OSCC

Transcript

1. One Stop Crisis Centre (OSCC) Shirley Chan
2. OSCC Integrated, comprehensive multiagency service center Established in all Emergency Department of MOH Suitably located to provide full privacy and confidentiality
3. The Need for OSCC Holistic approach (seamless continuity of care from crisis period to rehabilitative phase) Maintain confidentiality Multilevel crisis intervention to survivors Management of medicolegal evidence
4. Flow of OSCC Patient reach ED Triage Police report OSCC team in ED Documentation Examination Collection of evidence Disposition
8. Multidisciplinary approach Emergency Department Obstetrics and Gynecology Paediatric Surgical Forensic Psychiatric Medical Social Counselling Unit Social Welfare Royal Malaysian Police NGOs (eg. Child Protector)
9. Components Rape and sexual assault Child abuse and neglect Sodomy Domestic violence
10. Rape & Sexual Assault Rape Sexual Assault • Sexual intercourse obtained through force or threat of force without victim’s consent • <16 years old • Must be some penetration however slight, ejaculation is not necessary • Non-consented kissing and fondling of the breast or woman’s private part • But without penetration • Includes forced anal sex, insertion of objects into vagina, mouth or anus
11. Child abuse and neglect
12. Domestic Violence Act 2012 Domestic Violence (amendment)
13. Sodomy
14. General Approach History Taking Physical examination Evidence Collection
15. History Taking • Incident (time, date, location, circumstances, force/weapon, drug or substance) • Assailant (number, ethnic, relationship) • Types & details of acts • Events after incident • Relevant history: • O&G history (pregnancy, menstrual, contraception) • Medical history • Sexual history • Paediatrics history (immunization, development) • Surgical history (genitalia, anus)
16. Examination • General appearance • Clothing • Head-to-toe examination • Evidence of external injuries • Specific relevant examinations: • O&G (speculum: not for prepubertal) • Sexual (genitalia, anus) • Paediatrics (Pubertal staging: breast, axillary, pubic hair)
17. Evidence Collection • Clothing • Foreign materials • Body hair (head, pubic) • Body swab (oral cavity, vagina, anus, penis) • Bloods (DNA, Biohazard, blood alcohol) • Urine (UPT, urine toxicology screen, FEME, C+S)
18. References
19. “Your silence will not protect you.” ― Audre Lorde, Sister Outsider: Essays and Speeches