Abuse and Assault PDF

Summary

This presentation covers various types of abuse, including partner abuse, elder abuse, child abuse, sexual assault, and date rape drugs. It examines statistics, risk factors, and prevention strategies. The presentation also discusses characteristics of victims and perpetrators, along with legal issues and evidence preservation procedures.

Full Transcript

1 2  Partner Abuse  Elder Abuse  Child Abuse  Sexual Assault  Date Rape Drugs 3  Nearly three million children are abused each year.  More than 1,000 die every year.  Two to four million women are battered each year (Only 10% of women report battering incidents)...

1 2  Partner Abuse  Elder Abuse  Child Abuse  Sexual Assault  Date Rape Drugs 3  Nearly three million children are abused each year.  More than 1,000 die every year.  Two to four million women are battered each year (Only 10% of women report battering incidents).  700,000 to 1.1 million elderly people are abused every year. 4  Victims may: die suffer mental or physical injuries 5 6  Men, women who beat one another also most likely beat their children  Children of abusive, unloving homes more likely to become spouse, child, elder abusers 7  Prevention strategies Early detection Social services support Altering life styles 8 9  Physical or emotional violence from men or women toward their domestic partners or others 10  Fear of reprisal  Fear of humiliation  Denial  Lack of knowledge  Lack of financial resources 11 12  Physical  Verbal  Sexual 13 *Abuse may exacerbate existing medical conditions. 14  Pregnancy  Substance abuse  Emotional disorders 15  Male is unemployed  Male uses illegal drugs at least once a year  Partners have different religious backgrounds  Family income is below the poverty level  Partners are unmarried 16  Either partner is violent toward children at home.  Male did not graduate from high school.  Male is unemployed or has a blue- collar job.  Male is between 18 and 30 years old.  Male saw his father hit his mother 17  Use direct questions.  Avoid judgments.  Listen carefully.  Encourage patients to regain control of their lives.  Offer knowledge of community resources.  Advise the patient to take all necessary precautions before returning home. 18 19  Domestic  Institutional 20 21 22  The most common cases involve elderly women abused by their sons.  Most frequently occurs among people who are dependent upon others for their care.  In cases of neglect, abused elders most commonly live alone 23 24 *Child abuse can occur from infancy to age 18 y. and can be inflicted by any number of caregivers. 25 26  3,000,000 cases/year  > 1,000 fatalities  10% of trauma < 3 years old seen in ERs  All social, economic, religious, ethnic groups 27  Contributing Factors: Child “Different”: handicapped, hyperactive, precocious Male > Female 2:1 Small enough to be unlikely to retaliate 2/3 of abused children are < 3 years old 28  Use or abuse of drugs and/or alcohol  Immaturity and preoccupation with self  Lack of obvious feeling for the child, rarely looking at or touching the child  Seemingly unconcerned about the child’s injury, treatment, or prognosis  Little identification with the child’s pain  Often abused themselves as children  Lonely, unhappy, under stress  Lack of understanding of normal child development 29  Crying, often hopelessly, or not crying at all, during treatment  Avoiding the parents or showing little concern for their absence  Unusually wary or fearful of physical contact  Apprehensive and/or constantly on the alert for danger  Prone to sudden behavioral changes  Absence of nearly all emotions  Neediness, constantly requesting favors, food, or things 30  Child is: Apathetic Unusually stoic Extremely fearful of adults Unusually loving or cooperative 31 *A child’s behavior is one of the most important indicators of abuse. 32  Multiple or repeated injuries Unusual variety Different stages of healing Unusual locations  Inconsistency of injury with: Reported mechanism History Developmental abilities 33  History changes on retelling  Multiple ER visits, EMS contacts  Inappropriate parental response Prolonged delay in seeking help Parent hostile, indifferent, apathetic Person other then caretaker brings child in  Malnutrition  Poor hygiene  Inappropriate dress 34 35 *Soft-tissue injuries are common indicators of abuse, especially multiple bruises in different places on the body, in different stages of healing, and/or with distinctive shapes. 