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Human Trafficking: A Guide to Identification and Approach for the Emergency Physician - 24/09/16

Doi : 10.1016/j.annemergmed.2016.03.049 
Jamie Shandro, MD, MPH a, b, , Makini Chisolm-Straker, MD, MPH c, d, Herbert C. Duber, MD, MPH a, b, Shannon Lynn Findlay, MD e, f, Jessica Munoz, MSN, FNP-BC g, Gillian Schmitz, MD f, h, Melanie Stanzer, DO i, Hanni Stoklosa, MD, MPH d, j, Dan E. Wiener, MD b, k, Neil Wingkun, MD b, l
a Division of Emergency Medicine, University of Washington School of Medicine, Seattle, WA 
b ACEP Public Health and Injury Prevention Committee 
c Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 
d HEAL Trafficking 
e Department of Emergency Medicine Residency, University of Iowa School of Medicine, Iowa City, IA 
f ACEP Academic Affairs Committee 
g Pali Momi Medical Center, Emergency Services, Aiea, HI 
h Department of Emergency Medicine, University of Texas Health Science Center at San Antonio, TX 
i Emergency Medicine Residency, John Peter Smith Health Network, Fort Worth, TX, and the EMSC 
j Departments of Emergency Medicine and Medicine, Harvard Medical School, Boston, MA 
k Bronx Lebanon Hospital Center, Bronx, NY 
l Department of Emergency Medicine, University of Texas–Houston, Houston, TX 

Corresponding Author.

Abstract

Human trafficking is a significant human rights problem that is often associated with psychological and physical violence. There is no demographic that is spared from human trafficking. Traffickers maintain control of victims through physical, sexual, and emotional violence and manipulation. Because victims of trafficking seek medical attention for the medical and psychological consequences of assault and neglected health conditions, emergency clinicians are in a unique position to recognize victims and intervene. Evaluation of possible trafficking victims is challenging because patients who have been exploited rarely self-identify. This article outlines the clinical approach to the identification and treatment of a potential victim of human trafficking in the emergency department. Emergency practitioners should maintain a high index of suspicion when evaluating patients who appear to be at risk for abuse and violence, and assess for specific indicators of trafficking. Potential victims should be evaluated with a multidisciplinary and patient-centered technique. Furthermore, emergency practitioners should be aware of national and local resources to guide the approach to helping identified victims. Having established protocols for victim identification, care, and referrals can greatly facilitate health care providers’ assisting this population.

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 Supervising editor: Debra E. Houry, MD, MPH
 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist.
 A podcast for this article is available at www.annemergmed.com.
 Continuing Medical Education exam for this article is available at ACEPeCME/.


© 2016  American College of Emergency Physicians. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 68 - N° 4

P. 501 - ottobre 2016 Ritorno al numero
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