SANE-A key terms

An advanced credential from the International Association of Forensic Nurses, earned by licensed registered nurses who meet eligibility requirements and pass a computer-based examination covering adult and adolescent sexual assault care.

The legally defined limits of what a nurse may do, set by state licensure law, facility policy, and documented training, including which examinations, evidence collections, and treatments a SANE is authorized to perform.

A multidisciplinary group, typically including a forensic nurse, law enforcement, prosecutor, victim advocate, and crime laboratory, that coordinates a community's response to sexual assault from first contact through case resolution.

Cumulative emotional and physical strain from repeated exposure to patients' trauma narratives, which can erode a clinician's empathy and judgment and calls for self-care, supervision, and organizational support.

Placement of the patient supine with hips flexed and abducted and feet supported in stirrups for genital visualization; the examiner should offer alternatives, explain each step, and limit time in this position.

A thin membrane at the vaginal introitus whose appearance varies widely with age, estrogen exposure, and activity; its condition neither confirms nor excludes penetration or injury.

The thin fold of tissue where the labia minora meet posteriorly, just below the vaginal opening; a frequent site of small lacerations after penetration, consensual or not.

Insertion of a lubricated speculum to visualize the vaginal walls and cervix, allowing assessment for injury and collection of internal samples; it is not required in every assault case and requires patient consent.

A five-stage scale describing pubertal breast and pubic hair development, used to assess an adolescent's maturation and to interpret genital findings in the context of normal development.

An unbroken written record of who collected, handled, transferred, and stored each evidence item, with dates, times, and signatures, so its integrity can be defended in court.

A standardized, sealed set of swabs, envelopes, tubes, and forms used to collect biological and trace evidence from a patient; exact contents vary by jurisdiction and manufacturer.

A filtered lamp emitting specific wavelengths that makes semen, saliva, and some other biological fluids fluoresce on skin or clothing; a screening aid only, not a substitute for laboratory testing.

Genetic material recovered from swabs, clothing, or other items that can be typed and compared with reference samples to identify or exclude a contributor; collection should precede patient cleansing when feasible.

Blood and urine specimens collected within recommended time windows and with chain of custody, then tested for alcohol and drugs such as benzodiazepines, GHB, and ketamine that impair capacity to consent.

External compression of the neck that restricts blood flow or airflow; it may leave few visible marks yet cause delayed, life-threatening injury such as carotid damage or hypoxic brain injury, requiring imaging and follow-up.

Tiny pinpoint hemorrhages in skin or mucous membranes, often seen in the eyes, eyelids, or face after neck compression or forceful coughing; a subtle but meaningful indicator of strangulation.

The judgment that no immediately life-threatening condition is present and the forensic examination may safely proceed; unstable findings such as airway compromise or heavy bleeding require emergency transfer first.

Tissue damage from impact without a cutting edge, producing contusions, abrasions, and lacerations whose pattern, location, and shape may help reconstruct how force was applied.

Medication such as levonorgestrel or ulipristal acetate, or a copper intrauterine device, offered to reduce pregnancy risk after unprotected intercourse; effectiveness depends on timing and body weight.

A 28-day course of antiretroviral medication begun as soon as possible after a sexual exposure, ideally within 72 hours, to reduce HIV acquisition risk, with baseline and follow-up testing.

Empiric antibiotics, commonly ceftriaxone plus doxycycline, given at the initial visit to treat incubating gonorrhea, chlamydia, and trichomoniasis, paired with baseline testing and follow-up screening.

A highly sensitive molecular test that detects gonorrhea and chlamydia nucleic acid in urine or swab specimens, widely used for baseline and follow-up screening after sexual assault.

An immunization series, often started at the initial post-assault visit, that protects against hepatitis B; post-vaccination serologic testing may be advised for some patients.

An approach that recognizes trauma's effects, prioritizes safety, choice, collaboration, and empowerment, explains each step before it happens, and avoids recreating the powerlessness the patient experienced.

An involuntary freeze response during a threat in which a person cannot move or speak; it explains some victims' apparent passivity and must never be interpreted as consent or lack of resistance.

A pattern of psychological and physical responses after sexual assault, described as an acute disorganized phase followed by a long-term reorganization phase, helping clinicians anticipate distress and varied coping.

A lifelong process of self-reflection and openness to each patient's cultural identities, beliefs, and experiences, combined with active efforts to reduce bias and adapt care to individual needs.

A collaborative process of identifying warning signs, escape options, support contacts, and resources so a patient can lower the risk of further violence after leaving the care setting.

A voluntary agreement to examination or treatment by a patient with decision-making capacity, given after understandable information about purpose, risks, benefits, and alternatives, and free of coercion.

A legal duty set by state statute to notify designated authorities about suspected abuse of children, older adults, or dependent adults, or about certain injuries from violence, regardless of patient preference.

Testimony by a witness with specialized knowledge accepted by the court, who may offer opinions on forensic nursing practice, injury interpretation, or evidence handling to help the jury understand the facts.

An out-of-court statement offered to prove its truth, generally inadmissible, though exceptions such as statements made for medical diagnosis or excited utterances often apply in assault cases.

The ethical and legal duty to protect health information from unauthorized disclosure, subject to narrow exceptions such as mandated reporting, court order, or a serious threat of harm.

Systematic photographing of injuries and evidence with a scale, identifiers, and consistent lighting and angles so images accurately represent findings and can be authenticated later in legal proceedings.

A standardized diagram on which the examiner marks each injury's location, type, size, and color, supplemented by narrative and photographs to create a reproducible record of findings.

An ongoing, data-driven process of reviewing practices, outcomes, and patient feedback to identify gaps and implement changes that strengthen forensic care and program performance.

Clinical decision-making that integrates the best available research evidence, professional expertise, and patient preferences and values rather than relying on tradition, habit, or anecdote.