–Conduct screening for current and former domestic violence (DV)
- Screen patients at every visit (universal) so they see your staff are comfortable talking about DV and available for them when they are ready to share.
- Perform screening verbally, in the language the patient is most comfortable, and in a private location away from their partner.
A–Assess for signs and symptoms of strangulation
- Approximately 50% of the time, injuries from strangulation are not visible. You can save lives by assessing patients who have experienced domestic violence from for strangulation.
- Strangulation Brochure: Signs and Symptoms (English)
- Strangulation Brochure: Signs and Symptoms (Spanish)
- Order a CTA on victims that have experienced strangulation
- Discharge instructions
R–Report suspicious injuries to law enforcement
- Healthcare providers are required to make a report if they provide medical services for a physical condition to a patient whom they reasonably suspect is suffering from a physical injury due to a firearm, or from assaultive or abusive conduct inflicted upon the person.
- It's the Law to Report: Cal. Penal code §§ 11160-11163.2
- Visit our page on mandated reporting requirements for links to the forms and instructions.
- Suspicious Injury Reporting for Healthcare Workers
E–Evaluate patient (evidence collection by a forensic examiner)
- The Domestic Assault Forensic Examination (DAFE) program is free and can provide mobile response to your healthcare site within one hour, anywhere in San Diego County. The patient must consent to the exam.
- A qualified forensic nurse examiner will conduct a thorough assessment, collect evidence and document the DV (including strangulation).
- Call Palomar Health Forensic Services – DAFE program 760-739-2150 and 888-211-6347 (after hours, weekends, and holidays)
S–Safety plan and connect patient to resources
To request copies of the Health CARES posters and wallet cards, email Terra.Marroquin@sdcda.org
For more training, visit: