Sexual Assault - Scenario Posed in my class, What would you do?

[gradygirl]

How will you feel when you find out later, that this guy did nothing wrong? Maybe he was running from the scene, because he found the girl and got scared.

Now, if he is convicted of the crime and you transport him as an inmate, with medical problems, then the IV therapy could work!

HAHAHA! Fair enough. Especially because it seems like incarceritis cases are popping up more and more...

 

[Foxbat]

Sorry. forgot to mention that both your partners are male. I wanted to do that too, but the instructor told me i couldn't change the sex of the classmates that were assigned to me my partners.

I've heard that actually female rape victims often prefer to talk to males about what happened. They find them less judgemental than females. Go figure.

 

[gradygirl]

I've heard that actually female rape victims often prefer to talk to males about what happened. They find them less judgemental than females. Go figure.

As a female who has been assaulted, yes, I preferred talking about it to men over women. I don't think it's because I found them less judgmental, but rather it's almost that they served a protector role, at least on a subconscious level.

 

[Ridryder911]

Okay here is an opinion from a Forensic Sexual Assault Nurse Examiner. First, ask if there are any physical injuries, if unaware be careful but treat accordingly. Do NOT disrobe the patient unless you have evidence bags (must be paper) with proper chain evidence tape/seal on them and secured by investigators.

If there is NO serious physical injuries the victim should NOT be transported by EMS but by an officer, so any statements and discussion can be noted. As well PLEASE STOP THE MYTH OF THE FEMALE IS THE BEST TO OFFER!!! It has been proven over & over, that in real life, many rape victims prefer to discuss the event with a male in lieu of a female. Most feel that they are being "judged" by another woman. So please let's STOP THE MYTH!

Each community should have a rape crisis center. Most of the time it is NOT in the ER, rather a designated area. As well, very little of the examination is performed by a physician but rather a Forensic Sexual Assault Nurse Examiner. We are specially trained and certified in performing rape and sexual assault examinations and given statements, and testimonies in trials.

The examination of a rape victim usually lasts 2-4 hours and is VERY detailed and accurate. As well, questions of what to ask, and NOT to ask and proper documentation of each.

In regards to your Instructor, if what you have described is true then he is a dumbarse! I suggest asking for your money back, your getting cheated by an jaded and unprofessional person. Time to not only revoke teaching credentials, but medical cert as well.

I invite them to debate the issue here if they would like to attempt to disapprove my opinion...

Good luck, it appears you will need it!

R/r 911

 

[MMiz]

Rid,

I've worked with countless partners, and usually the female EMT will work as a tech on a female patient in emotional distress. Not only for the patients own well-being, but for the male medic's as well.

 

[Ridryder911]

Rid,

I've worked with countless partners, and usually the female EMT will work as a tech on a female patient in emotional distress. Not only for the patients own well-being, but for the male medic's as well.

I do understand but it has been found and well documented that many female patients prefer male personnel again because of the judgemental persona that may be given even if unintentional or just on what the patient may perceive.

What is primary important is the patients psyche should be considered no matter whom is giving care.. After experience the provider should recognize the possibilities of awkwardness but again realize they are just as capable of providing emotionally and physical treatment.

R/r 911

 

[WuLabsWuTecH]

Each community should have a rape crisis center. Most of the time it is NOT in the ER, rather a designated area. As well, very little of the examination is performed by a physician but rather a Forensic Sexual Assault Nurse Examiner. We are specially trained and certified in performing rape and sexual assault examinations and given statements, and testimonies in trials.

The examination of a rape victim usually lasts 2-4 hours and is VERY detailed and accurate. As well, questions of what to ask, and NOT to ask and proper documentation of each.

Yep! We learned of where a couple of these are in our city during our class when they were going over specialty centers, it was on the list we had to know--Trauma is either downtown or at the university, psych is riverside, peds is childrens, burns is OSU, Sexual assault are here and here, etc...

In regards to your Instructor, if what you have described is true then he is a dumbarse! I suggest asking for your money back, your getting cheated by an jaded and unprofessional person. Time to not only revoke teaching credentials, but medical cert as well.

