Sexual Assault Follow-up

  • Author: William Ernoehazy Jr, MD, FACEP; Chief Editor: Pamela L Dyne, MD   more...
 
Updated: Dec 3, 2009
 

Further Inpatient Care

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

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

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

Specialty Editor Board

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.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

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.

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.

References

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  2. Jones JS, Rossman L, Diegel R, Van Order P, Wynn BN. Sexual assault in postmenopausal women: epidemiology and patterns of genital injury. Am J Emerg Med. Oct 2009;27(8):922-9. [Medline].

  3. [Guideline] Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. Sep 22 2006;55:1-17; quiz CE1-4. [Medline].

  4. [Guideline] Centers for Disease Control and Prevention, Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. Aug 4 2006;55(RR-11):1-94. [Medline].

  5. [Guideline] New York State Department of Health. HIV prophylaxis following non-occupational exposure including sexual assault. Jan 2008;[Full Text].

  6. Braun GR. Sexual assault. In: Emergency Medicine: Concepts and Clinical Practice. 3rd ed. St. Louis: Mosby-Year Book; 1992:2003-12.

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  9. Das S, Huengsberg M. An audit on the management of female victims of sexual assault attending a genitourinary medicine clinic. Int J STD AIDS. Jul 2004;15(7):484-5. [Medline].

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  15. Kenworthy T, Adams CE, Bilby C, et al. Psychological interventions for those who have sexually offended or are at risk of offending. Cochrane Database Syst Rev. 2004;CD004858. [Medline].

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  17. Linden JA, Oldeg P, Mehta SD, et al. HIV postexposure prophylaxis in sexual assault: current practice and patient adherence to treatment recommendations in a large urban teaching hospital. Acad Emerg Med. Jul 2005;12(7):640-6. [Medline].

  18. Littel, K. Sexual Assault Nurse Examiner (SANE) Programs: Improving the Community Response to Sexual Assault Victims. US Department of Justice, Office of Justice Programs, Office for Victims of Crime; April 2001. [Full Text].

  19. Mancino P, Parlavecchio E, Melluso J, et al. Introducing colposcopy and vulvovaginoscopy as routine examinations for victims of sexual assault. Clin Exp Obstet Gynecol. 2003;30(1):40-2. [Medline].

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