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22 Cards in this Set
- Front
- Back
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sexual assault
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any sexual act performed by one person on another without that persons consent
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acts considered crimes
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1. intercourse
2. oral or anal sexual conduct 3. sexual contact 4. forcible touching 5. aggravated sexual contact |
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criminal sexual assualt
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stranger rape
spousal rape date (aquaintance) statutory rape |
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women is raped every
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2 min
66% by someone the victim knows: husbands, boyfriends, acquaintance, another relative |
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college student stats
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1 in 5 will be victims
9 in 10 know their offender |
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characteristics of the rapist
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-99% male
-40% in a relationship -history -motivation: control, power, degradation, humiliation; NOT sxual fullfillment -co-morbidities: most have high incidence of substance abuse |
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3 types of rape episodes
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1. power rape
2. anger rape 3. sadistic rape |
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rape trauma syndrome: acute phase
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1. physical concerns: soreness, infection, sleep disturbances
2. pyschological concerns: often in some form of shock, disorientation, express anxiety (DONT ALWAYS SEE THIS PHASE) |
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rape trauma syndrome: post-acute or PTSD
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1. physical concerns: infxs, preg, physical scars or damage, nightmares
2. psyc concerns: flashbacks, depression, anxiety, sexual problems 3. the hidden agenda 4. social concerns: need to get away, to change their address, phone number, friends |
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history taking: general principles
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1. explain the need to ask questions
2. conversational/street lang 3. simple, quiet, gentle, directed 4. non-threatening, non-judgemental 5. allow for brief answers (open ended questions) |
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history: background info
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1. medical illneses past and present
2. recent surgery 3. current meds 4. food/med allergies 5. last tetnus booster 6. current STDs and tx 7. contraception? 8. sexual orientation 9. last consenual sexual experience (within last 7 days?) 10. past pregnancies 11. LMP |
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history: other info to ask
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1. use of drugs or alcohol before attack? how much and when
2. has the pt: taken any meds, drugs, alcohol? Urinated, defecated, douched or given themselves and enema? Bathed, washed their hands, face, brushed their teeth, gargled, changed clothes, douched? smoke, drank, eaten? |
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about the assault: questions
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1. loss of consciousness during the attack?
2. when did it occur and where? 3. how many attackers had sexual contact? how many had physical contact? 4 |
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did the assault include any of the following...
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1. fondling
2. attempted or actual penetration (anal or vag) 3. kissing 4. attempted or actual oral penetration 5. ejaculation, and if so where? |
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did the perpatrator...
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1. use a condom
2. use a lubricant or contraceptive? what kind? 3. use restraints 4. use violence? what kind? 5. use force or threaten violence? 6. use a weapon? 7. use an object to penetrate the victim? |
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physical and evidence examination
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General: within 96 hrs of assault to be legally valid evidence
-dual purpose: medical and forensic evidence -YOU DO NOT HAVE TO PROVE A CRIME HAPPENED OR INFLUENCE DECISION TO OR NOT TO PRESS CHARGES, JUST COLLECT THE PROPER EVIDENCE |
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medical exam
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legible, clearly reflect that a sexual asault was conducted
traumagram: have an outline of the body front and back and use it to label EVERYTHING that you find (scars, bruises, how extensive they are, color, size, location in as much detail as you can etc.) |
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evidence exam general guidelines
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-collection kit only if within 96 hrs
-"chain of evidence" must kno where the evidence is at all times -collection of clothing -external evaluation -oral cavity -external genitalia and pelvic exam -rectum -nails |
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lab testing
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•GC culture
•Chlamydia •Slides/wet mount •ABO blood typing •Blood for VDRL/RPR, and Hepatitis B/C •Pregnancy test •HIV counseling/test •Blood/urine toxicology screens prn •Sterile swabs for rape kit -Patient’s saliva |
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medical concerns and tx
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-analgesics/ tranquilizers depending on their level of anxiety
-referrals -td booster -abx prophylaxis for STIs -Hep B and C -preg prevention -HIC PEP |
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follow up care
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visit with PCP within 7-14 days
follow up labs |
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if pt call yous...
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tell them to seek medical tx, call an emergency room companion, call the police, get support
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