What additional questions should the practitioner ask about the wound?

Some additional questions that should be assessed when exactly the injury occurred, is there a potential for a foreign body to be in the wound or caused the wound, if they are up to date on their tetanus shot, does it hurt, have they tried anything to clean the wound, have they been using any medication for pain control, does the wound bleed, have they had it covered?

What testing should the practitioner consider for the wound?

The practitioner should do a culture of the wound and assume that the laceration is infected due to her vitals and exudate coming from the wound. In addition to this, the provider may want to examine the wound under a bright light to determine if there is any foreign body in the wound. Additional testing may include a CBC to determine if her WBCs are elevated which may indicate an infection.

What treatment should be provided to the wound?  If you prescribe a medication, provide full prescription details.

The wound should be thoroughly washed out and debrided if necessary. In addition to this, an antibiotic should be prescribed. Doxycycline 100mg PO BID for 7 days would be indicated at this time for infection treatment (Kang, 2021).

What signs suggest that this may be an abuse and human trafficking situation?

Signs suggesting that she may be experiencing abuse of human trafficking include her appearing to be much younger than he stated age, the man appearing to be much older than her, not dressed appropriately for the weather, the man staying close to her during the exam, the man answering the exam questions, tension between the two, the laceration description not matching the injury, bruising, and the man not willing to leave the patients side.

What further assessment should the practitioner perform?

The provider should request to speak to the patient without the man present. She should provider an empathetic and nonjudgmental attitude while caring for the patient. Additional assessments may include asking if she has a safe place to live, if she feels safe at home, if she is being forced to perform sexual favors without her consent. Also, STI testing should be offered as well as an assessment to look for any abnormal injuries or signs of abuse (Leslie, 2018).

Who should the practitioner involve in the care to assist in assessing for human trafficking and in providing support to the woman?

Additional healthcare providers who may be involved in her care can include an OBGYN for STI testing/treatment and case management. In addition to this, referrals to women’s shelters. The National Human Trafficking Resource Center can help provider resources for victims of human trafficking. Referrals to psychiatry and psychology may be beneficial as well.

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