History

1. Emergency Department staff may be the first and/or only people to which the victim has disclosed the assault. As such, disclosure must be respected and met with sympathy and sensitivity. Clinicians should be aware that the absence of injury does not exclude sexual assault or rape, and that their response is likely to significantly impact the patient.
2. Details of the assault should include:
   • Time
   • Location
   • Characteristics of the assailant(s) and/or identity (if known)
   • Physical violence e.g. blunt trauma and relevant sequelae or ongoing symptoms
   • Sexual acts (vaginal, oral, anal; penile or digital penetration)
   • Contraception used or in situ
3. If the assailant is known, the presence of others in their care should be explored, and their safety assessed. Their age and vulnerability should be identified, and risks to wellbeing flagged to the most senior doctor in the department urgently.

Learning bite

The most senior or appropriately qualified doctor should undertake the medical assessment.

Patients should be offered a choice of clinician gender where possible.