7 X 11 Long.P65

Cambridge University Press 978-0-521-86707-8 - Emergency Care of the Abused Fiona E. Gallahue and Laura D. Melville Index More information

Index

abandonment, 139 American Professional Society of the Abuse of abdominal injuries, 19–20 Children (APSAC), 42 ABFO. See American Board of Forensic anal/rectal examination, 44–45 Odontology anal swabs and smears, 120 ABFO No. 2 device, 271, 272, 275 aperture, 266–267 abrasion, 8, 196, 279 APS. See adult protective service Abu Ghraib, 192, 221 APSAC. See American Professional Society of abuse. See also child abuse; elder abuse; ethnic the Abuse of Children minorities, abuse of; intellectually asphyxia, research regarding, 26 disabled people, abuse of; intimate assault. See sexual assault partner violence; mentally ill people, asylum seekers, 194–196 abuse of; neglect; sexual abuse asymptomatic eosinophilia, 212 cultural deﬁnitions of, 174–176, 178, 190 Australia, 195, 256 economic, 76–77, 138, 151 ayurvedic medicine, 177 emotional, 75, 76, 139 azithromycin (Zithromax), 56–57, 72–73, 123 peer, 151 as public health issue, 150 back injuries, 205, 254 religion inﬂuencing, 176, 180 bacterial vaginosis (BV), 50, 56–57, 72–73 acupuncture, 175–177 beds, falls from, 22–24 adaptive device, constraint of, 151 Behavioral Science Consult Team (BSCT),221 adolescents belt mark PEP assessment of, 58, 71 benzodiazepines, 103 pregnancy test for, 58 bite marks sexually active, 54 documentation of, 9, 272–275 STDs and, 55 evidence collection of, 119 adult protective service (APS), 139, as physical abuse, 9–10, 119, 272–275 141–143 blood-letting, 174 agricultural workers, 250 blood sample, 122 AIDS. See HIV/AIDS body diagrams, 116, 266 alcohol, in DFSA, 52 body injury map, 84, 85 alternative medicine, 174–177 bone scanning, 208 American Board of Forensic Odontology bone scintigraphy, 20–21 (ABFO), 10, 271, 272, 275 brain injury, 18, 210

283

284 Index

breasts, in sexual assault medical evaluation, caregiver abuse 117 among ethnic minorities, 180 bruising of ID people, 151, 154, 156 from pacifier neglect as, 138–139, 145, 156 from physical abuse, 8–9 CARIE. See Coalition of Advocates for the in protected body areas, 8 Rights of the Infirm Elderly visual dating of, 9 CBT. See cognitive behavioral therapy BSCT. See Behavioral Science Consult CDC. See Centers for Disease Control and Team Prevention buccal swab, 118, 121 cefixime (Suprax), 56–57, 72–73 bucket handle and corner fractures, 14 ceftriaxone, 56–57, 72–73, 123 buckle fractures, 14 Centers for Disease Control and Prevention Burma, 241 (CDC), 123, 127, 211 burns central injuries, 79 chemical, 11–12 cervix, 277–278 cigarette, 11 chain of evidence, 52, 110, 121, 268, 276 contact injuries and imitators, 11 chemical burns, 11–12 electrical, 11–12 chicken kebab, 197 epidemiology of, 10 child abuse. See also physical abuse; sexual first degree, 10 abuse immersion, 11 accidents v., 29 as physical abuse, 10–12 of children with disabilities, 59–60, scald, 10 152–153 second degree, 10 CPS and, 61 splash, 11 definition of, 2 steam disorders mimicking, 21 from stun guns, 11–12 epidemiology of, 1–2 thermal injuries and imitators, 10–11 factors lowering threshold for, 176 third degree, 10 failure to thrive and, 60–61 water temperature, exposure time, and gender difference in, 2 depth of, 12 identification of, 3 BV. See bacterial vaginosis judicial system handling, 62 medico-legal issues in, 61–62 Caffey, John, 16 neglect as, 2 Cambodia, 242–243 racial disparities in, 2 cameras, 275–276, 278 releasing information and, 62–64 Canada, 256 reporting of, 2–6, 64, 182 candida, 50 Child Abuse Pediatrics, 4–5, 18 CAPTA. See Child Abuse Prevention and Child Abuse Prevention and Treatment Act Treatment Act (CAPTA), 2–3 cardiac complaints, 78 child advocacy center, 4–5 cardiovascular system, in medical evaluation child protection teams, 4–5 of torture victims, 207 child protective service (CPS), 61

