In times of emotional stress, people, tend to minimize their own feelings out of self-protection, or out of consideration for the feelings of people who they love. Because you may be in shock, it's important to seek medical care as soon as possible.

Your need for treatment is, and should be considered, an emergency even if there are no visible signs of physical injury. Taking care of your health at this time is an important step in the healing process.

If you choose to have evidence collected, the sooner this is done, the more reliable it will be.

Why do I need medical care?

It is important to seek medical care in order to:

be examined and treated for any injuries;

be tested and be treated for possible exposure to sexually transmitted

diseases;

discuss the risk of pregnancy and to talk about options in case you are

pregnant;

collect medical evidence should you decide now or later to report the

assault to the police for possible prosecution of the offender.

Where Should I Go?

It's important that you receive treatment at a facility where the staff is specially trained to provide care for sexual assault survivors and correct methods for evidence collection.

In the Fairfax County area, Access of Fairfax, Fairfax Hospital, and Fair Oaks, like other hospital emergency care facilities, are both authorized to examine, treat and collect evidence after an assault on a 24-hour basis. The S.A.N.E. (Sexual Assault Nurse Examiner) have been trained to provide this emergency care for you whether or not you choose to prosecute in court, as long as you are willing to report your assault to police.

What if I need transportation?

If a friend or family member isn't available, you can call "911"for police or rescue squad transportation to the hospital, or the University Police Victim Witness or the Sexual Assault Service Coordinator may be able to arrange transportation.

Before you arrive at the hospital:

If you have any questions before or after medical treatment, call the Sexual Assault Services Coordinator at 993-4364, or the Student Health Center at 993-2835.

In case you decide to have evidence collected, it's important to not change clothes, shower or bathe, douche, drink, eat, smoke, brush your teeth, or use the bathroom unless absolutely necessary before the medical exam in order to keep your options open as long as possible. These activities can destroy vital evidence.

Bring a change of clothes with you.

If you've changed your clothes since the assault, place the clothes you wore at the time of the assault in a paper bag (not plastic). Bring them with you to the emergency room. Let the nurse or doctor know you have them, and tell them if you have done anything else (washed, etc.) before you arrived. This will assist them in making their report.

What happens in the emergency room?

If you arrive by way of rescue squad, you will be taken to a patient-care room and a nurse or admitting clerk will ask you initial questions.

If you arrive on your own or with a police officer through the emergency room main entrance, someone will ask you why you are seeking medical assistance. You will then be taken to a private area where the screening ("triage") nurse will talk with you.

You may be asked the following:

your name and address

occupation

date of birth

employer

insurance

next of kin or emergency contact

Information given regarding anything you are seen for in the emergency room is confidential but necessary for registration and also documentation.

If you are under the age of 18, your parent or legal guardian should give consent for an examination. However, if consent can't be obtained and you need care right away, hospitals and law enforcement offices have procedures for this situation.

Insurance

As mentioned above, the triage or screening nurse will ask you if you have insurance. Emergency care after a sexual assault isn't free, although the statemay pay for all or part of your treatment. If you have private insurance, you can decide whether you want that insurance to pay for your care. (See below for more information.)

The decision to report the assault to law enforcement authorities is solely up to you. However, if you want the state to pay for your sexual assault examination, you must make an official report to the police department within 72 hours of the assault. After this report is made (probably at the hospital), you will then be given a sexual assault examination to collect evidence. You don't have to follow through with prosecution or report to any other agency at this time. Having evidence collected does give you a wider range of options later if you decide you do want to press charges against the assailant(s). The evidence will be kept by the police until you do decide to file charges, which requires an officer to make a brief report without your name explaining why they are holding evidence. They will then wait for your decision. It's important for you to know, however, that even if you don't want to report the crime, the hospital must notify the police that any assault has occurred. The police should not press you for information.

Can I have a support person with me?

Hospital personnel will allow you to have someone with you. In addition to having a friend with you, you may request a S.A.N.E. (Sexual Assault Nurse Examiner, the University's Sexual Assault Services Coordinator or a University Police Officer to assist you.

A well-trained advocate can provide emotional support during the examination and report-taking. Your advocate can help to explain medical procedures and the process of evidence collection. This person may also counsel friends or family members who may be at the hospital. The advocate can assist you with follow-up medical and counseling appointments and provide support throughout the criminal justice process.

You may also request to see a hospital chaplain, other clergy, or your own private therapist (if you are currently seeing one). GMU students can receive follow-up care through Student Health Services.

What are my rights? Will I have any control in making decisions regarding my care and treatment in the emergency room?

The medical staff cannot examine you or collect physical evidence without your permission. They need your signed consent for the examination and to give the evidence kit to the police.

