Family Violence

Child abuse, defined here as physical abuse of a minor, and intimate partner violence (IPV), defined here as physical abuse of a spouse or significant other, together referred to as family violence, are responsible for a stunning amount of morbidity and mortality, and yet continue to go largely unrecognized. Outcomes may be poor by the time symptoms are obvious; thus, emphasis needs to be placed on early recognition and improved screening for abusive injuries in the emergency department (ED). This chapter provides an overview of the epidemiology of both child abuse and IPV, the clinical signs and symptoms that should trigger ED consideration of family violence, the data supporting routine abuse screening in the ED, and the methods for reporting and addressing suspected abuse.