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					SAN FRANCISCO TRAUMA
    RECOVERY/RAPE
  TREATMENT CENTER


A Very Brief Overview of Managing
      SEXUAL ASSAULTS
      Jessica Dodge, MMSc., PA-C
       Kara Duffy, MMSc., PA-C
          Case Presentation
A 38 yof presents to outpatient clinic with
 upper respiratory symptoms. She also
 mentions that she was sexually assaulted 5
 days prior. She reports no injuries, pain, or
 bleeding related to the assault.

What are your responsibilities and what
 should you do for this patient?
  What should you do for this patient?

• Treat the patient for her medical complaint
• Make a mandated report
  – Same as child/elder abuse, always make a
    mandated report for any reasonable suspicion
    of a sexual assault
• Refer, Refer, Refer
       Trauma Recovery/Rape
         Treatment Center
Trauma Recovery/Rape Treatment Center
  (TRC/RTC) medical providers are Nurse
  Practitioners (NPs) and Physician Assistants (PAs)
  who are specially trained to provide complete
  medical and forensic services to clients who have
  been sexually assaulted.
Services include:
  – Medical Care:
      •   Comprehensive medical examination
      •   STD, HIV, and pregnancy prophylaxis & testing
      •   Follow up medical appointment
      •   Link to primary care provider
  – Forensic Evidence Collection:
      • Evidence collection & documentation (DNA, toxicology,
        photographs)
      • With or without police involvement
  – Mental Health & Case Management Services
      • Short-term trauma focused therapy
      • Information about The California Victim Compensation Program
        (CalVCP)
      • Assistance navigating the legal system
      • Assistance accessing other community services
All RTC Services are FREE!


  REFER, REFER, REFER
       When Should I Consult?
• Any suspicion of a sexual assault
• Patient is interested in speaking with the police
  and or collecting evidence
• Patient is interested in STD / pregnancy
  prophylaxis and or an exam to check for injury
• Patient is interested in trauma focused mental
  health therapy – as with all sexual assault based
  care, there is no charge in San Francisco
• You are interested in hearing about our standard
  medical care over the phone, to be certain you
  offering the patient appropriate services
       How do I make a consult?
• RTC providers are available 24/7
• To speak to a provider directly, contact SFGH
  Emergency Department and ask for the RTC
  provider pager
• Patients may also call the RTC / TRC during
  regular business hours, and patients may self refer
  (mental health services)
   – 2727 Mariposa, Suite 100 (x Bryant & Florida)
   – 415/437-3000 (front desk)
   – 415/437-3050 (fax)
                                            References
National Protocol for Sexual Assault Medical Forensic Examinations – Adults/Adolescents, September 2004 -
http://www.ncjrs.gov/pdffiles1/ovw/206554.pdf


Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV in the
United States - http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm


Post Exposure Prophylaxis – May 2010, good summary of data on post exposure prophylaxis from AVERT, an international
AIDS charity - http://www.avert.org/pep-prep-hiv.htm


HIV prophylaxis following Non-Occupational Exposure Including Sexual Assault – information on transmission of HIV as
wells as Hepatitis B/C
http://www.hivguidelines.org/wp-content/uploads/a-non-occupational-pep-posted-05-18-2010.pdf
Questions? Comments?

      Thank you!

				
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posted:11/29/2011
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