If considering discharge from the emergency department, it is imperative to assess the safety of the woman and her dependents. Although the safety assessment may be delegated to a domestic violence expert, such as a hospital-based social worker or a community-based advocate, the physician is responsible for assuring this assessment has been completed prior to discharge from the emergency department. Safety assessments include the following:
• Ask in detail about the nature of the abuse.
• Is there a pattern of escalating violence?
• Were the police called? Was the batterer arrested? If not, does she know where he is now?
• Does the batterer have a weapon, especially firearms, which can easily turn an abuse situation into a lethal situation?
• Is the woman afraid to go home? If so, does she have somewhere safe to go? Can she stay with friends or relatives? Is she afraid that the batterer would find her if she went to the home of someone he knows?
• Would she feel safer in a battered women's shelter? Emphasize that the location of these shelters is kept secret—the batterer would not be able to find her in a shelter.
• If she feels it is safe and she wants to go home, this choice should be respected. It is appropriate, however, to discuss with her the need to have a safety plan in case violence erupts again.
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