Sexual assault

Unwanted sexual advances, Sexual harassment, Rape (attempted and completed), Other: Incest, human sex trafficking, female genital mutilation

Attempted: Threats of rape or intention to rape that is unsuccessful, Completed: Any penetration, no matter how slight, of the vagina or anus with any object or body part, or oral penetration by a sex organ of another person, without the consent of the victim

Spousal (or marital) rape, Statutory rape (minors do not have the capacity for consent), Date rape and acquaintance rape, Drug-facilitated sexual assault, Incest, Human trafficking

Know legal definitions in your state, Know state’s reporting requirements, All states require reporting if the victim is defined as a child by state law, Most states require reporting if the victim is a dependent adult, State/tribal governments must reimburse for sexual assault exams

Rape victims: 19.3% of women’s and 1.7% of men, For females the first rape experience happened: Before ages 25 in nearly 79% Before age 18 in 40%, Both males and females are more likely to raped by a male, The lifetime prevalence and 12-month prevalence of intimate partner rape is estimated at nearly 9% and around 1% respectively, Stalking: about 15% of women Nearly 6% of men 12-month: 4% of women; 2% of men

Sexual assault nurse examiners (SANEs) RNs with specialised training in caring for sexual assault pts Demobsstrated competency in conduction medical and legal evaluations Ability to be an expert witness in court, Sexual assault response team (SART)

Depression, Suicide, Anxiety, Fear, Difficulties with daily functioning, Low self-esteem, Sexual-dysfunction, Somatic complaints

Depression, anxiety disorders, Chemical dependency, suicide attempts, Self-mutilation, Complusive sexual behavior, Psychosis-like symptoms, Borderline personality disorder

Negative selfi=-image, Depression, Eating disorders, PErsonality disorders, Self-destructive behaviors, Substance use

Level of anxiety, Coping mechanisms, Available support systems, Signs and symptoms of emotion trauma, Signs and symptoms of physical trauma

Self-assessment (there is no reason/excuse for rape!)

Head to toe physical assessment for signs of injury, Detailed genital exam, Evidence collection and preservation, Documentation of physical findings, Treatment, discharge planning, and FOLLOW_UP care very important!

Rape tax centers: SANE (sexual assault nurse examiner) and advocates, Victims may feel re-victimized during evidence collection, Victim should not shower, brush teeth, douche, change clothes, eat or drink prior to exam*, Rape kits and rape protocols, Give as much control back to victim, Prophylactic tx and testing, Support groups/ counseling

24-hr telephone hotline, Emergency department, Nonjudgmental care: emotional support confidentiality listen and let survivor talk

Promotion of self-care activities provide detailed written information concerning referral and follow-up options, Case management After initial eval: Provide follow-up assessment within 24-48 hrs provide follow-up visits at 2,4, and 6 wks

Provide safe and private environment, Provide access to community-based advocate, Trauma informed approach, Consistent, objective, immediate medical care, Care in consultations with a SANE-trained forensic nurse, Medically appropriate STD prophylaxis and emergency contraception

Sleep well with few nightmares or wake-ups, Eat as they did pre-rape, Retain normal levels of calm and relaxation, Get support from family and friends, Demonstrate positive self-regard, Experiecne little or no somatic reactions, Return to pre-rape sexual functioning and interest