Patient selection: females 15 years of age or older
Types of injuries:
(1) general body injury
(2) genital and/or anal injury
General points:
(1) Approximately two thirds of assaults are by friends or acquaintances.
(2) Approximately a third of women did not have physical injury after sexual assault.
(3) General body injury is twice as common as genital-anal injury.
(4) Genital and anal trauma may not be readily apparent on external examination. Colposcopy and/or anoscopy should be performed if penetration occurred.
Risk factors for general body injury:
(1) perpetrator a stranger (vs friend, acquaintance, spouse or intimate partner)
(2) victim hit or kicked (more violent)
(3) strangulation attempted
(4) weapon used
(5) substance abuse by the victim
(6) oral and/or anal penetration occurred
Risk factors for genital and/or anal injury:
(1) age of the patient 15 to 19 or > 49 years
(2) virgin (no prior intercourse)
(3) anal penetration
(4) bodily trauma present
(5) medical examination within 24 hours (although this may reflect severity of injury, i.e. a person with more serious injury is more likely to present for medical care)
