Acute care needs

Respond to acute injury, trauma care, and safety needs before collecting evidence.  In addition to promoting physical health, sensitive and timely medical care can help reduce the likelihood of acute psychological trauma and its aftereffects, support patients’ existing and emerging coping skills, and set the tone for patients’ resumption of normal functioning.
 
Acute medical needs take precedence over forensic needs. Patients should be instructed to not wash, change clothes, urinate, defecate, smoke, drink, or eat until initially evaluated by examiners, unless necessary for treating acute medical injuries. If drug-facilitated sexual assault is suspected, and patients need to urinate prior to the arrival of examiners, ensure that the urine sample is collected properly while maintaining the chain of custody. 
 
As soon as possible after the initial medical evaluation, management, and stabilization of acute problems and before treating nonacute injuries, the medical forensic exam can be conducted (with patients’ permission). In circumstances in which patients are seriously injured, examiners must be prepared to work alongside other health care providers who are stabilizing and treating them. In such cases, examiners may need to perform exams in settings such as a health care facility’s emergency department, an operating room, a recovery room, or an intensive care unit.


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