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Pediatric emergency medicine trisk 4234 4234

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General Obtain consent to collect forensic evidence in adolescent sexual assault cases Refer to your state and institutional consent requirements for forensic evidence collection Instruct patient not to wash, brush teeth, change clothes, urinate, defecate, smoke, drink, or eat until evaluated by examiners, unless medically necessary Wash your hands and wear gloves Use a photo documentation system to document physical findings a The first photograph should be that of the child’s ID label with full name, date of birth, and medical record number b Take as many photographs as needed to document examination and findings/injuries c Document each injury separately with ruler/color guide in photographs Complete anatomical diagrams from evidence collection kit to document findings including location, size, and appearance Initial debris and clothing collection Debris collection: Carefully inspect patient’s head, hands, and other all exposed skin surfaces, as well as outer surface of clothing, for any loose debris including hairs, grass, leaves, fibers, threads, etc Using one piece of clean white copy paper carefully remove the loose material and place it inside the unfolded paper Refold paper to retain material; indicate location on patient’s body or clothing from which material was collected Repeat as necessary Place folded paper into envelope marked “Miscellaneous,” seal, and label envelope as indicated Clothing collection: Spread clean sheet on floor, place large paper sheet from “Foreign Material” envelope in the middle of the cloth sheet Have patient stand in the middle of the sheet and remove clothing one piece at a time, careful not to shake the clothing If caregiver or nurse is helping the patient, advise them not to stand on the sheet with the patient Ask the patient to remove one article of clothing at a time If the article of clothing has wet stains of potential biologic material (blood, saliva, semen, etc.), lay flat to dry Place each article of clothing in a separate paper bag, labeled with patient identification sticker, biohazard label, date, time, and forensic examiner’s initials

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