En route treatment of SA victim

[mshow00]

I had a call early Monday morning that was dispatched as a psych at a hotel. When we (my partner, a new hire, and I all males) got on scene, we had a local LEO escorting an early 30's woman to the back of our truck. I opened the back door and the woman climbed into the truck followed by the new hire and myself, the pt was very emotional otherwise seemed ok. My partner went to talk to the LEOs as I started the pt interview. My partner returned to the truck jumping in the drivers seat and started toward the hospital when I gave the ok. When I asked the pt why she called the ambulance and why she wanted to go to the hospital, she didn't answer. (1st little thing that went off in my head) I asked her the basic questions; ETOH consumption, Drug usage, Past Medical Hx, Current meds, obtained V/S(after specific request and permission) etc. She told me she "came home for Fathers day, spent the day with him, and went out with some friends-some not friends-and someone hurt me...." then shut down and curled into the fetal positon. (2nd little thing) I stoped asking. My mind was racing with what I should and should not do/say etc. We started to make small talk. She said "Alls I want to do is laugh." I replied with "I only know one joke: why is 6 afraid of 7? because 7 ate 9" She did laugh for a very short minute. She started to say something about the night before but stoped before saying anything, I used this window to ask if she was currently hurt(ing), if she was currently bleeding, and if she told the LEOs about this. She answered "no" to all and then said " I don't wanna talk about this anymore". So I dropped it. I continued to make small talk with her. When calling in the in-bound report to the hospital, I used my personal cell phone for privacy. My questions: is there anything I should have asked, or is does anyone have any tips for dealing with this kind of call in the future?

[mobey]

great question!!

We are taught far too little about anything phyc in school.

I look forward to the replies from our veterans who have learned through experience.

[Flasurfbum]

For the most part, go with the flow. If they are singing Frank Sinatra, ask if you can join in.

IF they are stating that they see a ghost in the corner, as them to describe it to you. Don't dismiss them as crazies. However, if it begins to take a violent, or dangerous route, direct it somewhere else.

[Doczilla]

Sexual assault victims will respond somewhat differently to the trauma based on their own personal experiences. There is very little that you can say that is universally applicable. The best thing that you can do is be compassionate. Do not try to "make everything better", since you can't. It is important that the victim knows you are there to ensure her (or his) safety and comfort. Apart from that, there is not much you can do. Collection of evidence, getting details of the experience, getting victim statements, none of these are important to do in the prehospital environment, since they will be done at the hospital by trained sexual assault nurse examiners. Just don't be uncomfortable with long silences. Letting her sit quietly with her thoughts is okay. If she wants to talk, fine. If not, don't make her.

'zilla

[CBEMT]

And if it is rape, everything- down to the sheet on your stretcher- is now evidence. Make sure it stays with her, preferably bagged.

[firedoc5]

You did as well as anyone else could in that situation. You can ask some questions but keep them simple. If they seem to be physically and emotionally traumatized try to keep them at ease, don't raise their stress levels. You can try to get them to think about something else. Sometimes they can be really unpredictable. Note everything they do say. Things they could say, even if it's something that is off the wall, could be used by professionals on what has occurred. And please leave it up to the professionals. Don't get too indepth. You just need to show compassion, understanding, and be at ease yourself. If you seem nervous or intense, they can feel that. Keep calm, cool, and collective.

[Just Plain Ruff]

I would not have used my personal cell phone. There is no recording of your conversation to the ER Staff.

Just keep it short and simple and to the point on the radio.

But then again, that's just me with the cell phone thing.

Just letting her sit there was more than enough for her. You helped her and you didn't even know you helped her. Funny how things work out sometimes right?

And one other thing, WE as EMS providers are in no way trained to treat the emotional needs of a Sexual assault patient. We are given like less than 8 hours of psych training and that's stretching it. So to say we can treat a sexual assault patient is correct only in saying the we can treat their injuries but we cannot treat their mind and emotions. We need to remember that in our day to day dealings with this type of patient.

Attend to their injuries, attend to their immediate needs and leave the psych stuff to the people who know what they are doing.

[CBEMT]

I would not have used my personal cell phone. There is no recording of your conversation to the ER Staff.

Then you'd really hate working here, because that's the only way to contact any of our hospitals. All agencies provide a cellphone for the truck, though, so no personal use unless you choose to. I have all the numbers programmed just in case.

[mobey]

Then you'd really hate working here, because that's the only way to contact any of our hospitals. All agencies provide a cellphone for the truck, though, so no personal use unless you choose to. I have all the numbers programmed just in case.

The area our radio is positioned in in our hospital, it can be heared by a few patients from their rooms. I often use my cell for sensitive calls such as SA.

[Asysin2leads]

My advice is this:

First, know what the procedure for treating a sexual assault victim. If your service or company does not have clear, written instructions and procedures for handling cases like this, be sure to inform them of the necessity of it and strive to make changes. This should include input from your local ER and law enforcement agencies. As sad as it is, not only are you handling a patient and a victim, you are also handling evidence in one of the most serious crimes we have on the books. Act accordingly.

Personally I think the only way to handle this is a careful mixture of compassion and professionalism. I think professionalism is extremely important not only because of the legal aspects, but because it reminds everyone that what has happened is a crime. Its not someone getting hurt, its not someone's feelings being injured and in need of a shoulder to cry on, it is a violent crime.

I don't think there is anything I, or anyone can really say that will even come close to taking away the pain and suffering of a sexual assault victim, and I think its the height of arrogance and hero mentality that any of us could swoop in and say some magic words. All we can do is our best to make the person feel safe, secure, and cared for. That and keep our own emotions involving hunting down the bastard and shooting him in the genitals at bay.