Sexual Assault

Question 1

Immediate Management of Sexual Assault

Answer 1

• Offer referral to sexual assault referral centre for collection of forensic evidence
• Recommend creation of police report
• Recommend use of sexual assault support hotline of 1800 RESPECT
• Offer emergency contraception
  
  • Copper IUD within 5 days, Levonorgestrel 1.5mg PO stat within 3 days, Ullipristal 30mg PO stat within 5 days.
• Offer STI prophylaxis
  
  • Chlamydia? Ceftriaxone 500mg IM
  • Gonorrhoea - Azithromycin 1g PO
  • Syphillis? Benzathine Benzylpenicillin IM 2.4milion units
  • HIV? Consider Tenofovir / Emtricitabine PEP
• STI infection screen with repeat investigations at 2 weeks and 3 months. (HIV, Hep B, Syphili Chlamydia, Gonorrhoea, Trichomoniasis))
  
  • Consider testing for other STIs if clinical suspicion when patient symptomatic. ?HSV, Mycoplasma, Candida, Bacterial Vaginosis.
• Undertake mental health assessment and assess suicide risk.