Index 285

children. See also child abuse for forensic photography, 268–269 abused partner controlled by, 76–77 human trafficking and, 235, 247 internationally adopted, 213 implied consent doctrine of, 104, 269 torture and, 212–215 informed, 268–269, 272 as trafficking victims, 221, 240–242, by mature or emancipated minors, 62 248–252, 254 minor consent laws for, 62 chlamydia, 53–57, 72–73, 254 to sexual assault treatment, 103–104 chronic pain syndromes, 78 contact burn injuries, 11 cigarette burns, 11 contusions, 8–9, 278. See also bruising ciprofloxacin (Cipro), 56–57, 72–73 conventional 35mm single lens reflex (SLR) circumcision, 174–175. See also female genital camera, 275, 278 mutilation corporal punishment, 176–181, 190 CIS. See Commonwealth of Independent CPS. See child protective service States crabs. See pubic lice clothing evidence, 118–119 cranial nerve deficits, 211 Coalition of Advocates for the Rights of the cross-cultural medical interview, 184, 185 Infirm Elderly (CARIE), 142 CT scan, 18 CODIS. See Combined DNA Index System cultural awareness, of medical providers, 172, coercion, 76–77, 235 174, 183–184, 222–223 cognitive behavioral therapy (CBT), 217–218, cupping, 177 232 cutaneous manifestations, of physical abuse, 8 coining, 177 colposcopy, 117, 120 DAIP. See Duluth Domestic Abuse equipment for, 277–279 Intervention Project filter selection in, 279–280 danger assessment, of IPV, 87, 97 follow-up, 279 debris collection, 119 forensic v. medical uses for, 277 debt bondage, 235 history of, 277 Democratic Republic of Congo, 242 for non-genital injuries, 280 Detection of Torture Survivors Survey, physics of, 277–278 199 Combined DNA Index System (CODIS), developmental disability, 151, 173. See also 125 intellectually disabled people, abuse of Combivir. See lamivudine/zidovudine developmental stage, of victim, 8, 15 commercial sex industry, 235, 242–243 DFSA. See drug-facilitated sexual assault Commonwealth of Independent States (CIS), diagnostic imaging 251–252 in emergency department, 20 Community Mental Health Centers Act, 158 in medical evaluation for child abuse, condyloma acuminata (venereal warts), 49 20–21 confidentiality, 61, 246, 247 for torture victims, 196 consent diagnostic testing, 53–54 cognitive inability to, 104 diaphysial fractures, 16 court order v., 269 digital cameras, 276 for evidence collection, 52 direct torture, 196, 199

286 Index

disabled adults, 82, 103 . See also intellectually economic abuse, 76–77, 138, 151 disabled people, abuse of ED. See emergency department DNA evidence, 10, 125 EEG, 210 documentation. See also forensic photography efavirenz, 125 of abuse of mentally ill people, 160 elder abuse, 82, 103 adjuncts to, in sexual assault, 276–277 APS and, 139, 141–143 of bite marks, 9, 272–275 CARIE and, 142 on body diagrams, 116, 266 clinical presentations of, 137 of chain of command, 110 cognitive impairment and, 156 hearsay and, 62–63 cost of, 134 in history taking, 6, 71 cultural backgrounds influencing, 140 injury, 12, 265–266, 273–274 decision-making capacity and, 143 of IPV, 84–85, 96 definition of, 134–135 of medical evaluation for child abuse, 8, 35, emergency department screening protocols 40, 53 for, 134 of medical evaluation of torture victims, emotional, 139 202–203 financial, 138 medico-legal issues of, 61 history taking for, 137 of sexual assault, 107–108, 116–117 identification of, 134, 137, 140–141 of shaken baby syndrome, 17 increase in, 134 of trafficking victims’ medical evaluation, institutional, 136, 142 253 institutionalization likelihood and, 140, 143 written description, 265 investigation of, 142–143 domestic violence. See child abuse; intimate legal considerations in, 134, 139–140 partner violence management and intervention for, 142–145 Domestic Violence Acute Care Checklist, medical case management teams for, 94–95 143–145 doxycycline (Vibramycin), 56–57, 72–73, 123 medical disorders and, 141 dried secretion evidence collection, 119 National Institute on Elder Abuse for, 133 drowning, 27 neglect as, 134–136, 138–139, 145, 156 drug abuse, 78 overview of, 133–134 drug-facilitated sexual assault (DFSA) perpetrators of, 136 alcohol and, 52 physical, 137–138 blood sample for, 122 reporting of, 134, 140–141, 143, 145 drugs for, 52, 103, 109 residential, 136 kit for, 108–109, 112, 114 resources for, 144 signs of, 108 risk factors for, 136 urine sample for, 106, 122 sexual, 138 Duluth Domestic Abuse Intervention Project violation of rights as, 139 (DAIP), 75–77 Elder Abuse Prevention, Identification, and Treatment Act, 134, 139 ecchymoses, 196 elder mistreatment (EM) 134–135 . See also ECG. See electrocardiogram elder abuse

