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Rape Hidden Injuries
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2. Part 1 of 3: Background & Challenges Background & Challenges
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7. “ You can have tremendous influence on the patient’s decisions and, therefore on the patient’s ultimate recovery from emotional trauma of assault.” (64) ultimate recovery from emotional trauma of assault.” (64)
8. Part 2 of 3: Patient’s Responses Patient’s Responses
9. Case Study: Jennifer Collins* Jennifer Collins* *see pages 64-67
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17. Part 3 of 3: EMS Provider Responses EMS Provider Responses
33. “ The consequences of rape can stay with the survivor for years. What you do in the minutes after the assault can help in the process of healing.” (73)
Editor's Notes
Above all, rape is a crime of violence, not of passion. It is usually violence toward a woman by a man with the objectives of dominating, inflicting pain, and humiliating her, not reaching orgasm.
With only a small proportion of sexual offenses formally documented through law enforcement, the prevalence of sexual assault in Canada has been difficult to quantify.
A victim of rape frequently wants one or both of two options: A) FLIGHT: to run and hide, to be invisible, and/or B) COMFORT: someone to give her support and security.
2 other reasons why a victim might be reluctant to report a rape: the rapist might be someone she knows, including a husband or ex-husband, or she might be an undocumented resident In this situation, the Primary Care Paramedic can be instrumental in encouraging the victim to turn to competent professionals such as a rape crisis center, and family - getting the victim to accept treatment and setting the stage for later recovery.
Denial, flashbacks, intrusive thoughts, fears of another assault, and nightmares may persist. She may blame herself or others, as she searches for explanations. Physical and emotional intimacy might become difficult.
So how can EMS providers help?
If the mechanisms of injury seem apparent, these should be noted.
One of the first challenges you face in assessing a rape victim is getting permission to assess and treat. In large part, success may reflect the attitude that you bring to the situation. Being overprotective may prevent the patient from initiating the normal process of working through her feelings. This applies to other cases with victims of intentional violence.
One of the first challenges you face in assessing a rape victim is getting permission to assess and treat. In large part, success may reflect the attitude that you bring to the situation. Being overprotective may prevent the patient from initiating the normal process of working through her feelings. This applies to other cases with victims of intentional violence.
-vigorous questioning can take on the character of another assault -a patient on blood-thinning medication may be susceptible to bleeding problems -do not overlook the possibility that the patient might have been pregnant at the time of the rape, but it may not be advisable to raise this question specifically
Your service should have policies and procedures for cooperating with police at scenes of crimes and safeguarding evidence - it is important that you know them.
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