Episode 19 - Sexual Assault & Intimate Partner Violence

Sexual Assault & Intimate Partner Violence


April 2024


Scott Wildenheim

Ray Pace


Dr. Stephanie Gaines

Jennifer Moreland


Danger Assessment Tools 

Strangulation Institute

Episode Videos

Sexual Assault and Intimate Partner Violence, Part 1

Sexual Assault and Intimate Partner Violence, Part 2

Sexual Assault and Intimate Partner Violence, Part 3

Sexual Assault and Intimate Partner Violence, Part 4 Live Show

Episode Audio

Show Notes

SANE stands for Sexual Assault Nurse Examiner

The UH SANE program has been around for about ten years and they take care of victims of sexual assault and victims of violent partners.

Something to remember people think SANE is strictly a psychological thing. They also have FNE a forensic nurse examiner who works directly with LEO for human trafficking.

SANE certified nurses and SANE Trained nurses are not the same thing. UH has around 32 on SANE Nurses on staff.

The SANE trained nurse qualifications are, a nurse for a minimum of two years, 40 hours didactic that trains everything SANE, a full two day practicum and 100 hours clinical training.

Then to become certified you have to have had an additional 300 hours prior to sitting for the examination. With this certification, they can then do cases on their own.

Being first responder in the front line we are most likely someone who will interact in a victims life. We have an opportunity (Maybe there only) to get information and resources to them.

For the patients EMS should always been safety and then medical first. We need to let the LEO do there rule. Are job is not to try to be investigators, being mindful not to destroy evidence.

The only evidence EMS should be coming in to the hospital with is what the victim has on or is wearing. If they tell you they have something left somewhere, you should direct LEO to get it for the evidence.

Something to remember. If the patient is an assault victim, the hospital will most likely be sending those close out for evidence. You may want to encourage the patient to bring an additional set of clothes to the hospital so that they can change after the fact.

A good thing to remember about evidence is that prosecutors will always tell medical teams your evidence will not make or break a case.

A good working relationship with your local LEO will help if you are faced with these situations. We should be training more often with them together jointly.

The UH SANE group is always willing to come out to any department to speak about these issues.

The strangulation institute is a website with enormous amount of resources. They are a stem of the family justice center out of San Diego. https://www.strangulationtraininginstitute.com/

Statistically only 3% of incidents are reported. It is reported that a patient will be a victim of 7 horrific assaults before they will report this to someone.

A red flag for EMS should be responding to the same locations for the same patients repeatedly. In this case, it is okay to ask the patients if someone is hurting them or if they are ok, in a nonjudgmental way.

EMS has the benefit of seeing these victims in places the hospital cant. We need to keep eyes open and look for red flags and report those red flags to the hospital and LEO.

 Remember if we have a patient that just does not want to be transported to the hospital but we feel strongly something is wrong and they need to go. We can call Medical control. It is a recorded line and they can talk directly to the doctor.

The SANE nurse has a patient who is declining services they will ask them a DA five questions and then give them a score. This will help move the victim to make the right decision, if not now maybe later.

The Danger assessment five questions are:

1.       Has the physical violence increased in severity or frequency over the past year

2.       have your partner or ex ever used a weapon against you, or threatened you with a weapon

3.       Do you  believe you partner or ex is capable of killing you

4.       Has your partner of ex ever tried to choke or strangle you or cut off your breathing

5.       Is your partner or ex violently and constantly jealous of you

Even giving the victims a card with resources on them is a great way to make sure they know help is out there if they ask for it.

Some of the most helpful things EMS can do for documentation would be using quotations in the narrative. Making sure to report any strangulation, bruises, and conditions of the environment.

Males will report assault even less than the 3% women do.

If the patients discloses a problem, calling ahead to the hospital may help if you looking for a SANE nurse. Getting the patient to the right resource is best for patient advocacy.

Words to avoid when working with or treating a victim would be words like “allege”.

Remember it is okay to ask direct questions. Like are you being assaulted? Asking closed ended-questions is baked into the way EMT’s think when not getting anywhere with open-ended type questions. It may be best to start with closed-ended questions in this case.

Getting labs prehospital is still a good idea so that we can treat the patient. If a

As of April 2023, the State of Ohio has made strangulation a felony.

Research shows that if a victim is strangulated just one time in their life they are ten times more likely to die by the hands of that assailant.

At the point that a victim is ready to leave the abuser is when they are at the highest risk of danger. However, remember sometimes the abuse is not physical. Then when they finally decide to leave, it becomes physical.

The Danger of Strangulation

The Danger of Strangulation is a training video clip of San Diego Firefighter and Paramedic Mitch Mendler, Joe Russo, Danielle Bebee and San Diego Police Detective Rena Hernandez, who demonstrate how to educate a victim about the danger of strangulation using the new strangulation assessment card.

Strangulation Assessment Card (English)

Strangulation Assessment Card (Spanish) La Tarjeta de Evaluación de Estrangulación

Read more at the Family Justice Center

The Protocols

From The Episode

Ray discusses interagency connection with Police

Dr. Gaines describes what not to say

Jennifer speaks to not changing care to "preserve" evidence

Scott sets the stage for discussion on Sexual Assault Nursing and care