Types of Abuse Overview

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Questions and Answers

What type of harmful procedures to the female genitalia is classified as Type IV?

Surgical procedures for trauma recovery

Non-medical procedures like pricking and scraping (correct)

Medical procedures for health improvement

Circumcision for cultural purposes

In some belief systems, what is assumed about children who do not conform to societal norms?

They need special educational support

They are simply misunderstood

They are exceptionally talented in other fields

They are being possessed by a spirit or demon (correct)

What tragic event happened to a 2-year-old girl named Jocelyn?

She was neglected and ran away from home

She was diagnosed with a terminal illness

She died during an exorcism performed by her father (correct)

She suffered an accident while playing

What was the reaction of a childminder upon hearing a girl being called 'wicked'?

She informed pastors about a supposed possession Signup and view all the answers

What extreme action did Nusayba's mother take after accusing her of being possessed?

She disemboweled her daughter Signup and view all the answers

What should paramedics do if they encounter a child in imminent danger?

Call for police assistance at the scene Signup and view all the answers

Which of the following is a responsibility of paramedics regarding patient advocacy?

Speak up for patients in vulnerable positions Signup and view all the answers

What obligation do paramedics have when they suspect abuse of an incapable adult?

Report the abuse despite professional confidentiality Signup and view all the answers

When can paramedics report or refer a capable adult without their consent?

There are no circumstances where this is allowed Signup and view all the answers

Which of the following services is NOT typically available for adult victims of abuse?

Children's Aid Societies Signup and view all the answers

What constitutes physical abuse?

Any intentional act causing trauma or bodily injury Signup and view all the answers

Which of the following is not classified as a type of abuse discussed?

Social Abuse Signup and view all the answers

What form of abuse involves the failure to meet a dependent's basic needs?

Neglect Signup and view all the answers

In the context of child abuse, what should be a cause for concern in non-mobile children?

Any physical injury Signup and view all the answers

Which of these actions is an example of financial abuse?

Using someone's finances to exploit or control them Signup and view all the answers

What is the primary tactic used by a 'Romeo' trafficker to lure victims?

False promises of love and gifts Signup and view all the answers

Which sign may indicate a victim of human trafficking?

Displaying unusual tattoos or brands Signup and view all the answers

How are victims often isolated from their support systems?

Having their identification and phones taken away Signup and view all the answers

What is often a characteristic of a young female victim's appearance in trafficking situations?

Inappropriately dressed for their age or the weather Signup and view all the answers

In human trafficking, which individual may assist the trafficker in controlling victims?

A trusted worker often referred to as the 'Bottom' Signup and view all the answers

What might indicate that someone is being coached on how to interact with professionals?

They give scripted, basic responses Signup and view all the answers

What is a common practice traffickers use to manage victims' locations?

Victims are moved frequently between locations Signup and view all the answers

Why might a trafficking victim show a lack of eye contact?

They are being coached on their behavior Signup and view all the answers

What is the primary action to take when interacting with patients or caregivers suspected of abuse?

Actively listen and probe gently for inconsistencies Signup and view all the answers

Which statement reflects a correct practice when questioning a suspected abuse victim?

Use a private setting for discussing sensitive issues Signup and view all the answers

How should you respond if a victim of abuse discloses information during your assessment?

Maintain a professional and polite demeanor Signup and view all the answers

What does the role of a paramedic as a mandated reporter entail?

Report any and all suspected or known cases of child maltreatment Signup and view all the answers

Which action is NOT appropriate during history taking from a suspected abuse victim?

Show your own biases during discussions Signup and view all the answers

What should be ensured when creating an environment for patient disclosure?

Provide a safe and private space for conversations Signup and view all the answers

What is one reason for providing reassurance during assessments?

To ensure that they do not withdraw consent Signup and view all the answers

When making a report to the Children's Aid Society, what detail is crucial to provide?

The child's name, age, and address Signup and view all the answers

What misconception might someone have about reporting cases of abuse?

If someone else has reported it, you do not need to Signup and view all the answers

Which of the following is NOT a guideline for effective history taking in suspected abuse cases?

Using leading questions to guide the patient Signup and view all the answers

What is a characteristic behavior that may indicate physical abuse in a child?

Hypervigilance and being jumpy Signup and view all the answers

Which physical sign might suggest that an adult is suffering from abuse?

