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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:
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The victim is unwilling to notify authorities or seek
medical attention for fear of personal humiliation.
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The victim is unwilling to notify authorities because
she fears retribution.
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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.
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The victim is not aware that the crime occurred. (eg,
when illegal drugs or alcohol are involved)
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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
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Evaluate the patient for serious injuries (fractures,
hemorrhage, etc.) which might require immediate treatment.
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Obtain a brief history, explaining to the patient what
will occur next. Obtain patient's consent.
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Gather all necessary materials and notify legal and
administrative authorities.
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Examine the patient, obtaining various specimens.
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Offer treatment for STDs, pregnancy.
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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 |
