Pediatric emergency medicine trisk 4236 4236
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6. Genital inspection: Carefully inspect entire external genital area for
signs of trauma. Use colposcope or other photo documentation system to
examine for injuries. Document findings, including size, shape, color,
and location, on anatomical diagrams of genitalia.
7. Pubic hair combings: Remove paper fold from envelope marked “Pubic
Hair Combings.” Ask patient to sit on unfolded paper so that the paper
protrudes between the thighs; comb downward on pubic hair to dislodge
any debris or loose hairs onto the paper. Place comb on paper and fold
paper to retain debris; place paper in the envelope marked “Pubic Hair
Combings,” seal, and label as indicated.
8. Perianal swabs: Carefully evaluate the anus and buttocks for signs of
injury. Document positive findings on gender-appropriate anatomical
diagrams. Using two moistened swabs simultaneously, gently rub swabs
on anal folds and anal opening. Dry completely and place in the
envelope marked “Perianal Swabs.”
9. Rectal swabs: After external anal swabs have collected, the anal area
should be cleansed by wiping carefully with a moistened gauze pad.
Simultaneously insert two sterile cotton swabs approximately 2 cm into
the rectum and swab rectal walls. Remove swabs, avoiding contact with
the external anal tissue. Dry completely and place in the envelope
marked “Rectal Swabs.”
10. External genital swabs: Use swabs in external genital envelope. For
male patients, wipe the surface of the glans and shaft; for female
patients, wipe the inner surfaces of the labia minora with a downward
motion. After drying, place in a marked envelope.
11. Vaginal swabs: Using two swabs simultaneously, collect secretions from
the vagina near the vaginal fornix (area below the cervix).
12. Cervix swabs: If indicated, obtain using two swabs simultaneously to
collect secretions from cervical os. This step should be performed only
with the use of a speculum to ensure visualization of the cervix and thus
is not performed in prepubertal children unless under anesthesia. Dry
completely and place in envelope marked “Cervix Swabs.”
a. If using a speculum for cervical examination, after evidence is
collected, use the NAAT swab to obtain specimen for STIs.
13. All tampons, pads, pantyliners should be collected and dried. Once dry,
place in the “Miscellaneous” envelope.