Index 287

electrical burns, 11–12 perpetrators of, 179–180 electric torture, 196, 199 religious and cultural rights influencing, electrocardiogram (ECG), 202 176 elephant, 197 social factors influencing, 184 EM. See elder mistreatment support groups for, 184 emancipated minors, 62 taboos influencing, 173, 175 emergency contraception, 56–58, 72–73, 122 underreporting of, 171–172 emergency department (ED) ethylsuccinate, 56–57, 72–73 diagnostic imaging in, 20 EU. See European Union elder abuse screening protocols of, 134 European Union (EU), 194–196, 253, 256 investigations not appropriate in, 5 evidence collection. See also forensic IPV and, 75 photography patient-health care provider encounter in, 1 anal swabs and smears, 120 photography in, 266 bite marks, 119 sexual assault evaluation in, 105–106 buccal swab, 118, 121 triage algorithm in, 5, 35–39 chain of, 52, 110, 121, 268, 276 victims initially presenting at, 1, 60 clothing, 118–119 emergent evaluation, 35–37 consent for, 52 emotional abuse, 75, 76, 139 debris, 119 emtricitabine, 125 diagnostic testing in, 53–54 Epivir. See lamivudine of DNA, 10, 125 erythromycin base, 56–57, 72–73 dried secretions, 119 ethnic minorities, abuse of examiner mistakes in, 101 barriers to care for, 172–175 fingernail scrapings, 119 by caregivers, 180 forensic, 101 child rearing practices and, 176–181 guidelines for, 52 community-focused culture influencing, hair, 119–120 172 IPV and, 84 corporal punishment and, 176–181, 190 post-assault testing in, 54–55 cross-cultural medical interview for, 184, in sexual assault medical evaluation, 101, 185 116–121 cultural definitions of abuse influencing, of trace evidence, 118–119 174–176, 178, 190 vaginal/penile swabs and smears, 120–121 culturally sensitive interventions for, exams. See also medical evaluation, for 183–184 physical abuse; medical evaluation, for culture-based medicine bias and, 169–170 sexual abuse; medical evaluation, for epidemiology of, 170–171 sexual assault equality and, 183 anal/rectal, 44–45 illegal immigrants and, 171–172, 182–183 genital, 120–121, 277–280 IPV and, 173, 176 pelvic, 120–121 language barriers in, 181 retinal, 18 legal requirements and, 181–182 expert testimony, 63 overview of, 190–191 exposure, 197

288 Index

facial fractures, 79 orientation photograph in, 272 fact witness, 63 physics of, 266–267 failure to thrive (FTT), 60–61 preparation for, 271 falanga, 197–199, 205, 208 procedures of, 272 falls, injuries from, 22–24, 27 quick reference page for, 282 family violence programs, 88–89 scales/measuring devices in, 270–271 Fatality Review Teams, 145 substantiated, 267 Federal Bureau of Investigation (FBI), 222 technique for, 270–275 federal reporting laws, 2–3 fractures female genital mutilation, 174–175, biomechanics of, 13 209–210 bucket handle and corner, 14 female victims buckle, 14 gender difference and, 2 diaphysial, 16 sexual abuse evaluation of, 41–44 facial, 79 femicide, 86 femur, 14, 15 femur fractures, 14, 15 medical conditions influencing, 15 film, 266–267, 271, 275 from physical abuse, 13–15 financial exploitation. See economic abuse rib, 13–14 fingernail scrapings, 119 in skeletal survey, 15 first degree burn, 10 spiral, 15 flunitrazepam (Rohypnol), 109 from torture, 207 forensically significant injury, 273–274 transverse, 14–15 forensic evidence kit 37, 52. See also rape kit FTT. See failure to thrive forensic odontologist, 9, 275 forensic photographyic 53, 116–117, 254. See gamma-hydroxybutyrate (GHB), 103, 109 also colposcopy gastrointestinal disorders, 78 adjuncts to, in sexual assault, 276–277 gay victims, 102–103 admissibility of, 267–268 gender, 2, 74–75, 86, 102–103, 241–242, 248 of all injuries, 266, 273–274 generalized pain, from torture, 204–206 background in, 270 Geneva Conventions, 219–222 bite mark, 273–275 genital bleeding, 30, 38 chain of custody for, 268, 276 genital diagrams, 115 consent for, 268–269 genital exam, 120–121, 277–280 in court, 267–268 genital injuries, 37–38 in emergency department, 266 genital mutilation. See circumcision; female equipment for, 275–276, 278 genital mutilation focusing in, 272, 273 genitourinary (GU) system, in medical identification picture, 272 evaluation of torture victims, 208–211, inflammatory, 268 231 introduction to, 265 GHB. See gamma-hydroxybutyrate lighting for, 267, 271–272 ghotna, 197, 199 minimum criteria for, 268 gonorrhea, 46, 53–57, 72–73, 254 objectionable, 268 Guantanamo Bay, 221–222

