Harbor:Sexual assault
Background
- See Sexual assault for general evaluation and management details. Details below are Harbor-specific.
- Harbor non-occupational HIV PEP protocol https://www.wikem.org/wiki/Harbor:Non-Occupational_Exposure
- Harbor SART Protocol https://www.wikem.org/wiki/File:SART_ED_Protocol_Recommendations.pdf
- Closest SART Center is in San Pedro
- Pediatric sexual assault protocol http://pemsource.org/wp-content/uploads/2017/09/Suspected-Child-Abuse-and-Neglect.pdf
Coming Soon
- Sexual assault order set in Orchid for all the medications, labs, consults, communication orders
- Working on policy with pharmacy for giving NPO patients their prophylactic medications to-go to take at SART center after forensic exam
Management
Forensics Logistics
- If a patient wants a forensic exam or evidence to be collected, please treat the patient medically first, and if otherwise medically clear, keep in mind the following recommendations.
- In addition to the instructions found on the Sexual assault page, the San Pedro SART has the following policies to preserve forensic evidence
- Place patient's clothes and belongings into a paper back (NOT the usual plastic patient belongings bags)
- If patient has had oral trauma within past 6 hours, place patient on strict NPO (no medications, no ice chips or swabs, no rinsing mouth)
- Have nursing call hospital police. The hospital police will coordinate to find the correct police department that needs to be contacted to file a report. The hospital PD will not take a report.
- Specimens that PD will take to SART center with the patient
- Dirty catch urine. Label specimen cup with patient's name, time of collection, and who collected
ED Consults
- Consult to Social Work
- Also speak to social work about arranging a ride home for the patient. Police will bring patient to the SART center, but some patients have no way to get home from the SART center.
- Consult to Violence Intervention Team
- If patient meets criteria for HIV post-exposure prophylaxis, give first dose in ED. (No longer need to call HIV consult)
Pediatric-Specific Modifications
- Consult SCAN team
- Pubertal patients will go to SART center after medical evaluation complete, but SCAN team can follow up with patient
- Speak to social work about calling DCFS
Disposition
- PD from jurisdiction where assault occurred will take patient to SART center
- See "Consult to Social Work" above to arrange a ride home for the patient
- If patient receives HIV PEP, provide a 2 week supply of medications and patient needs follow up appointment in 2 weeks