eMedicine Specialties > Emergency Medicine > Psychosocial

Sexual Assault: Follow-up

Author: William Ernoehazy Jr, MD, FACEP, Medical Director, Emergency Department, Ed Fraser Memorial Hospital, Florida
Coauthor(s): Heather Murphy-Lavoie, MD, FAAEM, Assistant Professor, Section of Emergency Medicine and Hyperbaric Medicine, Louisiana State University School of Medicine, New Orleans; Clinical Instructor, Department of Surgery, Tulane University School of Medicine
Contributor Information and Disclosures

Updated: Dec 3, 2009

Follow-up

Further Inpatient Care

  • Patients with coexisting injuries or psychiatric symptoms may require inpatient care, with admission to the appropriate service.

Further Outpatient Care

  • As noted above, aftercare is a vital component of recovery for the sexual assault victim. Every effort must be made to provide the victim with adequate referral to community resources.

Transfer

  • Patients may be transferred to freestanding sexual assault clinics for evidence collection (when such centers exist); however, patients should be transferred only after coexistent trauma and disease have been assessed and treated.
  • Severe injuries may mandate transfer to regional trauma centers following surgical consultation.
  • In either case, compliance with Emergency Medical Treatment and Active Labor Act (EMTALA) requirements is mandatory.

Complications

  • Unwanted pregnancy
  • STDs
  • Posttraumatic stress reactions and disorders
  • Morbidity and mortality (arising from physical injuries incurred during the sexual assault)

Prognosis

  • The prognosis for sexual assault victims is generally favorable if adequate aftercare is available to assist the victim in recovery.

Patient Education

  • Community education about sexual violence is generally agreed to be worthwhile, although evidence for its efficacy in incident reduction is meager, at best.
  • For excellent patient education resources, visit eMedicine's Public Health Center. Also, see eMedicine's patient education article Sexual Assault.

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize and treat life-threatening injuries in the haste to obtain evidence
  • Failure to offer adequate prophylaxis against pregnancy and STDs
  • Failure to provide adequate documentation of the findings of a sexual assault examination, either by inappropriate preservation of physical evidence or by inadequate charting
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous editor, Charles V Pollack Jr, MD, to the development and writing of this article.



More on Sexual Assault

Overview: Sexual Assault
Differential Diagnoses & Workup: Sexual Assault
Treatment & Medication: Sexual Assault
Follow-up: Sexual Assault
References
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References

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Further Reading

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Keywords

sexual assault, sexual assault victim, domestic violence, rape, posttraumatic stress disorder, pregnancy, sexually transmitted diseases, STDs, male victims of sexual assault, female victims of sexual assault, Sexual Assault Nurse Examiner, SANE

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Contributor Information and Disclosures

Author

William Ernoehazy Jr, MD, FACEP, Medical Director, Emergency Department, Ed Fraser Memorial Hospital, Florida
William Ernoehazy Jr, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Heather Murphy-Lavoie, MD, FAAEM, Assistant Professor, Section of Emergency Medicine and Hyperbaric Medicine, Louisiana State University School of Medicine, New Orleans; Clinical Instructor, Department of Surgery, Tulane University School of Medicine
Heather Murphy-Lavoie, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Francis Counselman, MD, Program Director, Chair, Professor, Department of Emergency Medicine, Eastern Virginia Medical School
Francis Counselman, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Association of Academic Chairs of Emergency Medicine (AACEM), Norfolk Academy of Medicine, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Robert Harwood, MD, MPH, FACEP, FAAEM, Program Director, Department of Emergency Medicine, Advocate Christ Medical Center; Assistant Professor, Department of Emergency Medicine, University of Illinois at Chicago College of Medicine
Robert Harwood, MD, MPH, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Council of Emergency Medicine Residency Directors, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD, Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center
Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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