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
- Vulnerable groups
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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