The Adolescent Victim of Sexual Assault

Karen D. Coleman, RN

SANE Coordinator

Victims Assistance Services

Sexual Assault in NYS• 2,206 victims of forcible rape (and 10,359

victims of other sex offenses) were 17 and younger in New York State in 1997(Bureau of

Statistical Services of the New York State Department of Criminal Justice Services).

• Rape Crisis Centers across the state provided services to 3,991 survivors 18 and younger during the 1997-98 contract year (Rape Crisis Program of the New York State department of Health, Bureau of women's Health)

Westchester SANE Statistics

26

17

2723

14 14

0

10

20

30

11YRS 13YRS 15YRS 17YRS

Adolescent Cases (37% of all cases)

Adolescent Statistics for 2001

• 31 cases in 2001, only 1 male

• 19 of 31 knew perpetrator (61%)

• 4 of 31 lived in residential placement (13%)

• 10 of 31 had genital injuries (32%)

• 10 of 31 had non-genital injuries (32%)

• 12 of 31 occurred in the victims home (39%)

Adolescent Statistics

• 11 of 31 are African-American (35%)

• 12 of 31 are Caucasian (39%)

• 7 of 31 are Latino ( 23%)

• 2 are mentally delayed, 2 required psych. hospitalization, 1 required acute care hospitalization, 1 was incarcerated, 1 case had multiple perpetrators

Factors that Increase Vulnerability

• Lack of communication about relationships, sexual activity

• Lack of education and awareness on subject of sexual assault

• Feelings of betraying family member or friend by “telling”

• Intimidation by adult authority• Failure to seek health care

Consents

• Minors in New York State, can give consent for all components of sexual assault care if they can understand the risks and benefits of the proposed treatments (informed consent).

• Minors who can give informed consent can also refuse to consent to such services.

Reporting

• Healthcare providers may not report rape or statutory rape committed against their patients to the police (unless the patient sustained a gunshot or life threatening stab wound.

• No report (CPS) should be made of minors who engage in consensual sex with a non-relative, or who are raped by a peer or by a stranger, unless the rape was the result of parental or guardian abuse or neglect.

DOCUMENTATION OF INJURIES

TEARST Tear (laceration) or tenderness An injury in the soft tissues, resulting from ripping, crushing, overstretching, pulling apart, bending, and shearing; lacerations result from blunt force; in contrast, cuts come from sharp objects.

E Ecchymosis (bruise) Irregular hemorrhagic areas of the skin; the color is blue-black changing to greenish brown or yellow; it is caused from extravasation of blood into the skin or mucous membrane

A Abrasion A scraping away of a portion of skin or mucous membranes from injury or mechanical means

R Redness (redness) A form of macula with diffused redness, caused by capillary congestion

S Swelling (edema) A local or general accumulation of fluids in the tissues

The Body Diagram is essential to completely document physical injuries.

The clock is used to assist in documentation of the areas of injury.

Suction Neck Injury

15 Year old with suction marks to the neck that occurred during rape.

The kit contains 13 envelopes, blood collection equipment, necessary paperwork and detailed instructions.

Role of the SANE in the Hospital

• Medical Assessment• Evidence Collection• STD Prophylaxis• Emergency Contraception • HIV PEP• Health Education

Role of the SANE in the Courtroom

• Fact witness• Grand Jury

testimony• Educate the

Jury• Criminal Trial

Testimony

How to Access a SANE

• Rape/sexual assault victim is triaged• E.D. Staff calls VNA @ (914) 666-

7079*• VNA contacts SANE on call• SANE arrives at hospital within 60

minutesSANE Nurse is available 24 hours a day

* Call (914) 345-9111 for an advocate to come and stay with the victim

Reminders• Photographs remain with the medical chart in a

sealed envelope. Each photo should be labeled with patient name, MR#, date, time, and photographer's name. Do not place in rape kit.

• Utilize police photographer if indicated• Document location of all injuries on body diagram.• Ok to use familiar terms (i.e. “size of a quarter”,

“cottage cheese”)• Be careful not to use laceration and cut

interchangeably!

Karen D. Coleman, RNSANE Coordinator

Victims Assistance Services

2269 Saw Mill River Road, Bldg. #3

Elmsford, NY 10523

(914) 345-3113

(914) 345-3513 Fax