Doctors as detectives: Domestic-abuse victims in the emergency department

March 06, 2017


Being on the frontline of health care, emergency department staff members sometimes have to serve as detectives trying to piece together cases of addiction and domestic abuse to protect their patients.

Dr. William Horgan, associate chief of the Backus Emergency Department, sees many cases of abuse in the Backus and Plainfield Emergency Departments.

During a conference on domestic violence in early 2016, Dr. Horgan said he was shocked to learn that the risks of attempted homicide increase about 700 percent for women who have been strangled by their partner. Not quite as surprising, says Horgan, was that emergency personnel often miss the signs of strangulation because they are very hard to detect.

“I was floored by the gravity of the problem and how often people were missing it — from law enforcement to the judicial system and especially medical personnel,” says Dr. Horgan. “I wasn’t aware what a profound problem it was.”

A 2008 study in the Journal of Emergency Medicine found that 43 percent of women murdered in domestic assaults, and 45 percent of victims of attempted murder, had been strangled by a partner in the previous year. To help address the issue, Horgan has teamed up with Safe Futures (a local advocacy group) and local law enforcement for a series of free community talks to help first responders better identify strangulation in domestic violence victims.

Horgan says more than half of strangulation victims don’t show physical signs, and that law enforcement and emergency personnel need to identify subtle signs like changes invoice, confusion, dizziness, problems with memory and recall that can be attributed to having one’s air supply forcibly constricted. While these cases are still very tough to prosecute, Horgan says by identifying the issue caregivers and law enforcement can offer support that could just save a life.

“Oftentimes when it’s an acute event,” says Dr. Horgan, “the victim just wants everything to be over with. They might not want to talk to police or a social worker on the spot. But when you let them know there are resources and support available, they are more willing to reach out for help, even its two or three days down the line.”

Dr. Horgan will be joined by local law enforcement and social services groups for another free lecture on domestic violence and identifying strangulation on March 23 at 7 p.m. at Old Lyme Middle School. The event is free and open to all. No registration is required.