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Sexual assault: immediate clinical care ⚠️
For education and revision only. Check current NICE/BNF, specialist guidance and local NHS policy before clinical use. Newly added V19 material has not received independent clinical sign-off.
A survivor of sexual assault needs trauma-informed, choice-led care, attention to urgent injuries and access to specialist Sexual Assault Referral Centre (SARC) services.
Immediate priorities
- Treat life-threatening injury, strangulation symptoms, head injury and mental-health risk; offer a private, safe and non-judgmental environment.
- Explain confidentiality and safeguarding limits; use the patient's preferred terminology and obtain consent before any examination.
Time-sensitive actions
- Offer urgent SARC referral and discuss forensic evidence preservation without making evidence collection a precondition of clinical care.
- Assess need for emergency contraception, HIV post-exposure prophylaxis, STI testing/vaccination and pregnancy follow-up under local time-dependent pathways.
- Involve specialist safeguarding support for children and adults at risk; competent adults generally choose whether to report to police, subject to applicable safeguarding obligations.
Clinical reasoning: Clinical treatment, forensic sampling and police reporting are separate decisions; consent to one does not imply consent to another.
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