52- sexual assault

Question 1

indirect presentations of sexual assault

Answer 1

• morning after pill requests
• STI checks
• alterled level of awareness with suspicison
• multiple injuries from obvious physical assault

Question 2

general approach to mgmt

Answer 2

1. medical care
2. reassure they are safe and put in a quiet place
3. believe the victim - not job to prove anything
4. don’t ask why questions
5. help them regain control
6. refer to sex assault Tx center
7. get nurse from there

Question 3

reporting?

Answer 3

PTs choice

- if under 16 - Children’s Aid

Question 4

parts of a SAE kit

Answer 4

1. Hx
   - medical and assault
2. collection of evidence
   - clothes
   - blood
   - urine
   - genital/anal
3. document injuries

Question 5

testing for prophylaxis

Answer 5

• HCG
• oral culture
• cervical culture
• rectal culture
• syphyllis and hep testing

Question 6

preg. prohpy

Answer 6

• plan B - levonogestrel

Question 7

STI prophylaxis

Answer 7

1. cefixime+doxycycline
   or
2. azythromycin

Question 8

hep B prophylax

Answer 8

hep B Ig + engerix

Question 9

HIV testing

Answer 9

ask about it - serial testing

PEP for up to 72 hours

Question 10

follow up

Answer 10

• sex assault cneter
• GP
• follow up at one week for blood
• repeat STI test 2-3 weeks following