Unusual bruising in easy-to-injure areas Signup and view all the answers

What is one type of Female Genital Mutilation (FGM)?

Type I: Clitoridectomy Signup and view all the answers

What age-related factor should be considered when differentiating between accidental and non-accidental injuries?

The ability of the injured person Signup and view all the answers

Which non-physical sign might suggest emotional distress in a child indicative of abuse?

Acting overly calm when examined Signup and view all the answers

What physical condition makes elderly individuals more susceptible to injuries?

Thinning skin Signup and view all the answers

What kind of behavior in children could signal potential abuse, aside from fearfulness?

Odd behavior for their developmental stage Signup and view all the answers

Which type of Female Genital Mutilation involves narrowing of the vaginal orifice?

Type III: Infibulation Signup and view all the answers

Study Notes

Victims of Abuse

Types of abuse include child abuse, elder abuse, and intimate partner violence.
Physical abuse involves intentional acts causing injury.
Sexual abuse is non-consensual or exploitative sexual behavior.
Emotional/psychological abuse uses words and actions to control.
Neglect is failing to meet a dependent's basic needs.
Financial abuse uses someone's finances to exploit or control them.

Types of Abuse

Physical abuse, defined as any intentional act that causes trauma or bodily injury.
Sexual abuse, defined as any non-consensual or exploitative sexual behavior imposed without consent.
Emotional/psychological abuse, defined as regular and deliberate use of words and non-physical actions to hurt, manipulate, demean, confuse, frighten or otherwise control another individual.
Neglect, defined as failure to provide for or meet a dependent's basic physical, emotional, educational and/or medical needs.
Financial abuse, defined as using an individual's finances to exploit or control that individual.

Physical Abuse of Children

Sometimes referred to as Non-Accidental Injury
May include hitting, slapping, kicking, shaking, throwing, burning, biting, scratching, breaking bones, drowning, poisoning, or causing illness.

Accidental vs Non-Accidental Injuries in Children

Consider age and ability.
Any physical injury for non-mobile children is cause for concern.
Toddlers/pre-schoolers/early school age are often covered in bruises and injuries.
Accidental injuries become less frequent in older children (with exception to sport injury).

Typical Accidental and Abusive Injuries in Children

Accidental injuries typically involve bony prominences, match the history, and align with the child's development.
Abusive injuries often affect both sides of the body, target soft tissue, have unusual patterns, delay in presentation, or no clear explanation.
Common injury locations include the head, forehead, nose, chin, palm of hand, ears, inner aspects of arms, back and side of trunk, knees, shins, and soles of feet.
Black eyes (especially if bilateral). Soft tissues of the cheeks. Forearms when raised to protect themselves. Chest and abdomen. Any injury to the groin or genitals.

Physical Abuse: Non-Physical Signs and Symptoms in Children

Fearfulness (unusual for age/stage of development).
Odd behavior for age/stage.
Bedwetting.
Hypervigilance (jumpy, anxious, always "on guard").
Overly compliant, unusually calm during examination.
Especially pained by painful procedures.
Dissociated or a “thousand-yard stare.”

Physical Abuse: Adults/Elders

Consider age and ability. Disabled/bed-bound adults should sustain minimal injuries.
Elderly people and those on blood thinners bruise easily; elderly skin is thinner and more susceptible to tearing.
Consider the accompanying stoy in comparison to the presenting injuries.

Physical Abuse: Cultural/Religious Practices

Female Genital Mutilation (FGM) is predominantly in African and some Middle Eastern countries.
Types of FGM include clitoridectomy (partial or total removal of clitoris), excision (partial or total removal of clitoral glans and labia minora), and infibulation (narrowing of the vaginal orifice).
Other harmful procedures to the female genitalia include pricking, piercing, incising, scraping, or cauterization.

Sexual Abuse: Children

Any form of sexual penetration.
Inappropriate sexual touching of a child (clothed or unclothed).
Forcing a child to touch an adult sexually/forcing a child to strip or masturbate.
Taking, downloading, viewing, or distributing sexual images of children.
Not taking measures to protect a child from witnessing sexual activity or images.
Engaging in any kind of sexual activity in front of a child, including watching pornography.

Sexual Abuse: Children - Indications

Genital or anal pain, irritation, and/or bleeding.
Injuries to external genitals or inner thighs.
Difficulty walking or sitting.
Torn, stained, or bloody underclothing.
Sexually transmitted diseases.
Distress exhibited when a particular caregiver approaches.
"Mimicking" behavior or re-enacting the abuse during play.
Bizarre, sophisticated, or unusual sexual knowledge.

