Expert Health Articles

Sexual Assault Nurse Examiner (SANE) Program

Mindy Lause, RN

Blanchard Valley Health System

Emergency Department

The #Metoo movement has empowered men and women to come forth and share their story regarding sexual assault. However, recent statistics reveal that only five to six percent of sexual assault cases are reported. My advice: Come to the emergency room. If you or someone you know has experienced sexual assault a medical and forensic exam can be provided free of charge.

Presenting with the chief complaint of sexual assault is taken serious by medical providers and sexual assault nurse examiners (SANEs) who “start by believing.” Victims will be expedited to a private room and greeted by a medical provider who will perform a medical examination to rule out an acute injury. Once care is complete and the victim consents to a forensic exam a SANE will respond within 60 minutes. A rape crisis counselor or advocate may also be called to provide emotional support and assist in guiding victims through the legal process if the decision is made to report the incident to law enforcement. Cases can be reported anonymously if victims are adults.

When the SANE arrives to the emergency room the victim will be transported to a special examination room in a private and secure location. The SANE will provide an overview of the sexual assault kit and obtain written consent to proceed with the forensic examination. A narrative history of the assault will be obtained. Should the victim choose to report the incident, a police officer or detective may be present during this portion of the exam. After the history has been collected, law enforcement will be excused and the victim will be encouraged to change into a hospital gown. Clothes worn during the assault are often taken as evidence.

A thorough physical assessment will be performed with swabs (to collect DNA), an alternative light source (which illuminates body fluids) and a special dye (which detects genital and perianal injuries). Forensic photography may also be taken. The exam is comprehensive lasting three to four hours. If a substance was ingested, either intentionally or unintentionally, urine and blood will be collected through a drug facilitated sexual assault kit. Consent is recognized as a continual process. The victim may decline any portion of the exam.

After the assessment has been completed the SANE will offer medications that are recommended and encouraged for prophylaxis of STDs, HIV and pregnancy. Follow-up care and a safety plan will be individualized for each victim upon discharge.

In the state of Ohio the sexual assault kit initiative requires law enforcement to turn in all kits to Bureau of Criminal Investigations (BCI) within 30 days. If the case is taken to trial the SANE nurse that performed the exam may be called to provide a testimony regarding the history and forensic evidence collected.