Patient Care Goals
Recognize when patients are being mistreated either through coercion, direct harm, or omission of care. Remove the patient from harm while preserving the evidence as much as possible. Document history and exam thoroughly.
Clinical Management Options
| EMT-B |
| • Demonstrate professionalism and courtesy • Perform an initial assessment and physical exam- document findings thoroughly • Wound treatment as appropriate |
| Paramedic |
| • 12 lead ECG acquisition and interpretation as appropriate |
Consult Online Medical Control as Needed
Pearls
- EMS are mandatory reporters in any case where there is concern for child and elder abuse. Always report your concerns to the hospital and/or law enforcement.
- Elder abuse is considered anyone who is 60 years old or older who is dependent on someone for their care
- Transport pediatric patients with concern for non-accidental trauma to level 1 pediatric trauma center.
- Consider abuse/maltreatment in BRUE cases
- You may find patterned bruising, bruising of multiple ages, age-inappropriate behavior, evidence of medical neglect, frequent calls for UTI/genitourinary complaints, evidence of malnourishment
- Human trafficking is common in Saint Louis. Signs may include but not limited to: tattoos, padlocks on interior doors, additional security.
- Human Trafficking Children’s Division for MO is 800-392-3738;
- National Human Trafficking Hotline is 1-888-373-7888
CHEMS Field Treatment Guidelines 