Sexual violence Flashcards
What should clinical enquiry cover?
- What/When/where/who
2.any injuries
- Type of sexual contact to offer best testing oral? Vaginal? Anal? Any sex since assault
- Pregnancy risk? LMP/conteaception EC needed?
5.info re suspect to establish hiv/hep b risk and need for PEP or vacinne
- Mood/support/mental health/DV/etoh/drugs
TRAUMA INFORMED/ENSURE SAFE
Health promotion opportunity re smears/hpv/hep a
What make clear at beginning?
What is persons priority?
Explain confidentiality early
Options re SARC referral including no police involvement
How can information be shared with police? (in absence of safeguarding requirement)
- Intelligence
Health professional informs of details but doesn’t give PII pt. With pt consent-may assist police. Could at later date result in identification depending on police response - third party reporting
With consent and with expectation of investigation, act as conduit - Police engagement directly
- No sharing
If concern re child/vulnerable person or in public interest/required by law only…..confidentiality may be broken without consent *make clear early
What if v complex situation re confidentiality?
MDT
MDO
You shouldn’t examine pt if wants SARC. But what about EC IuD?
Respect pt priorities
Who needs PEP?
<72 hours
Risk >1:1000
If taking daily Prep not needed if no missed doses
Who needs hep a post exposure vaccination?
Within 2 weeks if contact confirmed case/1 week onset jaundice in index case
Opportunistic if high risk group
Who needs hep b vacinnation?
Hmmm…ac to national recommendations
If offering give ideally <24hrs but up to 7 days
If v high risk give alongside HBIG
Fast schedules preferred
eg 0, 7, 21 days 12 months.
Or 0,1,2,12 mths
