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Sexual Assault Protocol

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Patient wants a forensic exam

Call SAVI for advice:

Send Patient to the ED:

  • Immediate triage

  • Private SAFE Room

  • Specially-trained forensic examiners who are on-call for the exam (or sometimes trained ED staff)

  • Offer a medical exam, treatment and documentation of injuries, medication for STIs, emergency contraception and HIV PEP

  • Can also consent to a forensic exam (a rape kit)

  • Connected to the Adolescent Health Center or the Jack Martin Clinic for HIV follow-up

  • Not billed for the ED visit and the follow-up appointments/meds

  • Involving the police is up the patient. all of the above can be done regardless if police are called

  • SAVI will hold all evidence for a minimum of 90 days at the hospital security department to give patients time to think about their options

  • Lauren Moran is the contact person for following up with these patients to explore police involvement

  • SW as well as a SAVI volunteer Advocate will assist the pt in the ER. They will provide emotional support as well as discuss follow-up counseling and address any other needs/concerns the patient may have.

Patient is undecided

Discuss pregnancy prophylaxis. Your two options are:

  • Plan B (Levonorgestrel 150mg x 1) -available under the counter and is more readily available at pharmacies.

  • Ella (Uliprastal 30mg). Ella has better efficacy for overweight or obese women and can be used up to 120 hours after intercourse.

Test and consider treatment for STIs

  • CTX 250mg x 1 for gonorrhea.

  • Azithromycin 1gm x 1 for chlamydia.

Discuss post-exposure prophylaxis (PEP)

  • Ideally, started within 72h of assault.

  • UCSF runs a phone consultative service 9am - 2am 7 days/week for PEP - 888-448-4911.

  • If a patient is started on PEP (typically initially given a one-week supply), arrange follow up in Jack Martin and they will be seen weekly until PEP completed (28 days).

  • Current regimen is: Tenofovir 300 mg PO qd + Emtricitabine 200 mg PO qd + Raltegravir 400 mg PO bid

Anticipate Delay in ED evaluation

Discuss pregnancy prophylaxis. Your two options are:

  • Plan B (Levonorgestrel 150mg x 1) -available under the counter and is more readily available at pharmacies.

  • Ella (Uliprastal 30mg). Ella has better efficacy for overweight or obese women and can be used up to 120 hours after intercourse.

Test and consider treatment for STIs

  • CTX 250mg x 1 for gonorrhea.

  • Azithromycin 1gm x 1 for chlamydia.

Discuss post-exposure prophylaxis (PEP)

  • Ideally, started within 72h of assault.

  • UCSF runs a phone consultative service 9am - 2am 7 days/week for PEP - 888-448-4911.

  • If a patient is started on PEP (typically initially given a one-week supply), arrange follow up in Jack Martin and they will be seen weekly until PEP completed (28 days).

  • Current regimen is: Tenofovir 300 mg PO qd + Emtricitabine 200 mg PO qd + Raltegravir 400 mg PO bid