MDCalc

Abuse Assessment Screen (AAS)

Detects domestic abuse (intimate partner violence) in pregnant and nonpregnant women in healthcare settings.

  • Use the tool in a private and safe setting to ensure confidentiality.
  • For affirmative answers, encourage respondents to identify who is committing or has committed the abuse.
  • A body map can be used to document areas of injury, which may be scored for each incident according to the following scale:
    • 1 = Threats of abuse, including the use of a weapon.
    • 2 = Slapping or pushing; no injuries and/or lasting pain.
    • 3 = Punching, kicking, bruises, cuts, and/or continuing pain.
    • 4 = Beaten up, severe contusions, burns, and/or broken bones.
    • 5 = Head, internal, and/or permanent injury.
    • 6 = Use of weapon, wound from weapon.

Have you ever been emotionally or physically abused by your partner or someone important to you?

Within the last year, have you been hit, slapped, kicked, or otherwise physically hurt by your partner or someone important to you?

Within the last year, has anyone forced you to have sexual activities?

Are you afraid of your partner or any one of the following: husband/wife, ex-husband/ex-wife, boyfriend/girlfriend, stranger?

If pregnant, have you been hit, slapped, kicked, or otherwise physically hurt by your partner or someone important to you during your pregnancy?

Result:

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Advice
  • If abuse is disclosed:
    • Validate the patient's experience and provide emotional support.
    • Assess the immediate safety of the patient and dependents; consider involving social services or law enforcement if necessary.
    • Document findings thoroughly in the medical record, following legal requirements.
    • Refer to appropriate resources, such as shelters, hotlines, or counseling services.
  • If no abuse is disclosed but suspicion remains:
    • Monitor closely and consider revisiting the topic in subsequent visits.
    • Provide the patient with information about local support resources.
Critical Actions

Be aware of local mandatory reporting requirements, especially when children or vulnerable adults are involved.

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