When attending to a 22-year-old woman who has been sexually assaulted and expressly refuses examination, what is your initial action?

In situations involving a patient who has experienced sexual assault and is refusing examination, it is crucial to prioritize their autonomy and comfort while ensuring their safety. Asking a female EMT to assess her serves as a sensitive and supportive approach. This action can help the patient feel more at ease, as a female provider may be perceived as less threatening and more relatable in such a vulnerable circumstance. It demonstrates respect for the patient’s feelings and may assist in building trust, potentially encouraging her to engage with medical care without feeling pressured.

Providing care in a way that respects the patient's wishes is fundamental in trauma-informed care. This approach also complies with ethical standards in healthcare, emphasizing the importance of consent and the patient's right to refuse services. It creates an environment that allows the woman to maintain control over her situation, which can be crucial in the aftermath of an assault.

While other options involve actions that may seem helpful or necessary—like asking for a release form, explaining the need for an examination, or transporting her without assessment—they do not effectively address the need for sensitivity and respect for the patient's autonomy and current emotional state. Each of these alternatives may inadvertently increase the patient's distress or sense of violation, which is counterproductive in a situation that already involves trauma.