Sexual assault aftercare in the Emergency Department
Scope and principles
Emergency departments must prioritise timely, trauma‑informed medical care while preserving forensic opportunities and meeting safeguarding obligations.
The ED’s immediate responsibilities are to assess and stabilise the patient (ABCs), treat urgent injuries, offer time‑sensitive interventions (emergency contraception, HIV post‑exposure prophylaxis - PEPSE - where indicated), protect vulnerable patients, document contemporaneously, and arrange rapid referral to a Sexual Assault Referral Centre (SARC) or local sexual‑health services when available (RCEM; FSR‑GUI‑0020).
SARCs are the accredited setting for forensic medical examinations and integrated aftercare; when transfer is not possible the ED must take contamination‑controlled measures to preserve evidence (FSR‑GUI‑0017).
Legal definitions and safeguarding thresholds (England & Wales)
- Age of consent: 16 years. Sexual activity involving a person under 16 requires safeguarding action.
- Rape: non‑consensual penile penetration (vagina, anus or mouth).
- Rape of a child: any intentional penile penetration of a child under 13 is legally rape.
- Sexual assault by penetration: non‑consensual insertion of an object or body part (not a penis) into the vagina or anus.
- Children and vulnerable adults: any sexual assault of someone under 18 or a vulnerable adult prompts safeguarding assessment and multi‑agency referral; certain findings (for example, STI or pregnancy in a child under 13) are child‑protection “red flags” (NICE NG76).