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Sexual Assault Treatment Unit. South Infirmary/ Victoria University Hospital. Other types of Sexual Assault Aggravated Sexual Assault Indecent Assault. What do we mean by Sexual Assault RApe. SEXUAL ASSAULT. Ignorance Fear Myths. SEXUAL ASSAULT TREATMENT UNITS IN IRELAND.
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Sexual Assault Treatment Unit South Infirmary/ Victoria University Hospital
Other types of Sexual Assault Aggravated Sexual Assault Indecent Assault What do we mean by Sexual AssaultRApe
SEXUAL ASSAULT • Ignorance • Fear • Myths
SEXUAL ASSAULT TREATMENT UNITS IN IRELAND Rotunda SATU in Dublin opened in 1984 Letterkenny SATU opened in 1998 South Infirmary/Victoria SATU opened in October 2001 Waterford SATU opened in September 2004 Mullingar SATU opened in February 2009 Galway SATU opened in August 2009
Aims of setting up a S.A.T.U. Holistic care for the victim Supportive, efficient and professional collection of forensic evidence and provision of legal reports Confidential / private area for history /examination Support and training to all staff providing the service
SATU • Opened 1st October 2001 • We see both Male / Female clients over 14 years years of age • No time restriction / with or without Garda involvement • year 2009: 91 • 2010: 125
Core services Provided • Forensic/Medical examination • Emotional and practical support • Liase with the Rape Crisis Centre • Post coital contraception • Follow up screening for Sexually transmitted infections • Answering queries and directing clients to appropriate services
SATU - The Unit Interview room - as comfortable and non clinical as possible Examination room - efficient and fully equipped Shower and bathroom facilities- wash kits, track suits Office- secure notes Database of clients
SATU - Staffing 24 hour service, 365 days of the year Clinical Nurse Specialist/ 0830 – 1630 Forensic Examiner Secretarial cover 0900 - 1230 5 General Practitioners off site - on call service 7 Nurses off site - on call service Crisis Support off site – on call service follow- up clinic weekly
SATU - Referrals • Referrals can come from anywhere • Gardai • G.P.’s • Emergency Departments • Sexual Violence Centre • Self referrals • contact the unit • time set for all to meet at the unit • victim support person • nurse and forensic examiner • +/- gardai
Consent Over 18 years (consent for all ages) 14 - 18 years Gardai informed and they provide appropriate person for consent Gardai must co-sign consent as we explain that the examination is to provide forensic information Childcare Act
Patient Details Address and phone No. Age Garda attending Garda station Name DOB Place of examination Date of examination Time of examination Persons present at the examination
Medical /Gynaecological History Date of Menarche Last Menstrual period Bruising tendency Skin problems Gynaecological problems Occupation Medical/psychiatric problems • Sexually active: • presently / previous / never • Last coitus: • Date and Time • STD • Pregnancy: • Previous and outcome
Details of assault Date of assault Time of assault Time lapse Relationship to assailant Place of assault Details of assault Site and mechanism of injuries Events preceding assault Drugs / alcohol consumed by victim Damage /disruption to clothing Weapon / implement used Ejaculation
Details of assault Digital / vaginal Oral / vaginal Oral / penile Penile / vaginal Penile / anal Digital / anal Lubricant used Condom used Ejaculation?
Events following Assault Change of clothes Showered Cleaned teeth Washed hair Vomited Medical treatment since event Activity since assault Bathed Washed genital area Micturated Defecated Eaten food/drank fluids
The Examination • Appropriate clinical setting: • - good lighting • - ancillary lighting for the genital examination • - magnifying lens for surface markings • Gardai to be present in room for continuity of samples • Client undresses onto white sheet • - all clothes given to gardai • Inspection of entire body including mouth • Drawing and description of all markings • Consider re-examination for bruising 1 - 2 days later • Photos - rarely taken and only by gardai
Examination - Samples Head hair- combed and pulled Pubic hair- combed (especially any matted area) and cut Nail clippings- swabs and clippings
Examination - Swabs • Control • Mouth • sample of saliva • external lips • internal mouth / gums • Vaginal • external vulva • low vaginal • high vaginal • Anal • external • internal • Extra swabs • any place where client thinks there may be saliva, blood or seminal fluid from assailant
Examination - Bloods • 1 x EDTA bottle - DNA • if blood is not provided, DNA can be obtained from a swab of the inner cheek • 1 x blank serum - blood group • 1 x Fluoride bottle - alcohol • Toxicology if appropriate
SATU - follow up • Emotional support and counselling • Cork Sexual Violence Centre • Medical • Follow-up of examination e.g. bruises reassessed • STI examination at 14 days • Gonorrhoea, Chlamydia, Trichomonas, Gardenerella Vaginalis, Hep.B-C and Syphilis • HIV counselling/ testing at 3-4 months
Referrals 2010 Acute cases =109, non-acute (beyond 7 days) =16 (4 Males) 38% of the clients were examined by the C.N.S. LOCATION OF ASSAULTS CORK CITY 43% CORK COUNTY 30% KERRY 17% ABROAD 6% LIMERICK CITY 4% Alcohol consumed - 76%
Alleged Perpetrator STRANGER 37% ACQUAINTANCE 28% FRIEND 11% NOT KNOWN 10% EX-PARTNER / EX-BOYFRIEND 6% PARTNER / BOYFRIEND 4% HUSBAND 2% BROTHER 1% NEPHEW 1% COUSIN 1% BOSS 1%
SCREENED FOR SEXUALLY TRANSMITTED INFECTIONS • TOTAL SCREENED 44% (of 125) • NON-SPECIFIC INFECTIONS 33% • CHLAMYDIA 15% • GONNORHOEA 2% • TRICHOMONAS 2%