As soon as possible after recovering consciousness the woman should:
(1) contact a rape emergency hot line, hospital or police
(2) not change clothing
(3) not bathe or douche
(4) not urinate (or to collect it in a clean container if have to urinate)
Data collection:
(1) listing of companions and places visited the evening before
(2) listing of drugs and alcohol used intentionally
(3) listing of food and drink consumed
(4) circumstances around last memories
The woman will be examined for evidence of intimate sexual contact (see above) that can be used to confirm the assault and to potentially identify the assailant.
In addition, the person should be screened for sedatives or hypnotics that could have been used to facilitate the assault. Testing should include:
(1) urine screen for routine drugs of abuse
(2) urine drug testing for specific drugs that may not be detected by a routine assay
Additional drugs that require a specific assay:
(1) gamma hydroxybutyric acid (GHB) - detectable for only about 12 hours
(2) flunitrazepam (Rohypnol) - a urine metabolite may be detectable for 72 hours or more
(3) ketamine HCl
(4) scopolamine
Many drug screens are called positive only if the drug levels exceed a certain threshold. In the case of drug-facilitated assault any drug level may be significant.
Differential diagnosis:
(1) blackout secondary to alcohol and drug abuse
(2) false claim to manipulate or get revenge
