During a sexual assault exam, the first thing that happens is a head-to-toe exam to rule out any life-threatening problems. Once the patient has been cleared for any problems that need to be treated immediately and a consent to collect evidence is signed, a forensic exam can be done. A forensic exam is done by either a nurse with special training called a sexual assault nurse examiner (SANE) or a physician.
During a forensic exam, the patient is interviewed about what happened. This helps the health care provider know what to look for and what evidence to collect for the sexual assault evidence collection kit. Clothing may be collected if the patient was wearing the same clothing when the patient was sexually assaulted. Injuries from head-to-toe are documented and may be photographed. A focused genital exam is done and any injuries in the genital area are documented and may also be photographed. Swabs are collected for DNA in the genital area and on the body. If at any time the patient doesn't feel comfortable with any part of the exam, the patient can tell the health care provider to stop that part of the exam. At the end of the forensic exam, the sexual assault evidence collection kit is turned over to law enforcement with the consent of the patient.
Labs can be done for sexually transmitted infections and other infectious diseases based on what the hospital protocol is. Preventive treatment for sexually transmitted infections can be given. A pregnancy test is done and an emergency contraceptive can be given.