Huiselijk geweld op de SEH: denk aan de kindcheck
Open

Klinische les
06-05-2014
Eva M.M. Hoytema van Konijnenburg, Johanna H. van der Lee, Sonja N. Brilleslijper-Kater, Frank J.M. van Leerdam en Arianne H. Teeuw

Domestic violence in the accident and emergency department: don’t forget the children

This supplementary information is presented as submitted by the corresponding author. It has not been copy-edited by NTvG.

Introduction

On July 1st, 2013, the Dutch government mandated a new policy stating that amongst others, all health care professionals should implement a ‘reporting code domestic violence and child abuse’. Part of this reporting code is that health care professionals, caring for adults in difficult psychosocial situations, such as intimate partner violence, psychiatric problems or alcohol or drug abuse, should always investigate the safety of any involved children. This is called the ‘child check’. One of the hospital departments where the ‘child check’ is performed is the emergency department.

We describe two examples of such ‘child checks’ at the emergency department.

Case-descriptions

Case 1) A 35 year-old woman was treated at the emergency department because she was a victim of intimate partner violence. During the violent incident, the woman’s 10-year-old daughter was present. According to the Dutch policy of reporting code, the woman and her daughter were referred to the outpatient pediatric department to assess the safety of the family situation.

At the outpatient pediatric department, the mother reported that there had been intimate partner violence in the relationship since three years, with frequent police involvement. The daughter had witnessed intimate partner violence multiple times. The mother said that she wanted help and the family was referred to voluntary social and psychiatric health care.

Case 2) A 46 year-old woman visited the emergency department because of serious injuries. She said that tripping caused the injuries. The emergency physician suspected that the injuries were caused by intimate partner violence, and, according to the reporting code, the woman and her 9-year-old daughter were referred to the outpatient pediatric department for an evaluation of the family situation. However, the mother refused to come, and in the end, the family was reported to the Youth Care Office for more serious measures.

Conclusion

These case descriptions emphasize the importance of the ‘child check’ when adult patients experience psychosocial problems. Recently, the American Academy of Pediatrics stated that reduction of adverse experiences in childhood, such as intimate partner violence, ought to be a high priority for the medical profession as a whole, and for pediatrics in particular. With the implementation of the ‘child check’, an important step in the right direction has been taken.