At the Hospital

If you decide to go the hospital, you will go to the emergency department. At the emergency department, you decide what treatment you want. Available treatments include:

• physical assessment, including injuries
• medical treatment of any injuries
• blood work
• preventative treatment for sexually transmitted infections (STIs)
• preventative treatment for pregnancy
• social work referral or support
• information about community supports
• forensic examination to collect evidence
• involvement and handover of evidence to the police with your consent

• The admitting clerk will ask for your name, date of birth, address, and hospitalization number.
• You will then see a triage nurse who will ask a few questions about your reason for coming to the hospital. You need to tell the triage nurse only that you were sexually assaulted. You do not need to provide other details at this time. The triage nurse may ask a few general questions, such as if you regularly take any medications or have any allergies.
• The triage nurse will try to quickly place you in a private room or area, away from other patients waiting to be seen.
• If you think you will want a forensic examination to collect evidence, try not to eat or drink before the examination.
• If you think you will want a forensic examination to collect evidence and you must urinate, let the triage nurse know so a sample can be collected. Air dry rather than wiping because this can remove evidence.
• Any interview with doctors, nurses or police about the sexual assault will be done in a private room.
• The triage nurse will request a doctor and, if available, a Sexual Assault Nurse Examiner.

You may be seen by a Sexual Assault Nurse Examiner (SANE). These nurses are part of the Sexual Assault Response Team (SART). They have additional specific training which enables them to provide excellent care to patients who have been sexually assaulted. If there is no sexual assault examiner at the hospital, it is usually the emergency room doctor who will conduct the exam. Your examiner will answer any questions you have. Feel free to ask anything. No questions are unimportant.

At this time, you need to decide if you want to just be treated medically or if you want a forensic examination. In most places, a forensic examination will not be done unless you are reporting the assault to the police. In some places, a forensic exam will be done and you can wait until after it is complete to make the decision to report and call the police.

Your examiner will ask you questions about your medical history and about the assault. Some of the questions may be a bit uncomfortable for you, but the examiner will allow you to take your time and speak as you are able. These include questions about:

• the date of your last period
• the date of last sexual activity
• your method of birth control
• details of the assault

A person from the hospital laboratory will collect blood samples to help determine your general health. This will also show if you have been exposed to HIV, Hepatitis B or Hepatitis C in the past. The results of these tests may be sent to Public Health. If you have not yet used the washroom, a nurse will ask for a urine sample for the lab.

You will then be examined for any injuries. When you are ready to begin the exam, you will be asked to undress and put on a hospital gown. Your support person or advocate may be present while you undress and for the remainder of the exam, if you choose. If police officers are attending, they will be asked to wait outside the room or behind a curtain for the examination.

After the examination, you will be treated for any injuries. You may be offered an emergency contraceptive (“the morning after pill”) and antibiotics to prevent infection. An emergency physician will evaluate your overall health and risk. They will also discuss with you the use of medications to prevent HIV.

You may be given some written material to explain some of the physical and emotional changes that you may experience in the next weeks and months. A safety plan may be discussed with you. If you have concerns for your safety or that of your family, please speak to your examiner.

You can decide that you want a forensic examination to collect evidence. A forensic examination includes a medical examination as described above but is more complex. A forensic examination involves using a specific kit containing forms and supplies for the standardized collection of items suited for analysis by police investigators.

The entire process will take approximately two to five hours. You have the right to decline any portions of the exam or to change your mind at any point during the exam. If you decide you want to have a forensic exam, you may want to have a friend or family member bring clothes to the hospital for you as some of your clothing may be kept for evidence.

If you consent to a forensic exam, you will receive a complete physical exam including:

• collection of clothing
• inspection for any foreign matter that may be on your body
• the type, location, and size of injuries will be recorded in your patient record
• a complete internal examination of any body openings affected by the assault (vagina, mouth, anus)
• collection of external and internal samples for presence of sperm and DNA, when appropriate

The examiner will let the police know that a forensic exam has been completed.

Once any examinations and treatments that you consent to are complete, you will be discharged. You will receive a follow-up phone call from SART, a social worker or Public Health. You will receive information about community supports that are available.