This document outlines signs that are consistent with different forms of abuse, including physical abuse, sexual abuse, elder abuse, and signs of an abusive partner. Some key signs mentioned include injuries that do not match the reported mechanism, details of injuries that change between accounts, multiple injuries in various stages of healing, and inappropriate use of restraints. The document stresses the importance of ensuring safety for victims and avoiding confrontation with alleged abusers. Health care providers are obligated to file a report when abuse is witnessed or suspected.

1. Abuse
Aries Glenn B. Galao, BSN, RN

2. SIGNS CONSISTENT WITH ALL
FORMS OF ABUSE

3. • Unlikely mechanism of injury
– Story does not match injury
• Details of injury change from person to
person
• Multiple injuries in various stages of
healing

4. • Injuries inconsistent with their explanation
• Use of several different health-care
providers or facilities
• Unexcused delay in seeking medical
attention

5. SIGNS OF CHILD ABUSE

7. Physical Abuse
• History is inconsistent with child’s
developmental stages
• Overly protective parent
– Interferes with assessment
• Unusual fear of parent or desire to please
parent

8. • Burns or wire marks
– Scalding, cigarettes
• Fractures or dislocations in a childe less
than 2 years old
• Withdrawn or aggressive behavior
• Malnutrition, insect infestation, disheveled
appearance

10. Sexual Abuse
• Bruised and/or bleeding genitalia or blood-
stained underwear
• Painful urination or itching of genital area
• STD or pregnancy
• Unusual sex bahavior

13. SIGNS OF ELDER ABUSE

14. • Malnourishment and unexplained
dehydration
• Poor hygiene
– Body and clothing soiled with urine and feces
• Clothing inappropriate for season
• Signs of inappropriate use of restraints
– Wrist and ankle bruises

15. SIGNS OF AN ABUSIVE
PARTNER

16. • Often, battered women will minimize their
injuries or the seriousness of the situation
• Repeated visits to the ED with increasing
severity of injuries
• Overprotective partner
– Refuses to leave patient alone with staff

17. EMERGENCY
MANAGEMENT

18. • Assess and ensure safety for yourself and
the victim
– Call security if alleged abuser is present
• Remove victim from abusive environment
and treat as indicated
• Avoid any confrontation with the alleged
abuser

19. • Discourage sexual assault victims from
urinating, bathing, or changing clothes
prior to going to the ED

20. It is a health-care provider’s legal
obligation to file a report with
appropriate authorities or
protective services when abuse is
either witnessed or suspected.