Development of a Human Trafficking Flowsheet for Clinical Forensic Examiners.

When trafficked patients are identified in the healthcare setting, clinical forensic examiners, including sexual assault nurse examiners (SANEs), may be consulted to provide medical care and to collect forensic evidence. However, using a standard sexual assault protocol and documentation form may not completely identify or address the unique needs of these patients. Our SANE program sought to improve the healthcare approach to trafficked patients by developing a trafficking-specific documentation flowsheet.

Challenges in conducting research on sexual violence and HIV and approaches to overcome them.

Studies have implicated sexual violence as a strong correlate of HIV acquisition in women. Characterizing how such violence affects the female immune system may provide insight into the biological mechanisms of HIV transmission and ultimately improve global HIV prevention strategies. Little research has been carried out in this domain, and the obstacles to investigation can be daunting.

Acute visual changes in the elderly.

Changes in vision are common complaints among the geriatric population. Causes range from cataracts and glaucoma to cerebral strokes or other systemic diseases. Loss of vision may be the turning point from independence to dependence in an elderly person's life.

Sexual assault.

Sexual assault is a problem that permeates all socioeconomic classes and impacts hundreds of thousands in the United States and millions worldwide. Most victims do not report the assault; those that do often present to an emergency department. Care must encompass the patients' physical and emotional needs.

Lack of evidence to support routine digital rectal examination in pediatric trauma patients.

Background: Current advanced trauma life support guidelines recommend that a digital rectal examination (DRE) should be performed as part of the initial evaluation of all trauma patients. Our primary goal was to estimate the test characteristics of the DRE in pediatric patients for the following injuries: (1) spinal cord injuries, (2) bowel injuries, (3) rectal injuries, (4) pelvic fractures, and (5) urethral disruptions.

Methods: We conducted a nonconcurrent, observational, chart review study of a consecutive series of pediatric trauma patients.

Poor test characteristics for the digital rectal examination in trauma patients.

Study Objective: Current advanced trauma life support guidelines recommend that a digital rectal examination be performed as part of the initial evaluation of all trauma patients. Our goal is to estimate the test characteristics of the digital rectal examination in trauma patients.

Methods: We conducted a retrospective medical record review study of consecutive trauma patients treated in our emergency department from January 2003 to February 2005 for whom the trauma team was activated and who had a documented digital rectal examination.

The feasibility of pain assessment in the prehospital setting.

Objective: To determine the feasibility of prehospital pain measurement among patients 13 years of age or older using a verbal and numeric rating scale and to assess the severity of pain in a prehospital patient population.

Methods: Retrospective cross-sectional study of emergency medical services (EMS) run sheets after the adoption of a universal prehospital pain assessment protocol. Data were abstracted from a sequential (1:4) sample of run sheets from the first three months after adoption of the protocol.