Index 289

GU system. See genitourinary system, in homicide, 86 medical evaluation of torture victims HPV. See human papillomavirus gynecologic disorders, 78 human papillomavirus (HPV), 49, 53, 253 human trafficking. See also trafficking victims hair evidence, 119–120 consent and, 235, 247 hanging, 197, 199, 205, 207, 211 cultural values’ role in, 241–242 HBV. See hepatitis B virus definitions of, 234–235 headaches, from torture, 204 in East Africa, 253 head injury, 15, 254 by families, 242, 248, 252 health care system, complexity of, 173 globalization’s role in, 241–242 Health Insurance Portability and immigrants and, 241 Accountability Act (HIPAA), 62 increased awareness of, 237 hearing screening, 207, 213 law enforcement’s role in, 242–243 hearsay, 62–63 locations of, 234, 237–239, 243–244, HEARTS mnemonic, 201 251–253, 255 hematoma, 8 organized crime’s role in, 236–237 hepatitis B virus (HBV), 50, 56–57, 72–73, overview of, 233–234 123–124, 213, 254 process of, 236 hepatitis C virus, 123–124, 213, 254 profits generated by, 238 herbal remedies, 174, 177 prosecutions of, 239 herpes, 49, 53 public health impacts of, 252–253 hidden submental injury, 274 recruiters of, 237 high chairs, falls from, 24 resources for, 253–255, 257–258 HIPAA. See Health Insurance Portability and rising rates of, 238 Accountability Act severe forms of, 234–235 history taking for sexual exploitation, 235, 242–243, appropriate location and provider 251–253 determined in, 7–8 smuggling v., 235 child’s safety determined in, 7 state sponsored, 241 documentation in, 6, 71 transnational, 240 for elder abuse, 137 victim-centered approach to, 245 IPV and, 83, 96 hunger strike, 222 in sexual assault evaluation, 107–109 hymen, 41–42 of shaken baby syndrome, 17 of torture victims, 201 ID. See intellectually disabled people, abuse of in trafficking victims evaluation, 253–255 identification picture, 272 triage and, 6–8 ID specialist. See Infectious Disease specialist “HITS” Scale, 81 illegal immigrants, 171–172, 182–183 HIV/AIDS, 48, 56–57, 72–73, 124, 127, 131, immersion burn, 11 195, 240, 251–254 immigrants. See also ethnic minorities, abuse Hmong, 173 of hogtie, 197 communication with, 223 homelessness, 156–159 cross-cultural competence and, 222–223

290 Index

immigrants (cont.) reporting issues of, 153–154, 161–162 culture-based medicine bias and, 169–170 risk reduced of, 155 definition of, 170 self-injurious behavior triggered by, 154 human trafficking and, 241 sequelae of, 154 illegal, 171–172, 182–183 sexual, 151–152 statistics of, 169 treatment of, 155–156 imminent danger, 36 types of, 151–152, 154 immunization history, 213 violence, disability and, 151, 153 implied consent doctrine, 104, 269 interpreters. See translators India, 241 intimate partner violence (IPV) Indian Ocean tsunami, 238 at-risk groups for, 82 infant mechanical suffocation, 26 clinical presentations of, 78–80 infants. See shaken baby syndrome counseling for, 89 Infectious Disease (ID) specialist, 124 cycle of, 77 informed consent, 268–269, 272 DAIP and, 75–77 injuries danger assessment of, 87, 97 back, 205, 254 discharge review for, 95 body injury map for, 84, 85 discussion of, with patient, 83 brain, 18, 210 documentation of, 84–85, 96 burn, 11 Domestic Violence Acute Care Checklist central, 79 for, 94–95 documentation of, 12, 265–266, 273–274 dynamics of, 75–78 from falls, 22–24, 27 emergency department and, 75 genital, 37–38 epidemiology of, 74–75 head, 15, 254 among ethnic minorities, 173, 176 hidden submental, 274 evidence collection and, 84 medically v. forensically significant, family violence programs for, 88–89 273–274 gender and, 74–75, 86 non-genital, colposcopy for, 280 guide to, 96 oral, 12–13 as health issue, 74 patterned, 9, 79 history taking of, 83, 96 straddle, 25 homicide from, 86 thermal, 10–11 among ID people, 151 “instant” camera, 275–276 medical consults for, 89 intellectually disabled (ID) people, abuse of medical evaluation for, 83, 96 of children, 59–60, 152–153 medical treatment for, 83–84, 96 cycle of, 161–162 mentally ill people and, 157 definition of, 150–151 Power and Control Wheel and, 75–77 elderly, 156 pregnancy and, 80 institutional, 153 referrals for, 88–89, 96 overview of, 150 reporting of, 88–89 prevalence of, 152 safety plan for, 84, 85 recognition of, 155 screening for, 80–83, 96