We had about 8-9 instructors all of whom were fabulous except this guy. He was getting married the day after our class ended, but during our practical exam, he was always on the phone. I remember him answering his phone while I was doing my BVM/intubation assessment, and it caught me off guard I forgot to mention Sellick, but it was irrelevant at that point as he already finished off my sheet and put it in the done pile with a perfect score and was already halfway across the room as i was talking to myself and my partner through the procedure! Yes, he had seen me do it correctly a hundred times before, but it still struck me that he really doesn't care about his job. Sadly, he received his medic card 4 days prior to this incident and luckily he doesn't work near my city! Don't get me wrong, I still have respect for all the knowledge he has as he is light years ahead of me in that respect, I just have little respect for him as a person.

 

[BossyCow]

There we go!

In evaluation later, he claimed I had made the WRONG decision to treat the assailant. Claiming that he was the guy who caused all of this so it was his own damn fault and that he was breathing so it wasn't my issue. I believe the quote was "It doesn't matter, leave him in pain on the sidewalk, he's scum anyway. Let the PD deal with him."

Triage states treating pts in an order determined by the severity of their injuries. Since the man had not be convicted of a crime and could have been an innocent bystander hurt by the rapist, I'm not going to make that call but will follow protocols regarding triage.

By the same logic, would you treat the broken arm over the multi-system trauma at an MVA if the worst injured was suspected of being under the influence? Would you fail to treat the severe burns of a suspected arsonist and instead treat the minor injuries of the ff called to put it out?

Slippery slope here. I would think that the only defense for your instructor's position is that you were called by LE for assistance with the victim. So, I suppose a case could be made for the other guy not being your patient yet. But again, slippery slope.

 

[newbie]

Your instructor's verbiage underpins an indefensible attitude of judge and jury. That being said if this assailant is hand cuffed because they have been arrested then the LEO placing this assailant under arrest has assumed the right and responsibility to make health care decisions on behalf of the assailant. What that translates to in simple terms is the officer has the right (at least where I work) to tell you the assailant is fine and in no need of medical attention.

 

[reaper]

So the LEO where you work are all medics? If not, then they are not going to be telling me that he is fine, until I check him out!

 

[ffemt8978]

So the LEO where you work are all medics? If not, then they are not going to be telling me that he is fine, until I check him out!

This is actually a separate topic so I'd suggest that you think about starting a new thread on it.

Basically, you stated that you're going to check him out WITHOUT obtaining consent first...in my area, that's a no-no.

 

[WuLabsWuTecH]

This is actually a separate topic so I'd suggest that you think about starting a new thread on it.

Basically, you stated that you're going to check him out WITHOUT obtaining consent first...in my area, that's a no-no.

The LEO in this case, at least for my area, has the ability to consent for (or provide non-consent) the detainee. They have their own set of protocols they have to follow in allowing access to medical care.

 

[BossyCow]

I'd be interested in hearing thoughts on this. Who is the pt? The one that the law enforcement called on, or anyone at the scene? Was the unit called to attend to only the victim or was the call to the scene itself?

Was the alleged rapist visible only peripherally or part of the scene as a whole? Knowing how likely people are to sue, I'd want to cover my liability ten ways from Sunday on this one. Is the perp going to sue because he didn't get care? Is the vic going to sue because we took care of her rapist first. What if the alleged rapist was only a bystander caught in the violence? Who wants to defend that lawsuit?

I think if I asked and was told that he was fine, I would probably mention in my report that I was denied access to properly assess the other potential pt at the scene due to law enforcement, safety concerns etc. It definitely deserves some clarification.

I'm known for calling up agencies after a call and asking them to clarify what is expected in similar situations. Dealing with potential 'what ifs' is easier than dealing with the aftermath of guessing wrong.

 

[WuLabsWuTecH]

My though is that scene size up is the ENTIRE scene. That is why the "Determine the number of pts" line is in there. An Assault automatically registeres in my mind as at least one person injured, but most likely at least two unless the guy getting assaulted was knowcked unconscious and unable to fight back, and even then there is possibly minor injuries to assailant.

I think its easier when I ignore who may be at fault. I try to take care of the sickest patient first. If I am unable to do so due to other barriers outside of my control, he runs away from me, an LEO stops me from doing so, I document that and move on. The person who was assaulted can try and sue me if he really wants to, but I followed procedures and if I did triage correctly, the victim was not in as bad of shape and was able to wait a few mor eminutes for treatment. in my case though, she received treatment at the exact same time.

