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Before the Examination Begins - Providing Patient-Centered Care

Sexual assault patients should be treated as emergency cases.74  Acute injuries, trauma care, and safety needs of the patient should take priority before or in concert with the medical forensic examination. Several steps should be taken to reinforce to the patient that their needs come first. The patient should be asked who they want to remain in the room during both the history-taking and the examination. It is preferable, however, to have only the advocate in the room during the history so the patient is able to speak freely and honestly. Where available, patients should always have the option to have a victim advocate present. It is important to identify any needs that the patient might have prior to starting an examination. This may include everything from arranging child care to taking a few minutes to smoke a cigarette. Examination protocols need to be flexible enough to protect important evidence while meeting the immediate needs of the patient. For example, the nurse can collect oral swabs and then let the patient eat before starting the examination or obtain a urine sample first if drug-facilitated sexual assault is suspected.