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!