Operational Medicine Medical Education and Training

Sexual Assault

Introduction

Sexual assault is any sexual act performed by one person on another person without that person's consent.

The incidence of sexual assault is not known. Published statistics only encompass reported sexual assault. In some cases:

  • The victim is unwilling to notify authorities or seek medical attention for fear of personal humiliation.

  • The victim is unwilling to notify authorities because she fears retribution.

  • The victim, particularly in cases of incest or close personal relationships, does not wish to disturb the family or friendship unit, dysfunctional though it may be.

  • The victim is not aware that the crime occurred. (eg, when illegal drugs or alcohol are involved)

Bacterial Cultures

Sexual Assault

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Prepackaged Sexual Assault Kit

Sexual assault is usually not a crime of sexual gratification, but rather expresses power, anger, hostility or aggression.

Although the stereotypical perpetrator of sexual assault is a stranger, in real life, the rapist is often known to the victim. This situation is known as "acquaintance rape" or, when applicable, "date rape."

Sexual assault  is an act of violence with medical, mental and legal issues which should to be addressed. Described below is a standard medical approach to sexual assault when resources are available and clinical circumstances allow.

Outline of Management

  • Evaluate the patient for serious injuries (fractures, hemorrhage, etc.) which might require immediate treatment.

  • Obtain a brief history, explaining to the patient what will occur next. Obtain patient's consent.

  • Gather all necessary materials and notify legal and administrative authorities.

  • Examine the patient, obtaining various specimens.

  • Offer treatment for STDs, pregnancy.

  • Arrange for follow-up care.

Serious injuries come first
If the patient has serious injuries, take care of the injuries before worrying about collecting legal evidence. Patient care takes priority.

Notify Legal and Administrative Authorities
Early in this process, legal and administrative authorities need to be notified that a sexual assault has been reported and medical care is being provided. Depending on your location, this might include local, county, state or federal law enforcement agencies.

Notify Social Services
In some settings, a sexual assault counseling service is functioning and can be contacted. In other settings, social workers or other support personnel are used for this purpose. Sometimes, a chaplain serves the role of a social service provider and should be notified of this occurrence.

Chaperone
Customs vary regarding the use of a chaperone in general OB-GYN practice, but they don't vary at all in the context of a sexual assault victim. It is important to have a medical chaperone (preferably someone from the nursing community) who can be a witness, both to the history-taking and the physical exam. This person can also provide valuable comforting and support to the victim.

Continue to the PowerPoint Lecture...

From:

Operational Obstetrics & Gynecology
2nd Edition
NAVMEDPUB 6300-2C

Bureau of Medicine and Surgery
Department of the Navy

 

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