Head to Toe Exam for SANEs

In busy emergency departments (EDs), sexual assault nurse examiners (SANEs) are often the first medical providers who examine patients after a sexual assault, and throughout the evaluation the SANEs are provided with a high degree of autonomy. While most experienced emergency room nurses can very efficiently make a “sick or not sick” evaluation of a patient, less-experienced nurses may have more difficulty. Additionally, many practicing SANEs do not have an ED background. Although most sexual-assault patients have only minor physical injuries that do not require urgent intervention, there are some physical signs that warrant further evaluation. This review summarizes potentially serious findings that, with appropriate training, can be observed during a head-to-toe exam. It primarily concentrates on the general physical exam supplemented by aspects of the genital exam and observations regarding the patient’s mental health.