Understanding SANE Examinations: What They Are and How They Work

As a professional in the field of child maltreatment and criminal investigation of child abuse, I am often asked about SANE examinations. SANE stands for Sexual Assault Nurse Examiner, and these professionals are specially trained to provide medical care and forensic evidence collection to victims of sexual assault or abuse.

There are two types of SANE exams - acute and non-acute. An acute SANE exam is performed within 120 hours of the assault, while a non-acute SANE exam can be performed anytime after that, up to several weeks, months, or even years later.

The purpose of an acute SANE exam is to provide immediate medical care to the victim and to collect forensic evidence that can be used in a criminal investigation. This evidence may include DNA samples, photographs of injuries, and documentation of any physical or emotional trauma experienced by the victim.

In contrast, a non-acute SANE exam is typically performed when a victim comes forward to report a past assault or abuse. The purpose of this exam is to provide medical care and to collect any forensic evidence that may still be present, even if the assault occurred weeks or months prior.

While law enforcement may seek SANE examinations to support the evidentiary strength of a criminal investigation, the primary focus of forensic nurses conducting these exams is always the medical care, safety, and well-being of the patient. Forensic nurses are trained to provide trauma-informed and compassionate care, assess and treat medical needs, and connect patients to ongoing support services. Evidence collection is a component of the exam that may be offered to the patient, but it is entirely voluntary and performed only with informed consent. It is important to emphasize that the forensic medical examination is not conducted primarily for the purpose of evidence collection. Mischaracterizing it as such can lead to significant issues in courtroom testimony, particularly when relying on medical records that are admissible only under the medical treatment hearsay exception.

In the past, SANE examinations were primarily conducted in emergency departments, but now there are also mobile forensic nursing programs and SANE programs that utilize specialized facilities. These programs are increasingly becoming the future of SANE examinations.

The Texas Forensic Nurse Examiners (TXFNE) model is a great example of a successful SANE program. The TXFNE model is a community-based, nurse-led program that provides sexual assault medical forensic examinations to individuals throughout Texas. The program utilizes a team of specially trained forensic nurses who work in collaboration with local law enforcement agencies, victim advocates, and healthcare providers to provide comprehensive care to victims.

Mobile forensic nursing programs are also becoming more prevalent. These programs allow for the examination to be conducted on site, rather than requiring the victim to travel to a hospital or clinic. This can greatly increase access to SANE examinations, especially for individuals who live in rural areas or who may have difficulty accessing medical care.

The use of mobile forensic nursing programs and specialized SANE facilities is a step forward in providing comprehensive care to victims of sexual assault and abuse. By providing access to SANE examinations in more locations, victims can receive care in a more comfortable and convenient setting, which can help them feel more comfortable during the examination process.

Overall, the importance of SANE examinations in the criminal justice system cannot be overstated. By utilizing specialized facilities and mobile forensic nursing programs, we can improve access to care and increase the likelihood of justice being served for victims of sexual assault and abuse.