Index 291

staff members witnessing, 83 male victims STDs in, 78 gender difference and, 2 victim evaluation and management and, 80 sexual abuse evaluation of, 43 Violence Against Women Act and, 182 of sexual assault, 102 intimidation, 75, 76 mandatory reporters investigation of child abuse, 4–6, 64 of sexual abuse, 31, 45 of elder abuse, 140–141, 143 supportive evidence in, 31, 38 of IPV, 88 involuntary servitude, 235 measuring tape, 271 IPV. See intimate partner violence medical evaluation, for IPV, 83, 96 isolation, 76–77 medical evaluation, for physical abuse Israel, 256 diagnostic imaging in, 20–21 Istanbul Protocol, 223–224 documentation of, 8, 35, 40, 53 Italy, 256 emergent, 35–37 legal issues in, 37 judicial system, 62 nonemergency, 7 over-interpretation of findings in, 64 Kaletra. See lopinavir/ritonavir peer review and supervision in, 64–65 keloid scar scheduled for later date, 38 for shaken baby syndrome, 18 labial adhesions, 31 skeletal survey in, 20–21 Labial Separation technique, 41 urgent, 37–38 Labial Traction technique, 41–42 medical evaluation, for sexual abuse, 31–35 labia minora, 279 adult accompaniment in, 40–41 lacerations, 8, 279 anal/rectal examination in, 44–45 lamivudine (Epivir), 56–57, 72–73, 125 clock face for noting findings of, 43, 44 lamivudine/zidovudine (Combivir), 56–57, conclusion of, 58–59 72–73, 125 of females, 41–44 Latino remedies, 177 key concepts of, 44 law enforcement, 161, 242–243 of males, 43 lead toxicity, 213 order of, 41 lens, camera, 266–267 preparation for, 40–41 lesbian victims, 102–103 traumatic, 40 Levaquin. See levofloxacin medical evaluation, for sexual assault. See also levofloxacin (Levaquin), 56–57, 72–73 rape kit levonorgestrel (Plan B), 56–57, 72–73, 122 advocate present during, 106 liver, 19 of breasts, 117 long-term care facilities, 136, 142 checklist for, 129 lopinavir/ritonavir (Kaletra), 56–57, 72–73, completion of, 124–125 125 emergency contraception in, 122 in emergency department, 105–106 malaria, 211–212 evidence collection in, 101, 116–121 male privilege, 76, 77 flexibility of, 106–107

292 Index

medical evaluation, for sexual assault (cont.) physical, 254–255 general medical care in, 121–122 resources for, 253–256, 261–264 history taking in, 107–109 trust gained in, 253 initial approach to, 103 medical history. See history taking laboratory studies for, 122 medically significant injury, 273–274 medical provider’s role in, 102, 106, 108 medical provider. See also physicians medication order sheet in, 131 cultural awareness of, 172, 174, 183–184, necessary materials for, 104–107 222–223 physical, 108, 114–117 evaluation concluded by, 58–59 policy for, 106 expert testimony by, 63 privacy of, 106 as fact witness, 63 quick reference pages for, 128 IPV screening avoided by, 112 re-traumatizing, 101 nurses, 64, 112, 125–126 of soreness, 117 psychiatric illness considered by, 216 by trained forensic examiner, 64, 105, qualifications of, 63–64 112–114, 125–126 role of, in sexual abuse cases, 34–35, 58–59 urine sample in, 106, 122 role of, in sexual assault evaluation, 102, victim prepared for, 116 106, 108 victim reinforced during, 108 as trafficking victims’ advocate, 243 medical evaluation, of torture victims medication noncompliance, 79 cardiovascular system in, 207 medication order sheet, 131 critical information in, 203–211, 230 medico-legal issues, in child abuse cases Detection of Torture Survivors Survey in, confidential and privileged 199 communication, 61 diagnostic adjuncts in, 196 consent by mature or emancipated minors, documentation of, 202–203 62 EU requirements for, 194–196 documentation, 61 in formal intake session, 203–211, 230 protective custody, 61 genitourinary system in, 208–211, 231 mentally ill people, abuse of head and neck in, 207–208, 231 cycle of, 161–162 HEARTS mnemonic for, 201 definition of, 156 initial proceeding of, 198–200 documentation of, 160 musculoskeletal system in, 207–208, 211 group homes for, 156, 158 nervous system in, 210–211, 231 homelessness and, 156–159 pediatric considerations in, 212–215 neglect and, 156, 158 preparation for, 202–203 overview of, 150 psychological considerations in, 215–219 prevalence of, 157–158 screening questions in, 200, 212–213 of prisoners, 158 skin in, 206, 208, 231 psychiatric illnesses and, 78, 157–158, 216 translator for, 202 PTSD and, 160 medical evaluation, of trafficking victims recognition of, 160–161 documentation of, 253 reporting issues and, 159, 161–162 history taking in, 253–255 risk reduced of, 161