36  Burns and scalds  Fractures  Head injuries  Shaken baby syndrome  Abdominal injuries 37 38 39 40  Malnutrition  Severe diaper rash  Diarrhea or dehydration  Hair loss  Untreated medical conditions  Inappropriate, dirty, or torn clothing  Tired or listless attitudes  Nearly constant demands for physical contact or attention 41 As with all other forms of abuse, paramedics have an obligation to report suspected child abuse. 42 43  Sexual assault—unwanted oral, genital, or manual sexual contact  Rape—penile penetration of the genitalia without the consent of the victim 44  Symptoms of sexual abuse, regardless of its form, may include: ¤ Nightmares ¤ Restlessness ¤ Withdrawal tendencies ¤ Hostility ¤ Phobias related to the offender ¤ Regressive behavior, such as bed wetting ¤ Truancy ¤ Promiscuity, in older children and teens ¤ Drug and alcohol abuse 45 46  Render a person unresponsive.  Weaken them to a point where they are unable to resist an attacker.  Some of these medications cause amnesia, thus eliminating or distorting the victim’s recall of the assault. 47  Flunitrazepam  Characteristics  A benzodiazepine  Colorless marketed in Mexico,  Odorless South America  Used for insomnia  Tasteless  10 times more potent  Can be dissolved in a than valium drink without being  Effects in 20 minutes detected  Duration up to 8 hours  Alcohol intensifies effects 48  CNS Depression  Amnesia  Respiratory depression  Muscle relaxation 49  Like GABA (Gabapentin is used in epilepsy,  Characteristics peripheral neuropathic  Liquid pain)  Odorless  Like alcohol  Colorless  Effect in 15–30 minutes  Duration 3 hours  Used as an amino acid supplement by body builders  Depressant with anesthetic-type qualities 50  Relaxation  Tranquilizer  Sensuality  Loss of inhibitions 51  Ketalar  Used as an anesthetic  Characteristics  10 times more potent  Potent anesthetic than Valium agent with dissociative  Hallucinogenic effects effects last 45–90 minutes  Duration up to 24  Colorless, odorless hours liquid  Widely used in  White veterinary practice  Off-white powder  Used in human anesthesia 52  Hallucinations  Delirium  Amnesia  Dissociation  Respiratory depression  Seizures  Arrhythmias  Cardiac arrest  Hypertension 53  One of most abused  Characteristics amphetamines by  10% the stimulant teenagers/college effect of students amphetamines  Large dose = same  Potent serotonin effects as release amphetamines  Effects:  Temperature is a key  Onset within 20–60 finding minutes  2–3 hour duration 54  Psychological  Physical  Mood alteration,  MI, dysrhythmias, sleep, anxiety CVA  Poor memory, poor  Seizures impulse control  Serotonin syndrome  Use of other drugs  Permanent damage  Tolerance to serotonin neurons  Hyperthermia 109° 42.8°C 55 56 *Your actions in the case of alleged sexual assault can affect the prosecution of a crime. Protect the evidence! 57  Anything that can be used to connect: A victim to a suspect A suspect to a victim A suspect to the crime scene 58  Legally retaining items of evidence and accounting for their whereabouts at all times to prevent loss or tampering 59  Patient care is the FIRST priority of ALL responding agencies  The most important part of evidence collection is protecting the crime scene  Be aware that anything on or around the patient may be considered evidence.  Whenever in doubt, save or treat an object as evidence.  Develop an awareness of evidence.  Record only the facts at the scene of a crime, and record them accurately. 60  Victims of alleged sexual assault should not wash or use restroom until they are examined at hospital  If victim reports scratching assailant, cover victim’s hands with paper bags; tape loosely at the wrists 61 *In calls involving abuse or assault, your primary responsibility is safety—both your own and that of your patient. 62

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