Rape

Numerous studies have shown that people (especially women) who respond to the situation quickly and actively resist the attacker are more likely to avoid being raped than those who exhibit either passive behavior or no resistance.

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SYMPTOMS

Rape is a very traumatic event. The victim may or may not be able to verbalize that she was actually raped or may come to medical attention for a different complaint. Emotional reactions differ greatly and may include: confusion, social withdrawal, tearfulness, nervousness or seemingly inappropriate laughter, numbness, hostility, and fear.

The victim may have a variety of other physical concerns needing to be addressed. Physical abuse is often present as well. Emergency room staff are specially trained to deal with all of these situations.

SIGNS AND TESTS

A history will be obtained in a supportive and non-judgmental way. This will include the details of the attack: the date and time of the rape, where it occurred and what the victim has done since the attack (for example, showered and changed clothes as opposed to coming directly to the hospital).

If possible, this should be done with both medical and investigating police present, to eliminate the need for the victim to repeatedly recall the incident.

Additional medical history that should be obtained includes: any possibility of pregnancy prior to the attack; the date of the last menstrual period; a pertinent gynecological history, including any prior sexual abuse or assault; and the presence of chronic illness or recent illness or injury, as well as current medications.

A complete physical examination should be done to document any objective signs of trauma. Pictures may be taken to note bruises, scrapes, or cuts. X-rays will be taken if fractures are suspected.

Numerous samples and specimens may be collected for evidence including clothing, pubic hair samples (particularly if foreign materials are noted within it), fingernail scrapings, and vaginal (and mouth or anal, if indicated) samples to examine for evidence of sperm and test for sexually transmitted diseases.

TREATMENT

In many cities, rape cases are referred to specific emergency rooms. This has allowed those sites to provide more specialized care for the unique needs of the rape victim and assure proper procedures are followed to maintain the "chain of evidence" necessary for a case that may go to trial.

Such sexual assault treatment centers may also employ, or have available on-call, a team specialized in assessing and dealing with the psychosocial, physical, and legal issues a rape victim faces. Most state laws require that the victim be evaluated in the emergency room prior to the rape being officially reported.