GP Connect Clinical feature by Dr Rosemary Stroud, GP, Sexual Assault Resource Centre
Sexual assault is common, and patients often present to primary care before they consult any other provider. Patients should be offered a forensic examination after any serious medical needs have been addressed. This article aims to update GPs on the forensic services currently available in WA so that patients can be directed to the most appropriate service.
Key points for GPs:
- All GPs are encouraged to discuss recent cases of sexual assault with the Sexual Assault Resource Centre (SARC) duty doctor.
- SARC has clinicians available 24/7 for advice and guidance.
- If a patient is based in Perth, a full forensic exam may be offered by SARC if the assault occurred within the previous two weeks.
- If a patient is living in remote or regional WA, local emergency departments (EDs) can facilitate a full forensic examination with the support of SARC.
- Early Evidence Kits can be used in the first 48 hours to allow collection of time sensitive forensic evidence that may otherwise be compromised before a full forensic examination can be arranged.
- EEKs are available through most EDs or WA Police.
- Forensic Toxicology Kits are available in most EDs and can be used in cases where drug facilitated sexual assault is suspected.
- Drink spiking test kits are only available at WA Police stations (24-hour metropolitan and all country stations).
What is an Early Evidence Kit?
An Early Evidence Kit (EEK) is used to collect time-sensitive forensic specimens before a full forensic examination. EEKs were originally known as ‘comfort’ packs as they allow a patient to eat and drink or to pass urine without losing forensic evidence. Most of the specimens are self-collected by the patient. An EEK is not a direct substitute for a full forensic examination.
What is a full forensic examination after sexual assault?
A full forensic examination is a detailed examination with collection of multiple types of evidence such as non-genital photographs and comprehensive injury documentation. It may include collecting swabs, urine and/or blood, and the collection of clothing. Medical and psychological care is normally offered at the same time.
Who performs a full forensic examination?
In the Perth Metropolitan Area, a full forensic examination is completed by SARC doctors. SARC is based in Subiaco but can attend metropolitan hospitals if required. A full forensic examination may be considered, even if the patient is unsure about reporting to police.
In rural and remote areas, full forensic examinations can be completed by a doctor or a SARC-trained nurse. SARC is available 24/7 to provide telephone guidance. In most regional and remote areas, there is no or very limited capacity to store evidence if police are not involved, and a report must be made to the police before a full forensic examination is undertaken.
Where can patients access an EEK?
Most WA EDs stock EEKs. Police are also able to collect early evidence with a similar kit which may negate the need for the patient to attend ED. General practices are not expected to stock or administer EEKs.
Most EDs also stock Forensic Toxicology Kits which can be used if drug facilitated sexual assault is suspected. This involves collecting blood and urine samples. WA Police cannot collect forensic toxicology specimens.
What are the timeframes for collecting forensic evidence after a sexual assault?
EEKs are only used in the first 48 hours post sexual assault.
Full forensic examinations are guided by DNA persistence guidelines, and each case is considered on an individual basis. The cut off for a full forensic exam is generally 14 days post assault but may be earlier, depending on the nature of the assault.
What are drink spiking test kits?
Drink spiking test kits are available in 24-hour metropolitan and all regional WA Police stations. They can be used if there is concern of a drink spiking, independent of a report of a sexual assault. Patients can decide if they wish to proceed with a criminal offense report if the test shows a positive result. EDs do not currently administer drink spiking test kits.
Further support for GPs
WA GPs seeing patients after a recent sexual assault are encouraged to access 24-hour phone advice from SARC duty doctors. Contact SARC on (08) 6458 1820 during office hours, or the King Edward Memorial Hospital switchboard on (08) 6458 2222 out of hours.
The SARC website provides an extensive range of support and information for patients, carers and health care professionals.
This includes a recently produced guide and checklist for GPs to aid history taking and basic management:
GPs are encouraged to provide patients who disclose a recent sexual assault with the following SARC resources:
SARC regularly update a comprehensive list of support services: