09-19-2006, 07:06 AM
29-year-old woman is seen in the emergency department for a broken ankle. She describes a fall down her stairs at home earlier that day. She denies any alcohol or drugs. She has no significant PMH, but she has been admitted to the hospital many times for previous fractures. The patient explains that all these visits are due to her "active lifestyle" and her frequent home repair projects. The patient has been married, she claims happily, for 2 years. She is employed as a manager at a local restaurant; her husband is unemployed and on disability pay for back problems. Domestic abuse is suspected. Do you know how to approach this “common” scenario, i.e. what you say? Pick: Confront the husband OR Refer to social services OR Ask her to talk about the relationship more openly.