Define Interpersonal Violence - Answers Pattern of assaultive of coercive behaviours, by a
partner.
Include: Injury, psychological abuse, forced social isolation, intimidation, threats, stalking
Describe the role of universal screening in the ED and how it relates to violence - Answers
Looking for a condition before it is overtly symptomatic
Interpersonal violence is common and high consequence
Describe the 3 necessary components of effective violence screening - Answers Interview in
private place, without visitors
Use respectful, non judgmental communication
An appropriate response if screen is positive and access to resources
Name 4 high risk groups that should receive a secondary interpersonal violence screen by an
MD - Answers Those admitted with mental health concerns, altered LOC and/or intox.
Those with high risk injuries (face, neck, head)
Those with repeat visits
Undocumented or dependent immigration status
State 5 actions required if a violence screen is positive - Answers Allow patient to explain via
open ended questions
Validate and legitimize the patient (To address shame, blame and isolation). Affirm disclosure
was appropriate
Encourage and empower patient to seek help for abuse
Address immediate safety concerns
Document conversation and injuries
State the 5 components of the screening tool for severe or high risk violence - Answers Has
violence increased in freq or severity in past 6 mo
Has your partner every used (or threatened) a weapon
Do you believe your partner is capable of killing you
, Has your partner ever beaten you while you're pregnant
Is your partner violently and constantly jealous
What 4 steps must occur once a patient discloses substance misuse, ETOH overuse - Answers
Provide support and resources
Ask about hx of withdrawal and prevent it
Prepare for worst case scenario
Maintain professionalism - curb negative thoughts
Define ectopic pregnancy - Answers Fertilized ovum implants in a location outside of
endometrial cavity
State 6 risk factors for ectopic pregnancy. - Answers Hx of pelvic inflammatory disease
Previous tubal surgery
Previous ectopic pregnancies
Pregnancy with fertility treatment
Pregnancy with IUD insitu
Maternal age >35
What is the classic triad of presenting symptoms of a non-ruptured ectopic pregnancy -
Answers Missed menstrual period
Abdominal pain
Vaginal bleeding
What symptoms suggest a ruptured ectopic pregnancy - Answers Signs of internal hemorrhage
- Hypotension, tachycardia
- Lateral rebound abdominal or pelvic tenderness and guarding
Describe the purpose/benefits of bedside Focused Abdominal Sonogram for Trauma (FAST) -
Answers Identifies the presence of free peritoneal or pericardial fluid
Rapid, Non invasive
What is the treatment for an ectopic pregnancy - Answers If ruptured - Surgical laparotomy
If not ruptured - Methotrexate (Inhibits DNA synthesis and cell replication)