EMS Care of Survivors of Sexual Assault - A Position Statement and Resource Document of NAEMSP.

Caring for sexual assault survivors requires interdisciplinary collaboration, pre-planning, and education. The purpose of this document is to guide emergency medical service (EMS) agencies and clinicians in the patient-centered management of survivors of sexual assault. The National Association of EMS Physicians Recommends:Trauma-Informed Care: EMS clinicians should recognize that sexual assault is a traumatic event, and we recommend a trauma-informed care approach. Some recommended actions include, but are not limited to, asking questions that validate a survivor's experience, asking permission before doing an exam to acknowledge a patient's choice, and allowing a support person during the physical exam.Physical Injuries after sexual assault: EMS clinicians should assess for serious traumatic injuries associated with sexual assault including strangulation.Collaboration with Sexual Assault Forensic Examiner Organizations: EMS clinicians should understand general forensic guidelines and state-specific regulations relevant to prehospital care. Indications for forensic exams vary by state, thus partnerships between EMS and sexual assault forensic examiner organizations can facilitate access to forensic examiners who can provide clear guidance on available forensic resources.Transport to Sexual Assault Forensic Examiner-resourced facilities: EMS systems should identify local facilities that are resourced to care for sexual assault survivors or systems designed to provide these resources to the survivor and preferentially transport stable survivors to these destinations for medical and forensic evaluation. If there is concern for a life-threatening injury, patients should be transported to a trauma center for evaluation.Documentation: In addition to awareness of local regulations, EMS clinicians should be complete, accurate, and culturally competent in their documentation. They should minimize bias in their documentation.Evidence Preservation: EMS clinicians should be aware of best practices for evidence preservation and be trained in evidence collection in the prehospital setting, including avoiding showering, eating, changing clothes before the forensic exam, and maintaining chain of custody.Consider other special populations: EMS clinicians should be aware of high-risk special populations for sexual assault with unique medical, cultural and/or regulatory considerations including, but not limited to, the pediatric, elderly, transgender, gender diverse, LGBTQ (lesbian, gay, bisexual, transgender, queer), pregnant, and male survivors.