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National Protocol for Sexual Assault Medical Forensic Examinations: Adults/Adolescents

NCJ Number
Kristin Littel
Date Published
September 2004
141 pages
This report presents the national protocol for sexual assault medical forensic examinations designed as a guide for criminal justice and health care practitioners who respond to victims of sexual assault.
The National Protocol for Sexual Assault Medical Forensic Examinations was developed by the U.S. Department of Justice, Office on Violence Against Women (VAWA), under the Violence Against Women Act of 2000 and designed to offer guidance to jurisdiction in creating and implementing their own protocols and recommending specific procedures related to the exam process. The protocol was developed with the input of national, local, and tribal experts throughout the United States including law enforcement representatives, prosecutors, advocates, medical personnel, forensic scientists, and others. The protocol is intended to assist jurisdictions in developing a response that is sensitive to victims of sexual assault and promotes offender accountability. This report focuses on elements of immediate response that are the responsibility of health care providers and seeks to assist health care personnel in validating and addressing patients' health concerns, minimizing the traumas patients may experience, promoting healing, and maximizing the collection and preservation of evidence from patients for potential use in the legal system. The protocol addresses the role of advocates, law enforcement representatives, and other responders in the medical forensic exam process. The report is divided into three main sections: (1) overarching issues -- coordinated team approach, victim-centered care, informed consent, confidentiality, reporting to law enforcement, and payment for the examination under VAWA; (2) operational issues -- sexual assault forensic examiners, facilities, equipment and supplies, sexual assault evidence collection kit, timing considerations for collecting evidence and evidence integrity; and (3) the examination process -- initial contact, triage and intake, documentation by health care personnel, the medical forensic history, photography, exam and evidence collection procedures, drug-facilitated sexual assault, STI evaluation and care, pregnancy risk evaluation and care, discharge and follow up, and examiner court appearance. Eleven recommendations are presented highlighting key points discussed in the protocol. Appendix A and B