MEDICAL ISSUES

Pregnancy Prevention

What You Need To Know About Emergency Contraception – “Morning After Pill”

Emergency contraception, sometimes referred to as the “morning after pill,” is used to prevent pregnancy. Most emergency contraception pills are 79%-95% effective if taken correctly in the first 72-120 hours (3-5 days) after the assault. If you are currently pregnant at the time of the assault, you can still receive medications for STI’s. If you were given emergency contraception or any other medication, make sure you understand and follow the doctor’s directions for taking it. Ask the doctor if you can have the instructions written down for you. If you are unsure about when, or how, to take the medication, call the prescribing doctor or hospital for clarification.

Can I Still Get Pregnant If I Take Emergency Contraception Medication?

Yes. Emergency contraception is not 100% effective. You need to discuss this further with your doctor.

Will Emergency Contraception Terminate A Pregnancy?

No. Emergency contraception prevents a pregnancy from occurring by stopping a fertilized egg from implanting itself in the uterus.  It does not terminate an existing pregnancy. If you think you may be pregnant and are concerned, talk with your doctor about emergency contraception.

Physical Injuries

Lacerations are blunt force injuries which result from tearing, ripping, overstretching, pulling apart, bending, and shearing soft tissue.

A Cut is a tissue wound resulting from a sharp object, under pressure, coming into contact with the skin.

An Abrasion or scrape is the removal of the outermost layer of skin by a compressive and/or sliding force over a rough surface or object.  Abrasions result when the skin contacts a rough object or surface with sufficient force to rub away part of the surface.

Care of lacerations, cuts and abrasions:

• Wash your hands to reduce the risk of infection.
• Keep the wound clean and free of infection by cleaning it with water and mild soap several times a day.
• If there is a dressing or band-aid covering it, keep it clean and dry. If bleeding starts, apply gentle pressure directly over the wound with a clean cloth or gauze. 
• To reduce the risk of infection you may apply antibiotic ointment. 
• If your wound was closed with steri-strips, leave these in place for at least a week.

Call your doctor if you experience:

• Increased warmth to the area.
• Redness or swelling to the area that gets worse instead of better.
• A red streak coming from the wound.
• Pain in the area that increases instead of decreases over time.
• If you have pus or bad-smelling drainage from the wound. (Pus is a fluid that may drain from a wound that is infected. Pus is milky - not clear- and may be white, yellow, green, or brown.)

Contusions or bruises are injuries that result from leakage from blood vessels into the soft tissue after sufficient force has been applied to distort soft tissue and to tear vessels.

Bites may have all of the components of bruises, scrapes, and cuts. Human bites often get infected. Watch closely for infection (redness, swelling, red streaks, and/or pus), and notify your doctor right away.

Strangulation is defined as a form of asphyxia and is characterized by closure of the blood vessels and/or air passages of the neck and may disrupt the delivery of oxygen supplying the brain.  Strangulation is often incorrectly referred to as choking which involves blocking, or obstructing the windpipe.  

The effects of strangulation may not be obvious, but they may be numerous.  Simple hoarseness or a complete loss of voice, and/or difficulty in swallowing or painful swallowing might result. Visible injuries to the neck may include scratches, abrasions, and scrapes. Redness on the neck may be fleeting, but may demonstrate a detectable pattern. These marks may or may not darken to become a bruise. Bruises may not appear for hours or even days. Chin abrasions are also common, as are tiny red spots called petechiae.

Call your doctor if you have: Loss of consciousness, light-headedness, and shortness of breath, loss of bodily functions or difficulty swallowing.

Genital / Anal Injuries: A genital injury is an injury to the genitals or perineum (the area between the anus and vulva in females, and the anus and scrotum in males). Genital injuries may be in the form of bruises, scrapes, and/or tears. These injuries can be very painful, and can bleed for a day or two. These injuries usually do not need any treatment and will heal quickly by themselves usually in 2 to 3 days. An anal injury can be trauma in the form of a bruise, tear, and scar around the opening of the anus. 

