Emergency Sexual Assault and Treatment

The following Point-of-Care Emergency Clinical Summaries produced by Emergency Care BC provide key facts and recommendations for the emergency department diagnosis and treatment of patients that have been sexually assaulted. Healthcare professionals should continue to use their own judgment and take into consideration context, resources, and other relevant factors.

For more information on sexual assault assessment, click here

For more information on sexual assault treatment, click here.

It’s critical for survivors to get medical care if there’s a potential risk that they’ve been strangled.

Strangulation is the external application of physical force that inhibits air or blood flow to/from the brain.  The trauma and brain oxygen deprivation caused by strangulation can impact the survivor’s ability to remember what happened (Fineman and Green, 2020).

It is estimated that more than half of survivors of strangulation will not have any physical signs of injury such as bruising. 

A survivor without visible external injury can die from strangulation days or weeks after the assault due to carotid artery dissection and respiratory complications such as pneumonia, acute respiratory distress syndrome, and the risk of blood clots travelling to the brain (Training Institute on Strangulation Prevention, n.d.).

Survivors should access emergency medical treatment if they have any of the following symptoms that could be related to strangulation:

  • Difficulty breathing.
  • Trouble swallowing.
  • Neck swelling.
  • Sore throat.
  • Hoarseness or voice changes.
  • Blurred vision.
  • Continuous or severe headaches.
  • Seizures.
  • Vomiting.
  • Persistent cough (Training Institute on Strangulation Prevention, n.d.).

 

The strangulation assessment card is a quick reference tool to help professionals conduct the initial assessment of a survivor that may have been recently strangled. 

This resource outlines the signs and symptoms of strangulation.

Recommendations for the Medical/Radiographic Evaluation of Acute Adult Non/Near Fatal Strangulation

The purpose of these recommendations is to help medical providers rule-out potential life-threatening injuries for survivors that have experienced strangulation.

Concussion

Survivors should get medical care if there’s a possibility that they have a concussion from being assaulted. 

A concussion is a traumatic brain injury caused by a direct blow to the head, face, neck, or elsewhere in the body with an impulsive force transmitted to the head.

Most concussions do not cause a loss of consciousness. Concussion signs and symptoms can be delayed for several hours or a few days after an incident (BCIRPU, 2023).

Survivors should receive emergency medical treatment and be transported to the nearest hospital if any of the following indicators are present:

  • Glasgow Coma score less than 15.
  • Deteriorating mental status.
  • Potential spinal injury.
  • Progressive, worsening symptoms, or new neurologic signs.
  • Persistent vomiting.
  • Evidence of skull fracture.
  • Post traumatic seizures.
  • Coagulopathy.
  • History of neurosurgery (e.g., Shunt).
  • Multiple injuries (Concussion Awareness Training Tool, n.d.).

 

Click here for information on how to assess a potential concussion.

This link for health professionals provides an overview of the process for providing emergency contraception and copper Intrauterine Devices to BC residents enrolled in the Medical Services Plan (MSP):

The EC-IUD Rapid Access Network can help you locate a clinician that can insert a copper IUD for emergency contraception.

Click here for a general overview of the different types of emergency contraception.

The BC CDC has practice guidelines, Decision Support Tools for STIs, and STI Clinic Practice supporting documentation for sexual health practitioners including:

 

Click here or here for more information.

The BC CDC has practice guidelines for testing and post-exposure prophylaxis:

Click here for more information.