6.9 Sexual Assault Group Discussion

Question 1

Rape vs Sexual assault
-Dfferentiate

Answer 1

• Rape: Any person (A) who unlawfully and intentionally commits an act of SEXUAL PENETRATITION with complainant (B) without the consent is guilty of the offense of rape.
• Under the influence of drugs/substances that leave them incapacitated
• Sexual Assult

Question 2

Physiology: sexual response (no complete control over)
- Cause the lack of injury
-

Question 3

Cases where the health practitioner is legally mandated to report

Answer 3

• persons with disabilities
  childre(</= 18 years of age)
• Female students on university campuses (18-25)

Question 4

National Health Act

Answer 4

Patient needs to be seen within 2 hours

Question 5

Sexual penetration vs Sexual violation

Answer 5

• Sexual penetration: include any act that causes penetration TO ANY EXTENT WHATSOEVER into or beyond

Sexual violation: No sexual penetration

Question 6

Consent

Question 7

Into and beyond
-reference to the int. and ext. female genitalia

Question 8

Urgency of assessment

Answer 8

• Less/more than 72 hrs
• Medical urgency
  Medical and surgical
  prophylaxisis: morning after pill, etc
• Emotional urgency
  Secondary trauma: the health practitioner examines the arae that the event occured at

Question 9

In practice

Answer 9

Tunner scale(sexual maturity) : esp. for minors

Question 10

Preservation of examination(when examination dealyed)

Answer 10

• Pad (cotton wool)
• Urination
  try to avoid
  wipe before urination’
  keep tissue paper in paper container
• Oral penetration
  Collect evidence ASAP
  Patients thirsy and hungry
  -Defeacation
  -

Question 11

The body as a crime scene

Answer 11

• organic/inorganic
  -foreign hair
  -lskin under nails
  -body fluid:
  semen
  blood
  saliva
  -identify features
  Bites:

Question 12

Clinical findings(extragenital)

Answer 12

• Evidence of violence
  nature of the violence
  Cannot exclude

Question 13

Medical interpretation

Answer 13

Medical diagnosis
sharp foece/blunt/thermal injury/gunshot woud

Question 14

Medico-legal application of medical information

Answer 14

-Sharp injuries over vital organs (supported by the report)
- The clinical picture is consistent with

Question 15

Ano-gentital assessment
Netters Atlas: Most vulnerable locations
*hymen (don’t look at how it’s intact but the presence of injuries)

Answer 15

-clockface rotation
picture with 2 clocks
Prone position: ususlly with children
anus is always at 6 o clock
also assess the anal structures

Question 16

Female genital examination

Answer 16

• signs of penetration
• number of anatomical sites injured
• *Swap technique
  -Pre-pubertal: contraindication
  -Puberty age : up and down, while turning down, don’t use a speculum as it can make the injury more severe
  *Foley’s catheter balloon technique
• Toluidine blue :NB!!!
  -Chemical used (also used to test cancer)
  attaches to injured dermis

Question 17

Male anatomy (survivours and perpetrators)

Question 18

Anal examination

Answer 18

-in every patient
- Before the gentital exam due to:
contamination

Question 19

Different evidence collection kits

Answer 19

NB: Underwear
perianal/rectal

Question 20

Documentation

Answer 20

-clinical notes
J88 form