Human Trafficking of Children and Adolescents: Recognition and Response in the Emergency Department (Human Trafficking CME and Ethics CME) -
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Publication Date: July 2022 (Volume 19, Number 7)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. CME expires 07/01/2025.

Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 4 Human Trafficking CME credits and 4 Ethics CME credits, subject to your state and institutional approval.

Authors

Lela Bachrach, MD, MS

Health Sciences Clinical Professor, Department of Pediatrics, UCSF Benioff Children’s Hospital Oakland, Oakland, CA

Larissa Truschel, MD, MPH

Assistant Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, Duke University School of Medicine, Durham, NC

Makini Chisolm-Straker, MD, MPH

Associate Professor, Department of Emergency Medicine; Core Faculty, Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, Mount Sinai Queens, New York, NY

Peer Reviewers

Shannon Findlay, MD, MPH, CTropMed

Clinical Assistant Professor, Department of Emergency Medicine, University of Iowa Hospital and Clinics, Iowa City, IA

Carmelle Wallace, MD, MPH, DTMH

Assistant Professor, Division of Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL

Abstract

Labor and sex trafficking impact children of all ages, genders, and nationalities. Trafficked patients present to the emergency department for illnesses and injuries both related and unrelated to their trafficking experiences. Emergency clinicians are not meant to be experts in labor and sex trafficking, but they must know enough to be able to identify patients at risk for trafficking and ensure that these patients have the opportunity to be connected to relevant services and support. This issue reviews the ways in which youth are trafficked, the indicators of trafficking, and the evidence-based and best-practice recommendations for addressing suspected or confirmed trafficking in the pediatric and adolescent patient populations.

Case Presentations

CASE 1

A 15-year-old boy presents to the ED with an injury to his right eye...

He is accompanied by a coworker who speaks for him because the patient speaks only Mam, a Mayan language.
The coworker reports that the patient was cutting tile with a handheld saw when a piece of tile flew into his right eye. The patient looks uncomfortable and anxious.
Your initial examination of the eye is suggestive of an open globe injury, so you call for an ophthalmology consult and place an eye shield over the affected eye.
As you offer the patient pain medication, it occurs to you that it is late morning on a weekday. You wonder why this young man is not in school...

CASE 2

A 13-year-old girl arrives in the ED complaining of dysuria and abdominal pain...

She says she has been experiencing these symptoms for the past week.
You see in her chart that she has a history of depression and post-traumatic stress disorder, with multiple inpatient psychiatric hospitalizations.
The chart also indicates that this patient tested positive for chlamydia and genital herpes in the past year, and a prior chart note says she has been in foster care and had run away from a group home.
You assess her pain score for pain relief, set up for a pelvic exam, and order lab work. As you address her medical needs, you consider whether and how you should address the multiple indicators that this patient may be experiencing trafficking…

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.