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: Feb 29, 2008

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, domestic violence, rape, impulse control disorders, post-assault emotional stress, posttraumatic stress disorder, post-traumatic stress disorder, PTSD, pregnancy, sexually transmitted diseases, STDs, male victims of sexual assault, female victims of sexual assault, Sexual Assault Nurse Examiner, SANE, Trichomonas vaginalis, T vaginalis

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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, 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: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Robert C Harwood, MD, MPH, Program Director, Chair, Department of Emergency Medicine, Christ Hospital and Medical Center; Assistant Professor, Department of Emergency Medicine, University of Illinois at Chicago Medical School
Robert C Harwood, MD, MPH 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, Associate Professor, Program Director, Department of Medicine, Division of Emergency Medicine, University of California at Los Angeles School of Medicine
Pamela L Dyne, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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