An Original, Standardized, Emergency Department Sexual Assault Medication Order Sheet

In an effort to clarify the treatment of sexual assault victims, our medication sheet was created by the following group of health care providers: an emergency physician, a psychiatric clinical nurse specialist, an emergency nurse with a masters degree in forensic nursing, an emergency nurse who had previously served as the regional coordinator of the MDPH Sexual Assault Nurse Examiner Program, the physician director of the MGH STD clinic, the medical director of the STD Prevention Division at MDPH, and the ED nurse manager. In Massachusetts, quinolones (eg, ciprofloxacin) are no longer recommended for gonorrheal prophylaxis because of the rise in quinolone resistance.1 If a patient is allergic to cephalosporins and there has been no pharyngeal contact during the assault, spectinomycin, 2 g intramuscularly, is recommended for gonorrhea prophylaxis. Because the medication accumulates in low concentrations in the pharynx, it is not useful for prophylaxis in an oral assault.1 This injection is not effective against incubating syphilis.