Authors: Ian Hunt, Emma Jenkinson / Editor: Bernadette Garrihy / Reviewer: Kathryn Blackmore / Codes: IP4, ObP4, SeC2, SeP4, SLO1, SLO2, SLO7Published: 20/09/2021

A 19-year-old student attends the ED (accompanied by a friend) and, at triage, complains of abdominal pain. She is seen by one of your SHOs, who notes that she seems distressed and wonders if there is an underlying, reason for her presentation. He asks to speak to her without her friend present and the patient discloses that she has been sexually assaulted earlier that evening.

The SHO appropriately seeks senior advice and is keen to ensure that this patient receives the best care possible.

On review, the patient is reticent but does engage and provide information. She reports that she was asleep in her bedroom and woke to find her housemate on top of her: on questioning she reports that he then had penetrative vaginal intercourse with her.

She is distressed and is reluctant for any police involvement, partly because she does not think she will be believed and partly because she is worried about what her friends and peers will think.

She does agree to police involvement and referral to the local Sexual Assault Referral Centre (SARC). You inform the police, however the sergeant who attends the ED for initial review is quite sceptical and dismissive. Fortunately you are able to overcome this and emphasise the need for timely assessment at the SARC.

The patient agrees to attend the SARC and is transferred there by the police.

You spend time reflecting whether there are any investigations or treatments that you should have instigated in the interim and what you would have done had she declined police involvement.