Index 293

self-injurious behavior triggered by, 160 non-lethal strangulation, 79 sequelae of, 159–160 non-occupational post-exposure prophylaxis substance use and, 161 (nPEP), 58, 71, 124–125, 131 types of, 156–158 non-verbal communication, 170 violence, mental illness and, 157, 159 nPEP. See non-occupational post-exposure Merlau-Ponty, 192 prophylaxis metronidazole, 56–57, 72–73, 123 nucleic acid ampliﬁcation test (NAAT), 54 military physicians, 219–222 nurses, 64, 112, 125–126 military triage, 220 Nursing Home Reform Act, 142 minor consent laws, 62 molluscum contagiosum poxvirus, 50 oral assault, 106–107 monkey bars, 25 oral injuries, 12–13 mothers, abuse perpetrated by, 2 oral swab and smears, 118, 121 motor vehicle crashes, 29, 80 organized crime, 236–237 moxibustion, 174, 177 orientation photograph, 272 MRI, 18, 208 musculoskeletal system, in medical evaluation pain of torture victims, 207–208, 211 chronic, syndrone, 78 generalized, from torture, 204–206 NAAT. See nucleic acid ampliﬁcation test neuropathic, 205 National Center for Health Statistics (NCHS), nociceptive, 205 60 visceral, 205 National Clinicians’ Post-Exposure pancreas, 19 Prophylaxis Hotline, 131 Partner Violence Screen, 82 National Institute on Elder Abuse, 133 patterned injury, 9, 79 NCHS. See National Center for Health peer abuse, 151 Statistics peer review, in abuse evaluations, 64–65 neglect pelvic exam, 120–121 caregiver, 138–139, 145, 156 penile swabs and smears, 120–121 of children, 2 peonage, 235 of elderly, 134–136, 145 PEP assessment. See non-occupational of ID people, 151 post-exposure prophylaxis of mentally ill people, 156, 158 perpetrators, of abuse unintentional, 145 of elder abuse, 136 Nepal, 237, 239, 251, 253 ethnic minorities and, 179–180 nervous system, in medical evaluation of mothers, 2 torture victims, 210–211, 231 of shaken baby syndrome, 17 neuropathic pain, 205 petechiae, 278 New York State Protocol for the Acute Care of photography. See forensic photography Adult Patients Reporting Sexual Assault, physical abuse. See also medical evaluation, 104, 126 for physical abuse; shaken baby New Zealand, 195 syndrome nociceptive pain, 205 abdominal injuries from, 19–20

294 Index

physical abuse (cont.) POW. See prisoner of war abrasions from, 8–9, 196, 279 Power and Control Wheel, 75–77 bite marks, 9–10, 119, 272–275 pregnancy burns, 10–12 complications of, 78 contusions from, 8–9, 278 emergency contraception for, 56–58, corporal punishment and, 176–181, 72–73, 122 190 IPV and, 80 cutaneous manifestations of, 8 prophylactic treatment for, 36 of elderly, 137–138 prisoner of war (POW) epidemiology of, 170–171 medications for, 220 fractures, 13–15 screening of, 220 of intellectually disabled people, 151 torture of, 219–222 lacerations from, 8, 279 translation for, 220–221 oral injuries, 12–13 prisoners, mentally ill, 158 of people with SMI, 157–158 profit laundering, 236 visual diagnosis of prophylactic treatment, 36, 55–58, 71–72, physicians 123–125, 127, 131, 156, 254 child abuse under-identified by, 3 prostitution, 252–253 cultural awareness of, 172, 174, 183–184, protective custody, 61 222–223 psychiatric illnesses, 78, 157–158, elder abuse reported by, 140–141, 145 216 emergency medicine, 64 psychological abuse. See emotional abuse IPV referrals by, 88 psychological torture, 196, 199 as mandatory reporters, 4 PTSD. See post-traumatic stress disorder military, 219–222 pubic hair evidence, 119–120 persecution of, 224 pubic lice (crabs), 49 torture by, 221–222 of torture victims, 199, 224 race, child abuse influenced by, 2 Plan B. See levonorgestrel “RADAR” mnemonic, 81 Polaroid camera, 275–276 RAINN. See Rape Abuse Incest National post-assault testing and treatment, 54–55 Network post-migratory stressors, 217 rape. See sexual assault post-traumatic seizures, 210–211 Rape Abuse Incest National Network post-traumatic stress disorder (PTSD), (RAINN), 126 100–101 rape advocate, 106 factors contributing to, 218 rape kit incidence of, among ethnicities, 219 96-hour limit and, 104, 114 among mentally ill people, 160 in chain of evidence, 121 rates of, 215–217 collecting of, 118–121 sleep disturbance from, 215 completion of, 121 in torture victims, 160, 210, 214–219 contents of, 109–111, 114 in trafficking victims, 252, 254 DFSA, 108–109, 112, 114 treatment modalities for, 217–218, 232 release of, 124–125

