Your presence is requested by law enforcement to assess a sexually assaulted patient who is bleeding; what should you do first?

• A. arrange for a rape crisis center representative to speak with the patient
• B. control any external bleeding, administer oxygen, and transport at once
• C. visualize the vaginal area and pack the vagina with sterile dressings
• D. allow her to change her clothes and take a shower before you transport

Answer: (B)

When there is active bleeding, the immediate priority is life-saving care. The first actions are to control any external bleeding with direct pressure and dressings, ensure adequate oxygenation (provide oxygen if needed), and arrange rapid transport to a facility for definitive medical and forensic care. Other steps, such as visualizing or packing the vaginal area, and asking the patient to shower or change clothes, can delay stabilization and may affect evidence—so they are not performed before bleeding control and stabilization. Involving a rape crisis advocate is valuable, but it should not delay urgent transport and medical treatment.