Remember, you have the right to refuse any part of the examination or treat- ment and to ask any questions you may have about any aspect of your care. All procedures should be explained so that you understand why and how they are done; if not, it's OK to ask the nurse or doctor to explain what they are doing. This may help you maintain some feeling of control during the medical procedures.

What is the Physical Evidence Recovery Kit (PERK)?

This kit is designed to assist the examining clinician and nurse in the collection of evidence (specimens) for analysis by the Virginia Division of Forensic Science. If the assault took place within 72 hours of the time of the medical exam, this kit can be used.

Physical evidence to check for semen from oral and/or anal penetration can be collected only within the next 24 hours.

If the sexual assault occurred more than the 24 or 72 hours prior to the medical exam, evidence may still be collected without the specific kit being used.

Before the medical exam, you will be asked details of the assault. Even though these questions may seem very personal and may be difficult to answer, the information you give may be helpful in identifying the assailant, in providing you with optimal care, and in documenting the assault.

Information is needed regarding the type of assault or penetration, such as oral, vaginal, or anal. You will be asked where the assault occurred, such as in a car, on grass or carpet, etc.

The medical staff will need information about your medical history regarding past and present health conditions, including date of your last period, contraceptive history and the date of your most recent voluntary sexual contact.

Clothing Evidence

If you're wearing the same clothes you wore during or after the assault these items must be collected for evidence. Sometimes even shoes are gathered. Tampons or sanitary pads may also be kept for evidence if you are wearing them. You'll be given clean clothes and new underwear to wear home if you didn't bring any with you.

Hair Samples

The nurse or physician will collect hair combings from your head and pubic region. 25 full-length hairs from different parts of your scalp and 25 from your pubic area must be pulled out to help distinguish your own hair from that of the assailant. If you'd rather pull out the hair samples yourself, the clinician and nurse should allow you to do so. Semen found on your pubic hair can be wiped with a moistened cotton swab, rather than clipping your hair.

If There Was Oral Sex

In order to collect moisture for evidence, the clinician will swab your lips and the inside of your mouth and then collect a mouth rinse.

Vaginal Assault and/or Anal Contact

Swabs moistened with distilled water are used to wipe your inner thighs and external genitalia. Female survivors have a pelvic exam to collect other samples of evidence and to test for sexually transmitted diseases. For both females and males who were assaulted anally, additional swabs are used to collect evidence of sexual assault in the anal area.

Blood Samples

After the physical exam, the nurse will draw a blood sample from your arm to determine your blood type, to screen for syphilis, and to do a serum pregnancy test. A baseline HIV test can be done on your request, but it may be advi- sable to wait to have the HIV test at the Public Health Department where the test can be done both confidentially and anonymously.

All screening tests done immediately after an assault are to document your state of health before the assault or for pre-existing conditions. This is why follow-up medical appointments are necessary for retesting 4-6 weeks after the assault. The follow-up tests will indicate pregnancy or sexually transmitted diseases. HIV antibody tests may not give reliable results until 3-6 months after an assault. It's best to have an HIV antibody test done where follow-up counseling is available. Free HIV antibody tests are available through the Health Department or Student Health Center. Again, your consent is needed before any of these tests are performed.

Toxicology Blood/Urine Screen

If you or an accompanying person (such as family member, friend, or police officer), state that you were drugged by the assailant, screening tests may be done, including testing for alcohol. Likewise if the clinician feels your medical condition appears to warrant screening to provide you with optimal care, screening will be done. You have the right to refuse this, as with all procedures.

Release of Evidence

Evidence collected in a hospital may be released to a law enforcement officer only with your written consent or if an authorized third party does so on your behalf. Remember, release of evidence does not require you to prosecute. Again, if you are unsure about prosecuting, the hospital can store your collected evidence in a locked, refrigerated area for a short period of time.

If you decide not to release evidence, you may be charged with costs involved in the collection of evidence, but that is highly unlikely in this area.

Follow-Up Care

It is important to have follow-up tests and an exam within 4-6 weeks after the emergency room visit. You can be seen by your private clinician or at the Student Health Center to check for possible pregnancy or sexually transmitted diseases and to talk about counseling.

If you are a GMU student, follow-up care can be provided (free of charge) at the Student Health Center. It's best if you call Student Health as soon as possible to talk to a nurse about a follow-up appointment.

After the Examination

If you wish to shower before leaving, the emergency room nurse may be able to provide you with soap, shampoo, towels, and fresh clothing if needed.

Transportation

If you don't have a ride and if you don't need to accompany a law enforcement officer for further questioning, transportation home or to a safe place may be arranged with a family member, friend, victim advocate, or the local law enforcement agency.