Index 295

RCT. See Rehabilitation and Research Center SBS. See shaken baby syndrome for Torture Victims scabies, 51 rectal examination. See anal/rectal scald burn, 10 examination schizophrenia, 157–158 referrals screening for IPV, 88–89, 96 adult v. pediatric, 214, 232 for trafficking victims, 246, 255 for elder abuse, 134 refugee, 192–196, 223–224, 242–243 hearing and vision, 207, 213 registered nurses, 64 for IPV, 80–83, 96 Rehabilitation and Research Center for of POWs, 220 Torture Victims (RCT), 201, 204, of torture victims, 194, 200, 212–213 217–219 of trafficking victims, 245–246, 261–264 religion, abuse influenced by, 176, 180 second degree burn, 10 reporting, of abuse selective serotonin reuptake inhibitor (SSRI), of child abuse, 2–6, 64, 182 217 child protection teams, advocacy centers self-injurious behavior, 154, 160 and, 4–5 self-neglect, 135–136 consequences of, 171 sensory deprivation, 196 of elder abuse, 134, 140–141, 143, 145 SERE. See Survival, Evasion, Resistance, and of ethnic minorities, 171–172 Escape identification and, 3 serious mental illness (SMI), 156–158 immunity provisions for, 4, 140 sex industry, 235, 242–243 of intellectually disabled people, 153–154, sex trafficking, 235, 242–243, 251–253 161–162 sexual abuse. See also medical evaluation, for of IPV, 88–89 sexual abuse laws regarding, 2–3 of children with disabilities, 59–60 by mandatory reporters, 4–6, 64, 88, disclosure of, 29, 33–35, 38 140–141, 143 of elders, 138 of mentally ill people, 159, 161–162 family issues in, 39 outcomes of, 89 of intellectually disabled people, 151–152 penalties for failure to do so, 4, 143 investigation of, 31, 45 response to, 4 medical conditions confused with, respiratory complaints, 78 30–32 retinal examination, 18 medical provider’s role in, 34–35, Retrovir. See zidovudine 58–59 rib fractures, 13–14 nonemergency exams for, 7 Rohypnol. See flunitrazepam oral injuries from, 13 Romania, 237, 239 overview of, 29 Russia, 240, 251–252, 256 peer review and supervision in, 64–65 of people with SMI, 157–158 SAFE. See Sexual Assault Forensic Examiner psychological reassurance and, 39, 59 SANE. See Sexual Assault Nurse Examiner risk factors for, 153 SART. See Sexual Assault Response Team signs and symptoms of, 29–33, 39

296 Index

sexual assault. See also drug-facilitated sexual herpes, 49, 53 assault; medical evaluation, for sexual HIV/AIDS, 48, 56–57, 72–73, 124, 127, assault 131, 195, 240, 251–254 abrasions and lacerations from HPV, 49, 53, 253 adjuncts to injury detection and in IPV, 78 documentation in, 276–277 with low likelihood of transmission, 50–51 better training and management needed molluscum contagiosum poxvirus, 50 for, 100–101 National Clinicians’ Post-Exposure colposcopy and, 277 Prophylaxis Hotline and, 131 consent to treatment for, 103–104 nPEP for, 58, 71, 124–125, 131 documentation of, 107–108, 116–117 with possible likelihood of transmission, New York State Protocol for the Acute Care 49–50 of Adult Patients Reporting Sexual prophylactic treatment for, 36, 55–58, Assault for, 104, 126 71–72, 123–125, 127, 131, 156, 254 oral, 106–107 pubic lice, 49 prophylactic STD treatment for, 123–124, scabies, 51 127, 131 from sex trafﬁcking, 252–253 resources for, 126–127 in sexual assault, 123–124, 127, 131 victims of, 100–103, 116 streptococcal perianal cellulitis, 51 sexual assault evidence collection kit. See rape syphilis, 47, 254 kit trichomonas, 48, 56–57, 72–73, 254 sexual assault forensic examiner with very high likelihood of transmission, examination by, 64, 105, 112–114, 125–126 46–48 SAFE, 64, 105, 125–126 shaken baby syndrome (SBS), 15–19 SANE, 64, 112, 125–126 age of children with, 16 SART, 112, 125–126 consequences of, 151 testifying by, 125–126 history and documentation of, 17 Sexual Assault Forensic Examiner (SAFE), 64, medical evaluation for, 18 105, 125–126 perpetrators of, 17 Sexual Assault Nurse Examiner (SANE), 64, as physical abuse, 15–19 112, 125–126 risk of, 17 Sexual Assault Response Team (SART), 112, skeletal survey for, 18 125–126 symptoms of, 16–18 sexually transmitted diseases (STDs) shoulder dislocation, from hanging, 197 in adolescents, 55 shutter speed, 266–267 bacterial vaginosis, 50, 56–57, 72–73 Sierra Leone, 242 candida, 50 skeletal survey chlamydia, 53–57, 72–73, 254 fractures in, 15 condyloma acuminata, 49 in medical evaluation for physical abuse, gonorrhea, 46, 53–57, 72–73, 254 20–21 hepatitis B, 50, 56–57, 72–73, 123–124, 213, for shaken baby syndrome, 18 254 skin, in medical evaluation of torture victims, hepatitis C, 123–124, 213, 254 206, 208, 231

