Pediatric emergency medicine trisk 4234 4234
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General
1. Obtain consent to collect forensic evidence in adolescent sexual assault
cases. Refer to your state and institutional consent requirements for
forensic evidence collection.
2. Instruct patient not to wash, brush teeth, change clothes, urinate,
defecate, smoke, drink, or eat until evaluated by examiners, unless
medically necessary.
3. Wash your hands and wear gloves.
4. 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.
5. Complete anatomical diagrams from evidence collection kit to
document findings including location, size, and appearance.
Initial debris and clothing collection
1. 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.
2. 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.