Care of genital and anal injuries:

• Keep the area clean and dry.
• Apply cold packs for twenty minutes, four times a day for the first two to three days after the injury occurred.
• Anti-inflammatory medicine may help.

Sexually Transmitted Infections

As a result of the assault, you are at risk of getting infections that are transferred through bodily secretions.  Not all sexually transmitted infections can be prevented.  It is strongly recommended that you abstain from sexual intercourse or use a condom until your follow-up exam.

BACTERIAL INFECTIONS

You can be prescribed medicine to prevent infections such as syphilis, gonorrhea, chlamydia, bacterial vaginosis and trichomonas. Preventing an infection is usually easier than treating one. Make sure you finish taking all medications that are ordered for you.

VIRAL INFECTIONS

The following 4 viral infections may be spread by sexual contact:

• HEPATITIS B - There is a vaccine for hepatitis B.  If you have been immunized, you should ask your doctor if you need to have a blood test to make sure you are properly protected. 
  The vaccination series is recommended if you have not been vaccinated.
• HERPES - There is no cure for herpes, but treatment is available.
• HUMAN PAPILLOMA VIRUS (HPV / GENITAL WARTS) - Treatment is available.
• HUMAN IMMUNODEFICIENCY VIRUS (HIV) - HIV is the virus that causes AIDS. Genital injuries may increase your risk for HIV. There is preventative medicine that may be
  recommended to you.

HIV/STD Testing: Testing for HIV is strongly recommended immediately following the sexual assault and every 6 months thereafter for 18 months. For information about testing, you may
contact your physician, the Pima County Health Department, or the Southern Arizona Aids Foundation.

Medical Follow-up:  Follow-up examinations are recommended to provide an opportunity to:

• detect new infections acquired during or after the assault.
• complete hepatitis B immunization, if indicated.
• complete counseling and treatment for other STDs.
• monitor side effects and adherence to post exposure prophylactic medication, if prescribed.

Examination for STDs should be repeated within one to two weeks of the assault.

Checklist for Follow-Up Medical Care

We strongly recommend that you receive the medical care listed below. Consult with your physician to make sure these are the appropriate recommendations for your situation.

AS SOON AS POSSIBLE (WITHIN ONE WEEK)

These are your “baseline” tests; the results of these tests show your body’s condition at the time of the assault.

___ HIV test                                                

___ Pregnancy test

___ Evaluation for infection                    

___ Hepatitis test

1-2 WEEKS:

___ Hepatitis vaccine                               

___ Evaluation for infection

IN 1 MONTH:

___ Pregnancy test                                  

___ Hepatitis vaccine

___ Evaluation for infection                    

___ HIV testing

IN 3 MONTHS:

___ HIV testing                                         

___ Syphilis testing

IN 6 MONTHS:

___ Hepatitis Vaccine                              

___ HIV testing

If You Feel You Might Have Been Drugged...

If you feel you might have been drugged, have had a loss of consciousness or are concerned that something happened to you without your consent:

Drugs used to facilitate rape include alcohol, Rohypnol, GHB and many other substances.  These drugs have a sedative and hypnotic effect on unsuspecting victims and are used to facilitate numerous crimes including rape. 

These drugs incapacitate the victim making it difficult or impossible to resist an assault or have a memory of the incident. These drugs may at some point render a victim unconscious, and even worse, the victim may appear to participate or may even appear to be the aggressor early on. 

Not only are victims uninhibited and likely to engage in behavior quite atypical; but they also, most likely, will not even remember such conduct.

Victims need to be encouraged to act promptly to get to a facility if they desire to make a report.  These drugs are metabolized quickly and may not be detected after several hours of delay.

Urine, not blood, is the most important sample in most cases and timing is of the essence.  The best sample of urine is from the first void after waking. It is important to know that most hospital labs aren’t able to detect the presence of these drugs during a standard urine analysis. 

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