HealthPathways South Australia (HPSA) has been working with South Australian experts to develop a range of pathways and resources to support clinicians working with people experiencing Domestic, Family and Sexual Violence. Four new pathways have recently been published, including; Strangulation and other forms of Asphyxiation, Sexual Assault, Emergency Contraception and Trauma Informed Care.
A person subjected to strangulation, can suffer serious immediate as well as ‘hidden’ ongoing health concerns. Strangulation by an intimate partner is recognised as a serious act of domestic violence, a predictor of future homicide risk1 and in SA, is a criminal offence in its own right2.
In order to provide a clearer understanding of strangulation, its associated risks, and to inform decision making regarding assessment, management and appropriate referral options, HPSA developed the Strangulation and other forms of Asphyxiation clinical pathway.
Dr Suzi Pedler (GP Clinical Editor) has this to say about the pathway:
‘The Strangulation and Other Forms of Asphyxiation Pathway equips health providers with SA Health guidelines regarding screening, assessment and management when strangulation or asphyxiation is suspected or disclosed. The pathway raises awareness about this common event which can be easily missed when there is no visible injury or because many patients are reluctant to disclose unless asked directly. Resources include a standardised assessment form and flowchart to guide management depending on modality of asphyxiation, time since event, symptoms, signs, patient age and associated pregnancy.’
Sexual assault is a serious offence, and one which may be disclosed to health professionals when working with patients. It is reported that 20 % of women and 5.1% of men have experienced sexual assault since the age of 15.3
The sexual assault pathway aims to support clinicians to deal with the consequences that their patients may experience following sexual assault. These may include immediate and short term psychosocial and physical health consequences.
Dr Suzi Pedler (GP Clinical Editor) provides the following on pathway:
'The new Sexual Assault Pathway contains helpful information for GPs and other health providers responding to disclosures of sexual assault or when this is a possible cause of unexplained injuries, infection or pregnancy which may have occurred during incapacitation. Resources include trauma-informed interview techniques, guidelines for anogenital examination, emergency contraception, STI screening and prophylaxis, safety planning, medical photography, options and timeframes for collection and preservation of forensic evidence, circumstances requiring mandatory reporting and forensic medical considerations when pregnancy results from rape.'
Two other resources, also recently developed, which may be useful to clinicians include, Emergency Contraception and Trauma Informed Care.
References
- Management of non fatal strangulation. RACGP; 2022, November.
- Criminal Law Consolidation Act 1935. Government of South Australia; 2024, January 1.
- Personal Safety, Australia. Australian Bureau of Statistics; 2023 Mar 15.
