Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 545 - SEXUAL ASSAULT SURVIVORS EMERGENCY TREATMENT CODE › Appendix C - Emergency Contraception Protocols

Current through Register Vol. 48, No. 28, July 12, 2024
CONTRACEPTIVE INTERVENTION
SAMPLE PROTOCOL I
A. GENERAL
Each survivor of sexual assault will receive
				medically and factually accurate written and oral information about emergency
				contraception as soon as possible and, in any event, no later than 12 hours
				after the sexual assault survivor presents herself/himself at the hospital for
				emergency treatment services; the indications and counter-indications and risks
				associated with the use of emergency contraception; and a description of how
				and when survivors will be provided emergency contraception upon the written
				order of a physician licensed to practice medicine in all its branches, an
				advanced practice nurse who has a written collaborative agreement with a
				collaborating physician that authorizes prescriptions of emergency
				contraception, or a physician assistant who has been delegated authority to
				prescribe emergency contraception. If the alleged sexual assault survivor
				accepts this treatment, the physician will administer emergency contraception
				as approved by the federal Food and Drug Administration (FDA), unless
				contraindicated for medical reasons, while the survivor is in emergency care.
				Each survivor of sexual assault will be provided with an appropriate referral
				to a physician licensed to practice medicine in all its branches as provided in
				the Medical Practice Act of 1987.
CONTRACEPTIVE INTERVENTION
SAMPLE PROTOCOL II
(CATHOLIC HOSPITAL ASSOCIATION)
A. GENERAL
Each survivor of sexual assault will receive
				medically and factually accurate written and oral information about emergency
				contraception as soon as possible and, in any event, no later than 12 hours
				after the sexual assault survivor presents herself/himself at the hospital for
				emergency treatment services; the indications and counter-indications and risks
				associated with the use of emergency contraception; and a description of how
				and when survivors will be provided emergency contraception upon the written
				order of a physician licensed to practice medicine in all its branches, an
				advanced practice nurse who has a written collaborative agreement with a
				collaborating physician that authorizes prescriptions of emergency
				contraception, or a physician assistant who has been delegated authority to
				prescribe emergency contraception. A female survivor of sexual assault who
				shows a negative result for pregnancy on the blood test and a negative result
				with respect to the urine dip-stick test, and whose history corresponds to
				this, will be offered a contraceptive intervention of high dose Ovral (or
				equivalent). If the sexual assault survivor accepts this treatment, the first
				dose will be provided in the emergency department to achieve the contraceptive
				effect.
If the survivor presents a positive result on the
				tests, the survivor will be counseled that the emergency department will not
				offer the formulation. If the blood test is positive for pregnancy, the sexual
				assault survivor will be counseled that this pregnancy is not of immediate or
				recent origin. If the urine test is positive and relates to the individual's
				history, it indicates that the LH surge is under way or that the woman is
				ovulating, and that a contraceptive formulation would not be effective in
				preventing ovulation, and contraceptive intervention will not be provided by
				the hospital.
Sexual assault survivors will be referred to a
				physician for appropriate follow-up health care.
B. CLINICAL APPLICATION
I. If a woman is determined to be in the preovulatory phase of
				her cycle, then Ovral (or equivalent) will be immediately available for the
				most effective contraceptive intervention in the dosage of 2 pills at the
				present time, and 2 in 12 hours.
1) History: Compatible with preovulatory
				phase
2) Physical examination: Compatible with
				preovulatory phase
3) LH urine: Negative
Progesterone level less than 1.5 ng/mL
II. If the woman is determined to be past the early
				postovulatory phase (LH urine: negative; progesterone: greater than or equal to
				6 ng/mL), because the timing of the sexual assault could not have coincided
				with the presence of an ovum, Ovral (or equivalent) may be prescribed for the
				psychological benefit of the woman who requests it.
III. If the woman is determined to be in the late postovulatory
				phase, because the timing of the sexual assault could not have coincided with
				the presence of an ovum, Ovral (or equivalent) may be prescribed for the
				benefit of the woman who requests it:
1) Progesterone level: Less than 6 ng/mL
2) LH urine: Negative
3) Menstrual history: Anticipation of menses in less
				than 7 days (usually 3-5 days)
IV. If a woman is determined to be in (1) her midcycle LH surge
				phase or (2) early postovulatory phase, Ovral (or equivalent) will not be given
				by the emergency department physician:
1) LH urine: Positive
Progesterone level: Unnecessary to perform
2) LH urine: Negative
Progesterone level: Greater than or equal to 1.5 or
				less than or equal to 5.9 ng/mL
Menstrual history: Compatible with midcycle and
				early postovulatory phase (menses expected in greater than 7 days).