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Sexual assault

This page deals with sexual assault as a medical emergency and gives information on how victims, first-aiders and medical personnel can respond.

See rape for definition, consequences, sociological context, and other available resources.


Note: Wikipedia does not provide medical advice. If you have a medical problem, you should seek expert help.

Definition

Sexual assault is a violent crime consisting of unwilling sexual contact with another person. Often the act is accomplished by force sufficient to cause physical injury. At other times, even though no lasting physical injury is sustained, the psychological damage done by this intimate violation is substantial and calls for tact and sensitivity from persons who would help the victim. In Western countries, forcible rape is considered a medical emergency and survivors are encouraged to call for help to report this criminal act and medical emergency.

Causes

The etiology of sexual assault is beyond the scope of this article and is a matter for criminology, not medicine. Contrary to popular belief, victim behavior is not a contributing or causal factor.

First Aid

Call for help or assist the victim in self-transport to the nearest hospital emergency room. Due to the sensitive nature of this criminal offense, first-aiders should be scrupulous about respecting the victim's wishes and providing what emotional support is appropriate to their role. (For example, a friend is in a better place to provide comfort than a security guard.)

Field Care (for EMTs)

Follow local protocols. Provide supportive care for other injuries as appropriate. Fully document any care given and additional information for use by later investigators.

Clinical Treatment

Psychological first aid in the immediate aftermath of the assault is important to successful emotional recovery from a sexual assault. Sensitivity and tact is required. Physical injuries such as gynecologic hemorrhage may have resulted.

Preventative treatment against sexually transmitted diseases may be required.

Voluntary administration of emergency contraception may be considered in societies where such administration is both socially acceptable and legal. Most Western societies fall into this classification, while most African and South American societies, and many Asian societies, do not. Health care providers in societies where emergency contraception is available should be aware that failing to inform patients of the availability may leave them open to allegations of malpractice.

All hospital emergency rooms should have complete procedures in place for assisting victims of sexual assault. Collection of evidence such as DNA samples which can help in criminal prosecution of the assailant should follow rigorous chain of custody procedures.

Victims should be referred to additional resources and made aware of their rights under policy and law.

See also: rape, medical emergency

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