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Forensic Nursing: SANE Exams and Sexual Assault, Exams of Pediatrics

The role of a forensic nurse specialist (sane) in providing care for victims of sexual assault. It covers the three main purposes of sane exams, the differences between pre- and post-sane care in er settings, and the definition and components of a sane exam. The document also provides information on communication during the exam, documenting injuries, and obtaining consent.

Typology: Exams

2023/2024

Available from 03/25/2024

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SANE
three main purposes of forensic nursing: - correct answer 1. provide specialized
care for pt's who have been involved in a crime
2. observation, documentation, and gathering/preservation of evidence
3. providing fact or expert legal testimony
rape culture - correct answer a culture that in some ways supports, condones, or
ignores sexually violent messages and behavior
pre-SANE what could one expect at an ER - correct answer long wait times
untrained medical personnel
poor understanding of dynamics of sexual assault
high rates of re-victimization
post-SANE what can one expect at the ER - correct answer greater focus on pt.
centered care
pt's treated as "real emergencies"
lower rates of re-victimization
higher rates of prosecution
SANE completed PERK's are found to be more complete
sex act - correct answer * penetration (however slight) of anus or vulva by penis
* contact btwn mouth and penis, mouth and vulva, mouth and anus
* penetration (however slight) of anus or vulva by hand, finger, or any object with
intent to abuse, humiliate, harass, degrade, or arouse, or gratify the sexual desire
of any person
sexual contact - correct answer touching with any clothed or unclothed body
part/object either directly or through the clothing of the clothing of the genitalia,
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SANE

three main purposes of forensic nursing: - correct answer 1. provide specialized care for pt's who have been involved in a crime

  1. observation, documentation, and gathering/preservation of evidence
  2. providing fact or expert legal testimony rape culture - correct answer a culture that in some ways supports, condones, or ignores sexually violent messages and behavior pre-SANE what could one expect at an ER - correct answer long wait times untrained medical personnel poor understanding of dynamics of sexual assault high rates of re-victimization post-SANE what can one expect at the ER - correct answer greater focus on pt. centered care pt's treated as "real emergencies" lower rates of re-victimization higher rates of prosecution SANE completed PERK's are found to be more complete sex act - correct answer * penetration (however slight) of anus or vulva by penis
  • contact btwn mouth and penis, mouth and vulva, mouth and anus
  • penetration (however slight) of anus or vulva by hand, finger, or any object with intent to abuse, humiliate, harass, degrade, or arouse, or gratify the sexual desire of any person sexual contact - correct answer touching with any clothed or unclothed body part/object either directly or through the clothing of the clothing of the genitalia,

anus, groin, breast, etc. with the intent to abuse, humiliate, harass, degrade, arouse, or gratify sexual desire of any person sexual assault - correct answer any sexual act by one or more person(s) on another without mutual consent or ability to give consent purpose of SANE exam (2 main) - correct answer 1. medical

  1. forensic stages of SANE exam - correct answer medical evaluation injury documentation psychosocial assessment evidence collection components of SANE exam - correct answer demographic info consent assault specific hx (strangled? weapons? etc) detailed head to toe exam body map diagrams forensic photography evidence collection alternate light source use with SANE exam, only take down this information... - correct answer account specific details and mechanism of injury (from first touch to last) how long can you do a PERK post assault? - correct answer 96-120 hours can you do a PERK in pediatric population? - correct answer consent varies state to state

toluidine blue dye - correct answer nuclear stain used to help detect and document genital and perianal injuries used from 3:00 to 9: *last thing you do before placing speculum always use sterile water on swab sticks- why? - correct answer saline degrades DNA when completing a PERK, what are some things you would collect from the person (outside of swabs)? - correct answer outer clothing (use large sheet - forensic fold - put in paper bags) underwear (even if it's not the same underwear worn) tampons anything under nails using a pick comb pubic hairs to find fibers/hairs foreign to person always use 2 swabs - why? - correct answer one for prosecution, one for crime lab areas to obtain swabs: - correct answer labia majora and minora vaginal and cervical swabs perianal area rectal swabs medications to offer patient - correct answer * emergency contraception

  • STI prophylaxis
  • HIV prophylaxis
  • HEP B prophylaxis
  • tetanus prophylaxis
  • analgesic
  • antiemetic (anti-nausea - esp for people who have been drinking or are now taking HIV prophylaxis) top three communicable diseases - correct answer gonorrhea chlaymydia trichonomas vaginalis then: bacterial vaginosis, HPV, syphillis further follow up options: - correct answer OB/GYN infectious disease clinic counseling/therapy case management emergency housing most sexual assaults occur to which population? - correct answer men and women under 30 this percentage of people have no visible signs of strangulation - correct answer 70-80% need to administer HIV meds within what time frame from assault? - correct answer 72 hours - 28 day supply most common area injured in sexual assault - correct answer posterior fourchette areas often injured: need to exam: - correct answer clitoral hood labia minora/majora urethra posterior fourchette perineum