Best Wishes to SANEs for a Happy New Year

The end of 2012 is almost here - and we have alot to be grateful for!  I am grateful for each of the MUSC SANEs, you put so much of yourselves into this program.  Without you it could not succeed, or provide care for our patients.  Your care is calming to the patient and family, and critical to the team. Thank you to each one of you, for being a member of the team, for sticking with it, and for looking ahead with me to a great 2013.  We will be getting our new camera system, continuing to build our reputation and presence in the community, and providing excellent care for those who have experienced terrible violence.  My best wishes for a safe and Happy New Year to you all!

Emergency Contraception

Plan B is levonorgesterel, and is provided in either a 1.5 mg (one time dose) or 0.75mg (2 doses given 12 hours apart, or can both be taken at the same time).  Both are also available over the counter for women (and men) age 17 and older.  Plan B is most effective within the first 72 hours, but can be given up to 120 hours post-exposure.

Click on this link to see a unique video describing how Plan B works:   http://www.youtube.com/watch?feature=player_embedded&v=7Vozr9vHeMo

Even if a woman has been on oral contraception or been taking Depo-Provera, it is ok to offer Plan B after a sexual assault.    Some women do not take their pills consistently on time, or get their Depo shots on time.  If you do not give Plan B in a case of vaginal/penile penetration, please document that you offered it, and patient declined (and why).  Plan B is safe to give women who are breastfeeding.  To minimize the infant's exposure to levonorgesterel, advise the woman to avoid nursing her infant for 8 hours. 

Patient Teaching Points:

• It is possible to become pregnant after a sexual assault.
• The medication is most effective when taken as soon as possible.
• Only contraindication is pregnancy.
• Most common side effect is heavier menstrual flow.
• Routine use of antiemetics is usually not necessary.
• Plan B will not protect against STI's.
• Plan B can be used safely more than 1 time during a menstrual cycle, but should not be considered first line of defense against pregnancy.  A visit to a primary care clinic is advised for education and contraception planning.

Current Stats on HIV Infections in Males

The CDC just published the latest data for the Charleston area on HIV infections for persons aged 13 and older.  In Charleston (2010), 63.5% of HIV infections are associated with male to male sexual contact.  Please remember to offer HIV screening to your patients, and help them with an assessment of risk for acquiring HIV from a sexual assault.  Dr Lazenby will see male patients at risk for HIV related to sexual assault.