• this is a method used in surgery to prevent contamination of the wound and operative site. All instruments used are sterilzed
• the technique is adapted at the bedside and in emergency and treatment rooms
• this technique is the same as sterile technique

• maintaining the sterile field
• place only sterile items within the sterile field
• open, dispense and transfer items without contaminating them
• dont allow unsterile personnel to reach arcoss sterile field
• if a sterile barrier is wet, cut or torn, consider it contaminated
• dont place sterile items near open windows or doors

this can cause;

• injury
• chronic health problems- neurologic, gastrointestinal (internal bleeding), gynocologic, chronic pain
• more visits, more costs

these effects are;

• depression
• suicide
• symptoms of posttraumatic stress disorder
• substance abuse

can cause these effects;

• chronic pelvic pain
• unintended pregnancy
• sexually transmitted infections, including HIV
• urinary tract infections

• How to screen
• assessment
• history
• physical examination
• documentation

Abuse Assessment Screen

(AAS)

• When you argue, are you ever afraid of your partner?
• does your partner try to emotionally hurt you?
• has your partner ever physically hurt you?
• did your partner ever physically hurt you when you were pregnant?
• has your partner ever forced you into sex?

Has anyone:

• ever touched you inappropriately?
• made you do things you didnt want to do?
• taken things that were yours without asking?
• physically hurt you?
• scolded or threatened you?
• have you signed documents you didnt understand?
• are you afraid of anyone at home?
•  are you alone alot?

this calls for;

• all women over the age of 14 years old
• primary care: every visit
• emergency/urgent care: all women, all visits
• OB/GYN: each prenatal/family planning visit all visits in STD and abortion clinics
• mental heath: every assessment
• Inpatient: all admissions/discharge

complete head to toe exam checking for:

• bruise/contusion
• laceration/avulsion
• ecchymosis/purpura
• petechia/purpura
• rug burn/friction abrasion
• incision cut
• cut/sharp injury
• stab wounds

• detailed nonbiased notes
• use of injury maps
• photographic documentation

Abuse...

1. is always sexual
2. is always physical
3. by definition is committed by men
4. can inculde neglect

Which of the following would constitute a clear, unbiased note?

1. "shows signs of brutal treatment by spouse including contusion and lacerations."
2. "displays bruises in several different stages of resolution, including several in a defensive pattern on both forearms."
3. "presents with suspicious injuries."
4. "can't be convinced to take proper action to end a destructive relationship."

A. all women over the age of 18

it acutally starts at 14

Which of the following is not the correct screening guideline of domestic violence?

1. All women over the age of 18
2. primary care: every visit
3. emergency/ urgent care: all women, all visits
4. Ob/GYN: each prenatal/family planning visit, all visits in STD and abortion clinics