title: Audit on the management of complainants of sexual assault at an emergency department.
abstract: OBJECTIVE
  Proper medical management should be offered to rape complainants, including systematic investigation for sexual transmitted diseases, prophylactic antibiotics, a pregnancy test, emergency contraception, and psychological and medical follow up. We conducted an audit on the medical management of complainants of sexual assault in a public university hospital with a high referral of rape complainants.
  
  
  METHODS
  Retrospective study of rape complainants, based on medical records (n=356) including women admitted at the emergency department between January 1, 2002 and December 31, 2007.
  
  
  RESULTS
  Most complainants were Caucasian (median age: 25 years, range: 15-79 years). About 82% of the assaults were committed by one assailant only, and almost two-thirds of the rapes were characterized by vaginal penetration. In 8% of the patients, no blood sample to screen for sexually transmitted disease had been taken and in 38% of the patients, no cervical smear for C. trachomatis had been done. Prophylactic antibiotics were provided to 40% of the patients. Eighty percent of the complainants who were not using contraception received an emergency contraceptive treatment. Respectively, 10%, 16% and 11% of the complainants were seen at a gynecological, infectious diseases or psychological support follow-up visit.
  
  
  CONCLUSIONS
  Only about 20% of the complainants received optimal care. Different steps were taken to improve the medical management, including a specific computerized checklist and involvement of a social nurse for the follow up. These steps aim at reducing psycho-affective and medical morbidity of rape complainants.
authors.affiliation: Departments of Obstetrics and Gynaecology, CHU Saint-Pierre, Université Libre de Buxelles, 322 rue Haute, 1000 Brussels, Belgium. christine_gilles@stpierre-bru.be
authors.forename: Christine
authors.initials: C
authors.lastname: Gilles
authors.forename: Christiane
authors.initials: C
authors.lastname: Van Loo
authors.forename: Serge
authors.initials: S
authors.lastname: Rozenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D001530:Belgium; D057189:Checklist; D044363:Contraception, Postcoital; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011785:Quality Assurance, Health Care / Q000379:methods; D011902:Rape; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D055815:Young Adult