Pediatric emergency medicine trisk 4235 4235
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a. Underpants and/or diapers should be collected even if they are not the
pair worn during or immediately after the incident. Vaginal secretions
may accumulate, even if the patient has bathed or showered.
b. Collect all clothing if worn during assault or immediately after
assault. If patient is not wearing the same underwear from the assault,
the examiner should inquire about the location of the garment and
instruct patient or family to save the garment for law enforcement
(ideally unlaundered in a paper bag).
Physical examination evidence collection
1. Skin surface assessment: Carefully perform a visual inspection of the
patient’s external skin surfaces. Locate, describe, and photograph any
evidence of trauma or adherent foreign matter. Use a ruler if available.
a. If areas of dried secretions are noted on external skin surfaces,
document findings on anatomical diagrams.
2. Secretions collection: Prior to any swabs or evidence collection, an
alternative light source should be utilized in a dark room over the
patient’s entire body. If there is a positive finding (fluorescent
specimen), a sterile swab moistened with sterile water should be used to
swab area. Allow to air dry. Place in “Debris or Miscellaneous”
envelope—noting where specimens were collected.
a. Use extra swabs to collect specimens if needed. Be sure to label the
“Debris or Miscellaneous” envelopes carefully to what evidence is
inside and where it was obtained.
3. Bite mark evidence: Document location of bite mark(s) on anatomical
diagram form and, where possible, photograph the bite mark with and
without scale. With two premoistened swabs, simultaneously rub swabs
over area of potential/actual bite mark in order to collect any dried
saliva left by the offender.
4. Examination of hands: Carefully inspect dorsal and palmar surface of
hands for any signs of trauma. Document all findings on anatomical
diagram. Swab only fingernails if there are dried secretions, if so, follow
directions for dried secretions.
5. Oral swabs: Open the swab packet from the envelope marked “Oral
Swabs,” grasp both swabs together by the shaft, and swab the area
between the patient’s cheek and gum, and behind the back molars on
both the maxilla and mandible.
a. Mucosal membranes swabs do not need to be moistened.
