CAEP position statement executive summary: Where is the love? intimate partner violence (IPV) in the emergency department (ED))

IPV transcends socioeconomic classes, ethnicities, gender and sexual orientation, and physical borders: the World Health Organization (WHO) estimates the prevalence to be 1 in 3 women worldwide, with no significant difference between continents (WHO). Women exposed to IPV are twice more likely to suffer from depression and alcohol use disorders and 38% of all murders of women worldwide are IPV-related.

The COVID-19 pandemic has worsened the prevalence of IPV with shelter-at-home orders, increased calls to police and community support, and decreased recognized presentations in the ED.

A 2008 study found that 44% of women murdered by their intimate partner had visited an ED in the last year; 93% of these victims visited specifically for IPV-related injury. ED physicians identified 5% of IPV cases; only 13% asked about domestic violence, despite almost 40% of females presenting with violent injuries. The stereotypical “battered woman” is often the only image that comes to mind when thinking of IPV, when it can encompass things like stalking, threats to take away their children, workplace sabotage, or blackmail. In addition, multiple visits for the same presentation, chronic pain syndromes, mental health concerns and substance use are highly associated with IPV.