Index 297

sleep disturbance, from PTSD, 215 medical sequelae of, 203, 208, 211, 231 SLR camera. See conventional 35mm single physical signs of, 197, 203–211, 231 lens reflex camera by physicians, 221–222 SMI. See serious mental illness of POWs, 219–222 smuggling, of migrants, 235 psychological effects of, 215–219 spectinomycin, 56–57, 72–73 types of, 196–199, 205–208, 211 spiral fractures, 15 UN and, 192–195 splash burns, 11 U.S. and, 194, 221–222 SSRI. See selective serotonin reuptake weight loss from, 210 inhibitor torture victims. See also medical evaluation, stairs, falls down, 24 of torture victims state reporting laws, 3 from Abu Ghraib, 192, 221 STDs. See sexually transmitted diseases asylum seekers as, 194–196 steam burn Australia and New Zealand medical care STI. See sexually transmitted diseases for, 195 straddle injuries, 25 communication with, 223 strangulation, 26, 79 dental health of, 213–214 streptococcal perianal cellulitis, 51 diagnostic adjuncts for examining, 196 stun gun burns, 11–12 endemic illnesses of, 211–212, 231 substance use, 161, 249–250 financial concerns of providing health care sucking blister to, 195–196 suffocation, 26 history taking from, 201 suicide, 160, 248–250 Istanbul Protocol for treating, 223–224 Suprax. See cefixime national policies regarding, 194 Survival, Evasion, Resistance, and Escape physicians of, 199, 224 (SERE), 221 political violence exposure of, 217 sweatshop workers, 250 post-migratory stressors of, 217 syphilis, 47, 254 post-traumatic seizures of, 210–211 psychological recovery of, 217 tape measure, 271 PTSD in, 160, 210, 214–219 TBI. See traumatic brain injury RCT for, 201, 204, 217–219 television set toppling, research regarding, 28 refugees as, 193–194, 196 tenofovir (Viread), 56–57, 72–73, 125 resources for, 232 thermal injuries, 10–11 screening for, 194, 200, 212–213 third degree burn, 10 treatment models for, 200–201 Title XX of the Social Security Act of 1974,133 UN guidelines for, 193–194 Title VI of the 1964 Civil Rights Act, 182 trace evidence, 118–119 toluidine blue, 276–277 trafficking. See human trafficking torture Trafficking Information and Referral Hotline, of children, 212–215 253–255 definition of, 192 trafficking victims. See also medical delayed reporting of, 200 evaluation, of trafficking victims Geneva Conventions on, 219–222 assisting of, 244

298 Index

trafficking victims (cont.) trichomonas, 48, 56–57, 72–73, 254 children, 221, 240–242, 248–252, 254 tuberculosis, 254 in conflict areas, 242 T visa, 244 deportation of, 243 TVPA. See Trafficking Victims Protection Act emergency intervention for, 247 follow-up with, 255 UK. See United Kingdom gender and, 241–242, 248 Ukraine, 256 health concerns for, 250–251 UN. See United Nations for human sacrifices, 240–241 unbroken chain of evidence, 52 identification of, 233–234, 245–246, 261 underwear collection, 119 inadequate protection for, 240–242 undue influence, 135 interviewing of, 246–250 UN High Commission of Refugees intranational, 240 (UNHCR), 192–196, 223–224 language barriers and, 245–247 United Kingdom (UK), 251 medical providers advocating for, 243 United Nations (UN), 192–195, 234 origin of, 238–241 United States (U.S.) PTSD in, 252, 254 Department of Defense of, 222 referral information for, 246, 255 human trafficking and, 234, 238, 239, resources for, 253–256, 261–264 243–244, 252–253, 255 re-trafficking of, 240 torture and, 194, 221–222 re-traumatization of, 247 urethral prolapse, 30–31 risk assessment and, 246–248 urgent evaluation, 37–38 screening of, 245–246, 261–264 urine sample, in sexual assault evaluation, shunning of, 252 106, 122 substance use by, 249–250 U.S. See United States, torture and Trafficking Information and Referral U.S. Department of Defense, 222 Hotline and, 253–255 T visa for, 244 vaginal swabs and smears, 120–121 victims of other crimes v., 244 vaginitis, 31, 51 work locations of, 238–241 venereal warts. See condyloma acuminata Trafficking Victims Protection Act (TVPA), Vibramycin. See doxycycline 234, 243–244 victims. See also female victims; male victims; transgender victims, 102–103 torture victims; trafficking victims translators, 202, 220–221, 224, 246–247 developmental stage of, 8, 15 transverse fractures, 14–15 elderly, 103 traumatic brain injury (TBI), 210 helpless feeling of, 172 triage IPV, evaluation and management of, 80 algorithm for, 5, 35–39 lesbian, gay, and transgender, 102–103 emergent evaluation in, 35–37 non-English speaking, 104 evaluation scheduled for later date in, 38 of sexual assault, 100–103, 116 history taking and, 6–8 Victims of Trafficking and Violence military, 220 Protection Act. See Trafficking Victims urgent evaluation in, 37–38 Protection Act

Index 299

violence. See also intimate partner violence vision screening, 213 cycle of, 77 Vitullo kit. See rape kit family programs for, 88–89 Voodoo, 177 intellectually disabled (ID) people and, 151, 153 walkers, 26 mental illness and, 157, 159 water torture, 196, 199, 207 political, 217 withholding, 197 Violence Against Women Act, 182 Viread. See tenofovir zidovudine (Retrovir), 56–57, 72–73, 125 visceral pain, 205 Zithromax. See azithromycin