SANE-A flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

SANE-A certification body

The SANE-A credential is issued by the American Nurses Credentialing Center and covers forensic care of adolescent and adult patients; renewal requires continuing education and clinical practice hours.

Informed consent for forensic exam

Voluntary, uncoerced agreement to examination that can be withdrawn at any point; patients may accept medical care while declining evidence collection or any individual step.

Fact versus expert witness

A fact witness testifies only to direct observations, while an expert witness may give opinions based on specialized education, training, and experience after being qualified by the court.

Chain of custody definition

A chronological written record of every person who handled an evidence item, including date, time, and purpose, maintained from collection through laboratory analysis and return to authorities.

Posterior fourchette

The fold of tissue at the posterior junction of the labia minora, just below the vaginal opening; a common site of acute genital laceration during penetration.

Tanner staging

A five-stage scale describing breast and pubic hair development; stages 3 through 5 indicate pubertal estrogenization, which alters hymenal tissue appearance and injury interpretation.

Fossa navicularis

The shallow depression between the posterior hymenal margin and the posterior fourchette within the vestibule, examined for tears or abrasions after penetration.

Lithotomy and knee-chest positions

Lithotomy places the patient supine with legs abducted in stirrups; prone knee-chest positioning improves visualization of the anus and posterior vagina during anogenital examination.

DNA evidence collection window

Body swabs for DNA are typically collected up to about 120 hours after assault, while clothing and other items may still yield DNA beyond that window.

Drying evidence before packaging

Swabs and wet clothing must be air-dried before packaging in paper, because sealed plastic traps moisture and promotes bacterial growth and DNA degradation.

Toxicology timing in DFSA

Blood and urine should be collected as early as possible in suspected drug-facilitated assault; urine has a longer detection window for most drugs, while blood better detects alcohol and GHB.

Evidence kit sealing

Each item is sealed separately with tamper-evident tape, then initialed, dated, and labeled with patient identifiers, collector name, and the specific source site.

Signs of strangulation

Petechiae, subconjunctival hemorrhage, neck pain, hoarseness, dysphagia, cough, and voice change; visible external marks are often absent even after significant compression.

Delayed airway edema

Swelling of the airway can worsen over 24 to 72 hours after strangulation, so patients need explicit return precautions even when they are initially asymptomatic.

Tonic immobility

An involuntary freeze response during assault in which the person cannot move or speak; it is a survival reflex and is never evidence of consent.

Trauma-informed examination

An approach that explains each step beforehand, asks permission, offers breaks and a support person, and lets the patient control the pace and order of the examination.

HIV nPEP window

Nonoccupational post-exposure prophylaxis should begin within 72 hours of exposure, ideally within 2 hours, and continues for 28 days using a three-drug antiretroviral regimen.

STI prophylaxis regimen

Ceftriaxone 500 mg IM once (1 g if 150 kg or more), doxycycline 100 mg orally twice daily for 7 days, and metronidazole 2 g orally as a single dose.

Emergency contraception options

Copper IUD within 5 days is most effective; ulipristal 30 mg orally within 120 hours; levonorgestrel 1.5 mg orally within 72 hours, with declining efficacy up to 120 hours.

Pregnancy-safe STI prophylaxis

When doxycycline is contraindicated, as in pregnancy, azithromycin 1 g orally as a single dose is the recommended substitute for chlamydia prophylaxis.

Rape trauma syndrome

A two-phase response described by Burgess and Holmstrom: an acute phase of disorganization, followed by a long-term reorganization phase that may include phobias, anxiety, and depression.

Use of interpreters

Trained medical interpreters should be used instead of family members, children, or an accompanying partner, because the accompanying person may be the assailant and untrained interpretation distorts forensic detail.

Trauma and memory

High stress narrows attention and fragments memory, so survivors may recall central details vividly but peripheral details poorly; inconsistent recall is not evidence of fabrication.

Screening for suicidality

Ask directly about thoughts of self-harm, prior attempts, and current safety plan; provide crisis numbers and a warm handoff to behavioral health when risk is identified.

Subpoena duces tecum

A court order requiring a witness or facility to produce records or evidence; release should be coordinated with hospital legal counsel and limited to the material requested.

Rape shield laws

Statutes that restrict the defense from introducing the complainant's prior sexual history or reputation in most sexual assault prosecutions, subject to narrow statutory exceptions.

Mandatory reporting statutes

State laws requiring clinicians to report specified injuries, such as child abuse, elder abuse, and gunshot wounds, to designated authorities regardless of patient preference.

Consent rules for minors

Consent rules for adolescent forensic examinations vary by state and may involve parent or guardian consent, emancipation, or minor-consent provisions; local statute governs before proceeding.

Objective documentation

Recording measurable findings such as size in centimeters, shape, color, and anatomic location, with quoted patient statements, rather than conclusory labels like patient was raped.

Photography log

A record of each image listing time, photographer, body location, camera distance, and whether a scale was used, allowing later authentication of the photographs in court.

IAFN Standards of Practice

Peer-reviewed practice standards from the International Association of Forensic Nurses defining assessment, evidence collection, documentation, and follow-up expectations for forensic nursing care.

Quality improvement audit

A structured review of specimen kits, charts, and timelines against defined criteria, with findings used to revise protocols and target staff education.