Recognition and Management of Human Trafficking

  • The ED is the front line for human trafficking: most trafficked persons access healthcare while being trafficked and they most commonly present to the ED
  • Definition: a crime involving the recruitment, transportation, harbouring and/ or exercising control, direction or influence over the movements of a person in order to exploit that person, typically through sexual exploitation or forced labour
    • Means of control can be force, fraud and/or coercion (psychological, financial, threats to person or family)
  • Trafficked persons present with a variety of chief complaints: suicidal ideation, substance use, and illnesses of poor living conditions are common
  • You have the skills to suspect that a person may be trafficked
    • Vulnerable groups
      • Under-regulated, underpaid industries
      • Migrant workers
      • Substance use/addiction (particularly opioids)
      • Individuals experiencing homelessness
      • Individuals supported through child welfare system
      • LGBTQ youth
    • Clues in the assessment
      • History inconsistent with physical exam
      • Patient is more fearful than expected
      • Delayed presentation of common conditions
    • Use the PEARR tool to foster safety and permit disclosure in your conversation
      • Privacy: ensure patient privacy unless unsafe to do so
      • Educate: educate patient about abuse and violence, available resources
      • Ask: ask patient about their experiences
      • Respect: respect patient wishes to disclose/not disclose
      • Respond: as appropriate, provide resources
    • Law enforcement: work with your patient to determine whether to involve law enforcement and which service to involve; Acting without their consent may harm them more than it helps

The Podcast: EM Quick Hits 20 Imaging Renal Colic, Human Trafficking, Atrial Fibrillation During COVID, Transvenous Pacemaker Placement, COVID Lung POCUS, COVID Derm, Virtual Simulation

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