 

[traumateam1]

Well here is what I would do. I would first attempt to talk to the patient and establish some contact. At least tell her my name, partners names and who we (local EMS). After that I would tell her that we would like to take her into the back of the ambulance for privacy and to make sure she is ok. Ask the patient if she wants to be taken over on the stretcher and if no reply get it anyways and take her into the back of the ambulance. Once in there let her know that we are here to help her. I wouldn't allow myself or partners to do to much talking.. let her do the most talking, and if she doesn't want to talk I wouldn't offer up any stories or anything. In terms of vitals and what not I would beging by doing my primary. ABC. Ask her if she hurts anywhere and if she is in serious distress give her some O2 via nasal prongs at 4 lmp unless p/t doesn't want that. The last one I did, she threw up so keep a bio bag near by. I tried to get as much clothes for forensics but knew that the hospital would get that when she got changed into a gown so I left mostly everything on, as the sperm/DNA etc was already there and not going anywhere. Keep the p/t as calm as possible, transport to the hospital and en route fix up and cuts or scrapes. Of coures constantly telling your p/t what you are doing. I covered my last p/t with a blanket just so she didn't feel so exposed and she later told me she really appreciated that.
There's not a whole lot you can do (from my levels perspective) just clean up any minor wounds. Obviously take care of any major emergencies. Transport to the hospital, and if you advised the ER before arriving you will have a private room.. so hand off patient to the hospital and your done.
I got a recommendation for the last Sexual Assault/Rape call I attended as Primary Attendant.. and that's basically what I did.
As far as my partner not wanting to listen to the lungs. ADVISE the patient of what you are doing.. tell them and ask them if it's ok. If yes then go ahead. If no than don't. And if no answer try it and if your hand gets smacked away then don't try again. I find that many EMS providers get so caught up in the emotions of these calls and while thats no completely bad.. we need to realize and remember we need to do our job, and that includes vitals, listening to the lungs and other things like a Rapid Body Survey.

 

[SCFD8REZ]

The very first thing i would do is offer the female a blanket beause she is probably feeling very vulnerable and blankets always seem to compfort people, its also 1AM and probably chilly outside, i would then compassionately start the sample process explaining to her that we are here to help her. i would obviously ask her if anything hurts and if so where specificly, i would then act accordingly to her response " if her head hurt from being punched or something give her an icepack." i would then ask her if she had noticed any blood, if there is i would then do a trauma assesment based upon symptoms, if her spo2 is ok, her core is stable and she has no symptoms, all you can really do is talk with her and try to provide the best compfort you can in this situation, if S.O. is already on scene then the crime scene is probably already well protected, if you must remove clothing make sure it is placed in an evidence bag, always use BSI in this situation to protect her as well as your self and the evidence against the perpitrator, also, make your own report based on what she tells you and write it down, you may be called in to court better to be safe then sorry if you rely only upon what the sherrif tells you. and she is obviously going to need to be transported to be checked out for internal injurys, have bloodwork done, possibly stitches et... at the hospital.

 

[Somedude]

Like I saw in one post before, ive done a small handful of cases like this. They are never fun for anyone and usally everyone takes a quiet trip back to the station. The best and only advise I can give is be professional. This is may be very difficult but retain every bit of professionalism you have. Second speak softly but confidently. Remind the pt. she did not deserve what happened. This will help establishing short relationship with the pt. for the trip to the hospital. Do not lie to the pt. and say it is all ok. Finally, as for the test, if you went to check out the other pt. then good for you being viligent. If not, the ambulance didnt get called for him so he didnt need medical help. If he is a rapist...he has plenty worse coming to him.

 

[WuLabsWuTecH]

Yeah, this is not a case i would ever want to run on, but I was just appalled at how some people can say a human life is not important, everyone screws up, some really f**k up, but they are still human right?

 

[ride2k]

So you transport the girl because she is your patient and the reason you were called, obviously. But you leave without the assailant and later find that he did in fact have some form of injury, who knows, maybe he bumped his head and had a minor concussion... now what? Sure he is in police hands but wouldn't you consider that neglegence to not even do some sort of assessment?

I agree with you in saying that you do in fact, have two potential patients. Unfortunatly, EMS is an opening for a ton of potential lawsuits. I say, err on the side of caution and check him out.

 

[emt19723]

i would probably acknowledge the turd in custody, laugh at him and say "you got tore the f*** up by a girl" then let the PD take him to the hospital to get checked out. UNLESS.....for some reason his ABCs were compromised. then my conscience would probably kick in. then id go in to the hospital after he got out of the ICU and then laugh at him!! lol