Laceration Injury

The practitioner is working in the urgent care when a young woman comes in with a man who appears to be a much older boyfriend. The woman appears young but states that she is 22 years old. Despite cool weather, the woman is dressed in shorts and a t-shirt with a sweatshirt. The man stays close to her in the examination room and answers most of the questions for her. When she does respond, her answers are short and vague, with the boyfriend elaborating on her responses. There seems to be tension between the two, and the man is harsh with the woman.The woman has a large laceration on her upper thigh, which she says she received a week ago due to falling. The wound appears red and inflamed, and has greenish yellow drainage seeping from the lower aspect. The entire anterior surface of the thigh appears swollen and red, is warm to the touch, and is painful. The wound edges are not approximated, and it appears to be a partial thickness wound about 10 cm in length. The wound appears painful, but the woman is guarded in her answers to questions about pain. The woman has a temperature of 100.5°F, heart rate of 92 bpm, respirations of 24 breaths per minute, and blood pressure 110/60. As the practitioner, you sense something is “off” between the woman and the man, who will not leave her side.Further examination reveals bruising on both thighs and arms, all in various stages of healing. The woman has a few minor lacerations on her forearm, which are healing. While reviewing the wounds, you are reminded of a recent in-service on human trafficking. During the in-service, you reviewed the article “Red Flags: Identifying Sex Trafficking Victims in the ED” found at this website: http://epmonthly.com/article/red-flags-identifying-sex-trafficking-victims-in-the-ed (Links to an external site.)/. Participants were also directed to the National Human Trafficking Hotline found at https://humantraffickinghotline.org (Links to an external site.)/. Remembering these resources, you feel concerned for the woman’s well-being.Case Study Questions1.What additional questions should the practitioner ask about the wound?2.What testing should the practitioner consider for the wound?3.What treatment should be provided to the wound?4.What signs suggest that this may be an abuse and human trafficking situation?5.What further assessment should the practitioner perform?6.Who should the practitioner involve in the care to assist in assessing for human trafficking and in providing support to the woman?

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