Emergency Department Treatment And Disposition

Treatment is preceded by forensic evidence gathering, consisting of a Wood lamp examination to identify semen for collection, pubic hair sampling and combing, vaginal and cervical smears (air-dried), a cervical and vaginal wet mount to identify sperm, vaginal aspirate to test for acid phosphatase, and rectal or buccal swabs for sperm. A prepackaged kit with directions may be available to facilitate the collection of evidence.

Cervical cultures for Chlamydia and Neisseria gonorrhoeae should be obtained as well as serum testing for syphilis, hepatitis, and HIV. Empiric antibiotic coverage against sexually transmitted diseases should be provided and an oral contraceptive offered (after confirming a nonpregnant state) to prevent unwanted pregnancy.

Figure 10.12.

SnurcE! Knoop KJr Stack UB, Storrow AB, Thurman RJi The Atlas of Emergency Mediane, 3rd Edition: http;//wwwaccEssme(Jidne,ciom Copyright ©ThE McGraw-Hil Companies, Inc. All rights reserved.

Genital Trauma (Posterior Fourchette). Linear tears to the posterior fourchette—due to sexual assault—enhanced by toluidine staining. (Photo contributors: Hillary J. Larkin, PA-C, and Lauri A. Paolinetti, PA-C.)

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Snuncei Knoop KJr Stack LB. Storvow AB, Thurman RJi The Adas of Emergency Medicine, 3rd Edition: Sittp;//www.a ccesEmedicine.com

Copyright ©The McGraw-Hil Companies, Inc. All rights leEenied.

Genital Trauma (Perianal). Perianal lacerations following sexual assault. (Photo contributors: Hillary J. Larkin, PA-C, and Lauri A. Paolinetti, PA-C.)

SnuniE! Knoop tO, Stack LÖ, Storraiv AB, Thurman RJi The Atlas of Emergency Medicine, 3rd Editionl- nttp!//www,acces£medicine.iom

Copyright ©The McGraw-Hill Companies, Inc. Alf rights reserved.

SnuniE! Knoop tO, Stack LÖ, Storraiv AB, Thurman RJi The Atlas of Emergency Medicine, 3rd Editionl- nttp!//www,acces£medicine.iom

Copyright ©The McGraw-Hill Companies, Inc. Alf rights reserved.

Genital Trauma (Toluidine Staining). Toluidine staining showing subtle perianal lacerations following forceful anal penetration. (Photo contributor: Aurora Mendez, RN.)

Figure 10.15.

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