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Domestic and Family Violence

Emergency Departments are critical in identifying and responding to domestic and family violence. Approximately 38% of women who present to EDs have experienced physical abuse in their lifetime, and of those, approximately 12-14% have experienced that violence within the past 12 months (UNSW 2014).

Domestic and family violence can take place within the context of intimate partnerships (past or present), including marriage, de facto relationships and same sex partnerships. It can also occur in family relationships including kinship ties in Aboriginal communities and extended family relationships.

Some individuals or group of people are more vulnerable to domestic and family violence including Aboriginal people; women who have a disability; women from culturally and linguistically diverse (CALD) backgrounds; people who identify as LGBTIQ; younger women; older women; pregnant women and women with children; women with mental health and or drug and alcohol issues; and children living in a family where violence occurs.


Possible indicators of domestic and family violence in the ED may include:

  • Acute pain with no visible injuries, chronic pain (especially if evidence of tissue damage cannot be found);
  • Serious bleeding injuries, especially to the face, head and internal organs;
  • Single or multiple bruising to any or all parts of the body, fractures, lacerations, burns (including cigarette), haematoma, perforated ear drums, stabbing, gunshot wounds;
  • Indicators of choking or strangulation;
  • Controlling or intrusive behaviour by partner; and
  • Haematuria


Intervention when domestic and Family Violence is suspected or disclosed:

Health workers in the ED are well placed to identify a risk of domestic and family violence, and to take action to intervene early.

  • In addition to providing urgent medical attention, the safety of the patient and their children is paramount so referral to social work must occur.
  • Where indicators or inconsistent histories are present, it is best to ask direct questions about the cause of an injury or presentation. Talk to the patient privately and alone.
  • Always ask about the safety of any children in the home; where the children are now and who is looking after them. Follow mandatory reporter responsibilities in relation to any children that are at risk.
  • Reassure the patient that responsibility for violence always lies with the perpetrator; that domestic and family violence is a crime; and that they have a right to be safe, as do their children.
  • Document injuries in detail. Take measurements and photographs.
  • Make a referral to the Social Worker who will complete a psychosocial assessment and coordinate appropriate intervention. If the situation presents out-of-hours, the hospital on-call Social Worker should be contacted. If this is not available at your service, the patient may require overnight admission to ensure adequate assessment is made in daylight hours.
  • Always be aware of a patient’s autonomy. This means that the choice to report domestic and family partner violence rests with the patient unless they have significant life threatening injuries or serious safety concerns.
  • Police should be contacted for serious injuries and serious safety concerns.
  • Serious injuries would include gunshot wounds, stab wounds, fractures, head or neck injuries including strangulation.
  • Serious safety concerns includes if perpetrator has access to a gun, carrying or using a weapon and is threatening to cause physical harm to any person including children.
  • Under the NSW Government’s Domestic and Family Violence Framework reforms (2014) it is strongly recommended that safety overrides patient confidentiality.
  • Be supportive and protective during any processes and explain fully what you are doing to the patient.

Support and referral information for patients

  • The Domestic Violence Line: 1800 656 463This service provides support, counselling and coordinates referrals to a number of additional services such as women’s refuges, police, and lawyers 24 hours a day / 7 days a week.
  • The National Sexual Assault, Domestic and Family Violence Counselling Service: 1800 737 732. This service provides help with safety planning, support and referral for people experiencing violence.

Further References and Resources

  • NSW HealthResources, Policies and Procedures for identifying and responding to domestic violence.
  • Symptoms of Strangulation (SOS) Card for non-fatal strangulation (NFS)developed by Western NSW Local Health District PARVAN Team
  • Department Community and Justice DCJ (previously FACS) - NSW Domestic Violence Service - provides support for women (only) experiencing intimate partner violence (including sexual assault). This service provides referral to specialist and local services, housing support, child protection and initial telephone counselling. Phone: 1800 65 64 63.
  • Should you wish to discuss printing options with your organisation’s logo on the back, please contact the Printer directly: Ben Weal, Accounts Manager, Digital Services, Spatial Services, Department of Customer Service, PH: 02 6332 8072.
  • The NSW Elder Abuse Helpline and Resource Unit: 1800 628 221 Provides advice to service providers on identifying and responding to elder abuse.
  • It's time to talkGP Toolkit.
  • Relationships Australia - provides counselling support for couples living in DV relationships (including same sex couples.)

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