EMRG 251

Sexual Assault and

Sexual Practices
Sexual Assault
Sexual Assault (1 of 2)

• Most common form is rape

• In Canada, around 50% of women have experienced an incident of sexual
or physical violence.
• If possible, a female paramedic should treat a female rape victim.
• Victim may “shut down.”
• The job of a paramedic is to deal with medical issues.
Sexual Assault

• Treat patient with psychological support.

• Attempt to preserve evidence by :
• Do not cut clothing, if possible
• Place each article of clothing in separate paper bags.
• Gently persuade patient not to shower, or wiping genitals
• Nothing by mouth, do not brush teeth
• Do not change clothing (explain why)
• Urge not to void their bladder and bowels, if possible
Sexual Assault

• Assessment
• Limit examination to a brief survey.

• Do not ask for details of assault, if patient opens up

on their own, just listen.

• Protect the patient’s privacy.

Sexual Assault

• Management
• You have a responsibility to preserve evidence.

• Discourage the patient from doing anything that will

possibly corrupt any evidence.

• Police involvement should be expected.

Sexual Assault

• Drugs used to facilitate rape

• Alcohol
• Club drugs
• GHB
• Ketamine
• Ecstasy
• Rohypnol
Rape Drugs (1 of 4)

• GHB: colourless liquid that causes amnesia

• Symptoms include:
• Intoxication
• Respiratory depression
• Seizures
• Coma
Rape Drugs (2 of 4)

• Ketamine: veterinary anesthetic

• Blocks pain without respiratory or circulatory
compromise
• Creates “out of body” experience
• Causes loss of coordination, muscle rigidity, and
slurred speech
Rape Drugs (3 of 4)

• Ecstasy: methamphetamine with hallucinogenic

properties
• Creates mental confusion and feelings of heightened
sexual experiences
• May cause hypertension and diaphoresis
Sexual Assault Documentation

The patient care report is a legal document.

• - keep report concise and factual
• - do not insert your own opinions
• - all documentation can be subpoenaed to court

• Record the following observations:

• The patient’s emotional state
• The condition of her clothing
• Any obvious injuries
• If patient does give account of the assault, document as ….
• Patient states….
• Use quotation marks “ “
Sexual Practices
Sexual Practices and Foreign Bodies

• Foreign objects stuck in the vagina or anus

• Keep the patient calm.
• Protect his or her dignity.
• The objects often become lodged causing bleeding and
trauma.
• Do not attempt to remove any foreign object.
• Do not let the patient walk.
Sexual Practices and Vaginal Foreign Bodies

• Assessment
• Maintain your patient’s privacy.
• Inspection of the genital area may be
necessary.
• Conduct a thorough patient assessment.
Sexual Practices and Vaginal Foreign Bodies

• Management
• Treat as you would with any foreign object.
• Remain nonjudgmental
• Transport.
• Do not attempt to retrieve the object.
• Transport with knees-flexed, legs-together… why?