Domestic abuse and violence - emergency department guidance
Definition and legal framework
Domestic abuse is a pattern of behaviour used by a person to control, coerce or dominate someone with whom they are or have been in a personal relationship.
The Domestic Abuse Act 2021 defines abuse to include physical, sexual, psychological, emotional and economic (financial) harm, and recognises that children can be victims in their own right. Coercive and controlling behaviour is a common pattern and may be criminal.
Who this guidance applies to and professional duties
Emergency department (ED) clinicians are frequently the first or only healthcare contact for people experiencing domestic abuse. National guidance expects health services to identify and respond via multi‑agency working, trained staff, clear referral pathways and quality standards (NICE PH50, NICE QS116).
Local Trust/Board policies and safeguarding procedures must be followed for referrals, forensic sampling and data sharing.
Recognition - when to suspect abuse Consider domestic abuse when presentations include any of the following:
- Acute injury with an inconsistent history, repeated presentations, or injuries of differing ages, including facial trauma, fractures, patterned bruises, or signs of strangulation.
- Less visible presentations such as chronic pain, headaches, unexplained gastrointestinal symptoms, mental health crises (depression, self‑harm, PTSD), repeated STIs, unintended pregnancy, or missed antenatal care.
- Red flags for high risk: non‑fatal strangulation, threatened or actual use...
Ready to master this topic for the FRCEM?