Sexual Abuse of Adults

Any contact (or non-contact) sexual activity without consent.
May include rape/date rape, attempted rape, sexual assault, groping/forced kissing, exposing genitals, or other forms of sexualized activity.
Exploitation concerning adults with physical or psychological disabilities in long-term care facilities, group homes, and home care services.

Human Trafficking

Recruitment, transportation, or harboring of a person with the goal of exploitation.
Victims are often young girls held hostage, forced into the sex trade, often with a traumatic past.
Common types of traffickers include "Romeo" or "boyfriend" types, who lure victims online or in person.
Indicators include inappropriate clothing for weather in a specific location, unusual places/circumstances, and any apparent form of controlling behavior.
Tattoos/brands (crown, roses, barcodes, dollar signs), often located at the neck, wrist and collarbone areas.

Psychological Abuse in Children/Adults

Humiliating or constantly criticizing.
Threatening, shouting at, or calling demeaning names.
Subjecting to jokes or sarcasm.
Blaming and scapegoating.
Making perform degrading acts/acts that should not be imposed on others.
Not allowing to have friends.
Ignoring them constantly.
Never showing kind or positive reinforcement.
Manipulation.
Gaslighting (pushing for perfection, or ignorant of limits/ignorant of their limits).

Neglect

Unmet basic needs including food/water, clothing, warmth, shelter, hygiene.
Inadequate access to health care services.
Inadequate education.
Inadequate supervision
Inadequate protection from hazards.
Can include self-neglect in adults

Financial Abuse

Pressuring/forcing/tricking someone into theft of money/possessions, lending/giving possessions, moving from home, or changing of will/power of attorney/document signing.
Including those who sign legal or financial documents that they don’t understand.
Includes working for little to no money and using bank cards/cheques for items that aren’t needed, without consent.
Providing food, but without compensation for work.
No/limited access to financial accounts.

Paramedic Roles and Responsibilities

Function as patient advocates.
Employ power to speak up for those vulnerable.
"Mandated reporters" for duty to report any and all suspected cases or known cases of child maltreatment.
This overrides normal professional confidentiality laws.

Assessment

Employ a nonjudgmental and noninterrogative approach.
Carefully listen to patient and caregivers.
Probe gently when necessary.
Observe inconsistencies.
Look for subtle signs of abuse (quiet children who seem abnormally compliant).
Be sensitive to patient/caregiver issues (especially elderly).

History Taking

Assume nothing. Don't immediately jump to conclusions about a situation
Active listening without being interrogative.
Gently probe for inconsistencies in stories.
Avoid accusations or judgmental remarks.
Guarantee patient privacy, especially when speaking to family/caregivers privately.
Nonjudgmental approach.
Avoid immediately reacting with emotion of disgust, shock, etc.

Therapeutic Approach

Be aware of personal bias.
Conduct thorough assessment and history taking.
Secure a safe and private space.
Employ least invasive approach when first speaking to a patient.
Build rapport by active listening, sensitivity, dignity, respect.

Patient Advocacy & Duty to Report (Children)

Function as patient advocates.
Duty to report child abuse.
This overrides normal professional confidentiality laws
Report to appropriate authorities and make all relevant disclosures.
Even if someone else states they will report, you are also required to make a report.
Pass concerns to hospital staff.

Patient Advocacy & Duty to Report (Adults)

Function as patient advocates.
Report if needed to appropriate authorities.
This overrides normal professional confidentiality laws.
If a person has capacity, ensure you don't act on their behalf without consent.
Be aware of capacity and allow them to make their own decisions.

External Assistance

List of services available to provide assistance.
This includes; police, Children's Aid Societies, Victim Service Agencies, Crisis Centres, temporary shelters, and the National Human Trafficking Helpline.

Child in Imminent Danger?

If a child is in immediate danger, and/or significant danger; have the police attend to the scene.
Provide specific details; be thorough and concise.

General & Specific Standards

General geriatric standards.
Sexual Assault (reported) standards.

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Description

This quiz explores various forms of abuse, including physical, sexual, emotional, neglect, and financial abuse. Each type is defined and explained to enhance understanding of their impact on victims. Test your knowledge on these critical issues and learn how to identify them.