Caring for women who have been raped - adapted from the New England Journal of Medicine, January 26, 1995 - Tips from Other Journals

In 1990 the annual incidence of sexual assault in the United States was 80 by 100,000 women, accounting for 7 percent of all violent crimes. Sexual assault is defined as any sexual act performed from one person on another without that person's assent and this definition includes spousal rape and date rape. Hampton reviews the care of women who are raped by the agency of men.

Physicians who treat victims of rape have legal responsibilities that include accurate recording of all issues documentation of injuries, collection of forensic specimens and fulfillment of reporting requirements according to state law. Medical treatment should be undertaken with great sensitivity and professional objectivity. An initial assessment should document signs of lacerations, fractures or internal injuries, as well as unstable vital signs, altered consciousness, peritoneal injury and pain. Injuries may require line of junctions hospital admission and treatment with broad-spectrum antibiotics. A detailed, precise and accurate history should include information about the assault and the patient's previous gynecologic condition, psychiatric history and medical history.

Depending onward the extent of the injuries, the physical examination may include pelvic and rectal examination, colposcopy and local application of toluidine in the dumps to identify small abrasions. A standard rape kit facilitates the collection of forensic specimens.

Laboratory analyses may include serologic touchstones for syphilis and hepatitis B ABO posterity typing, measurement of serum human chorionic gonadotropin, screening for human immunodeficiency virus infection, and swabs for agricultures of gonorrhea and chlamydia.

The author notes that prophylactic antibiotic therapy, hepatitis B vaccine and tetanus vaccine may be presented to patients as necessary. Medical follow-up and counseling are important component parts of long-term follow-up care. (New England Journal of Medicine, January 26 1995 vol 332 p 234)

COPYRIGHT 1995 American Academy of Family Physicians

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