6 Excessive delays between injury and seeking treatment, repeated use of EMS services, injuries during pregnancy, substance abuse, and frequent suicide gestures are also hallmarks of domestic violence. Any of these conditions should lead EMS personnel to suspect abuse and respond accordingly. However, special attention should be directed toward the emotional needs of the victim. Domestic violence stems from the abuse of power and control. It is characterized by a pattern of coercive behaviors that includes physical and sexual battering, verbal and psychological, abuse, economic control, and progressive social isolation, deprivation and intimidation.
Domestic Violence tends to follow a cycle of three phases.
Phase one is comprised of arguing and verbal abuse, phase two progresses to physical and sexual abuse, and phase three consists of denial and apologies. Intervention is best accomplished in phase two or three. Without intervention the cycle repeats itself, usually increasing in frequency and severity. EMS personnel must understand this cycle of violence in order to adequately assess the situation and care for the victim. They must understand that victims of abuse feel ashamed, humiliated and responsible for the violence.