Pregnancy risk evaluation and emergency interception policy and procedure
The sexual assault nurse examiner (SANE) will evaluate the risk of pregnancy for every victim seen in the ED or clinic. If she determines that the victim is at risk of becoming pregnant as a result of the rape, the SANE informs the victim and explains to her options to prevent a pregnancy.
Procedure
To determine if the victim is at risk of becoming pregnant, the SANE should determine the following:
- Was there vaginal-penile contact?
- Is the victim mid-cycle or are her menstrual cycles irregular?
- Is she using contraceptives, or has she had a tubal ligation or hysterectomy?
- Is she currently menopausal?
- Is she currently pregnant, based on the results of a urine pregnancy test (UPT) completed in the ED or clinic?
If it is determined that the victim is at risk, her UPT results are negative, it is within 72 hours of the rape, and she wants to take medication to prevent a pregnancy from occurring, the SANE will consult with the staff physician.
With the physician’s concurrence, the SANE then gives the victim one Levonorgestrel, 0.75-mg (Plan B) tablet to take immediately and one to take in 12 hours. The SANE instructs the victim to call if she becomes nauseated and vomits within one hour of taking Plan B.
When Plan B is used, the patient should be instructed to take the sexually transmitted infection medications at least two hours later.
If the client does not want pregnancy prevention medications, this fact and her rationale should be noted on her exam report.
11/97, Rev. 10/00
Source: Sexual Assault Resource Service, Minneapolis.
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