Sexual violence resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rinky Agnes Botleroo, M.B.B.S.

Synonyms and keywords:

Overview

Sexual violence is a public health issue as well as violation of human rights. It has many forms,for example rape, sexual assault, sexual coercion, sexual harassment, sexual exploitation sexual battery. It occurs without the consent of the victim or when the victim refuses or is unable to give a consent due to age, intoxication, illnesss or any other reasons.It is a common problem that may be seen in primary care.It is important for physicians to identify if a person has suffered any type of sexual violence and take care of their safety.

Causes

Common Causes

• Aggressive nature, including hostility against women
• Rape-supportive attitudes
• Alcohol use
• Nonsexual delinquency
• Lack of parental monitoring
• Poor emotional bond between caregiver and child is also associated with sexually aggressive behavior
• Peer pressure to engage in sexual activity
• Pornography use
• Substance abuse

Diagnosis

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Patient with history of sexual violence

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Take complete history

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ask the following questions about the complaint

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ask the following questions about Circumstances of attack, including :

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❑When did it happen,tell me the date, time, and location.

❑ Is the location familiar to you?

❑ Can you provide any information about assailants (number, name if known, description)

❑Did they use any weapon

❑Did you get any threats recently?

❑ Type of sexual contact (vaginal, oral, rectal)

❑ Did they use condom?

❑Was there any extragenital injuries sustained?

❑Occurrence of bleeding (patient or assailant)

❑Did they ejaculate, if yes, where did they ejaculate?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ask the following questions about activities of the patient after the attack:

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❑Did you douch or take a bathe

❑Did you use a tampon or sanitary napkin

❑Did you urinate or defecate

❑Is there a history of use of toothpaste, mouthwash, enemas, or drugs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ask the following questions about Gynaecological history:

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❑Last menstrual period

❑Date of previous coitus and time, if recent

❑Contraceptive history for example oral contraceptives, intrauterine device

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Record the vitals:

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❑ Blood pressure

❑ Temperature

❑ Respiratory rate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do physical examination

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Record the vitals:

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❑ General (extragenital) trauma or injury to any area

❑ Genital trauma to the perineum, hymen, vulva, vagina, cervix, or anus

❑Foreign material for example stains, hair, dirt, twigs on the body

❑Examination with Wood’s lamp or colposcopy when available

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❑ Condition of clothing,check if it is damaged, stained or if there is any foreign material attached to any part of body

 

 

 

Treatment

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Do's

• Make sure the victim is not left alone.
• Provide emotional support and reassure the victim that they are not at fault for what happened.
• If the victim has been raped, a doctor will use a rape kit to collect hair, semen, clothing fibers, and other evidence of the attacker's identity
• Even if the victim is not sure they want to report about the violence, it is important to collect and preserve evidence so it can be accessed at a later date, if required.

• If the victim wishes to report about the violence, the staffs of the hospital will call the police from the emergency room.
• Victims should be treated for sexually transmitted diseases (STDs)
• Victims should be told about emergency birth control. It is important to receive birth control and treatment for STDs within 72 hours of the assault for maximum effectiveness. Although victims can get emergency contraception up to 5 days after but it will be less effective.

Don'ts

• To preserve evidence, the victim should not take a bathe, go to the bathroom, comb their hair, or change clothes until they have received a medical examination.
• Do not clean up anything at the site of the assault.

References

Template:WikiDoc Sources