Screening for domestic violence in the emergency department

The objective of this study was to determine whether two brief screening questions at the time of emergency department triage can increase the detection of domestic violence. Two questions concerning domestic violence were asked by emergency department personnel (registered nurses, licensed practising nurses, physician assistants) to all adult patients presenting to an urban level one trauma centre from 1 January 1993 to 31 December 1993. Patients were excluded if they were in extremis, or active labour. All potential abused patients were referred to a social worker for verification and intervention. A total of 59,405 patients were seen during the study period, and (79%) 46,929 participated. Of these, 132 (0.3%) total cases of domestic violence were identified. Of these 132 cases, 123 (93%) of them were available for follow-up and social worker intervention. Of these 123 cases, 17 (14%) were identified by the initial screening questionnaire. Screening questions concerning domestic violence can identify a small number of otherwise occult cases. Simply asking about domestic violence by emergency department triage personnel is insufficient. Further study is needed to identify the presumed greater number of unrecognized cases.