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ACEP Policy Statements
Management of the Patient
with the Complaint of Sexual Assault
Revised and approved by the ACEP Board of Directors October 2002
This statement replaces one with the same title originally approved by the
ACEP Board of Directors January 1992 and reaffirmed June 1999. As an adjunct to
this policy, ACEP's Emergency Medicine Practice Committee has prepared a
handbook titled "Evaluation and Management of the Sexually Assaulted or Sexually
Abused Patient" to assist in developing a community or ED plan. It is available
from ACEP's Customer Service Department or on ACEP's Web site.
The sexually assaulted patient, who may be an adult or child of either sex,
presents special medical, psychological, and legal needs. ACEP believes that all
patients who report a sexual assault are entitled to prompt access to emergency
medical care and competent collection of evidence that will assist in the
investigation and prosecution of the incident. ACEP has therefore developed the
following guidelines:
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With the cooperative efforts of local governments, law enforcement
agencies, hospitals, courts, and other relevant organizations, each county,
state or other geographic area should establish a community plan to deal with
the sexually assaulted patient. The plan should ensure that capable, trained
personnel and appropriate equipment are available for treating sexual assault
patients.
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Each community plan should address the medical, psychological, safety, and
legal needs of the sexually assaulted patient. The plan should provide for
counseling, and should specifically address pregnancy and testing for and
treatment of sexually transmissible diseases, including HIV.
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Each hospital should provide for access to appropriate medical, technical,
and psychological support for the patient. A community may elect to establish,
under the supervision of a physician, an alternative medical site, which
specializes in the care of the sexually assaulted patient and provides medical
and psychological support capabilities when no other injuries are evident.
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A victim of sexual assault should be offered prophylaxis for pregnancy and
for sexually transmitted diseases, subject to informed consent and consistent
with current treatment guidelines. Physicians and allied health practitioners
who find this practice morally objectionable or who practice at hospitals that
prohibit prophylaxis or contraception should offer to refer victims of sexual
assault to another provider who can provide these services in a timely
fashion.
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Specially trained, nonphysician medical personnel should be allowed to
perform evidentiary examinations in jurisdictions in which evidence collected
in such a manner is admissible in criminal cases.
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Physicians and trained medical staff who collect evidence, perform in good
faith, and follow protocols should be immune from civil or criminal penalties
related to evidence collection, documentation of findings, and recording of
the patient's subjective complaints.
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For the special diagnostic and therapeutic needs of the pediatric patient,
a community plan should provide for primary referral centers with expertise
and ancillary social services that support a multidisciplinary approach.
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As part of its ongoing quality management activities, the hospital should
establish patient care criteria for the management of the sexually assaulted
patient and monitor staff performance.
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ED staff should have ongoing training and education in the management of
the sexually assaulted patient.
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ACEP supports appropriate measures to prevent sexual assault in the
community. ? |
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