ED Pathway for Evaluation/Treatment of Children with Physical Abuse Concerns
Collection of Forensic Evidence
Clothing Collection for Suspected Abusive Injury
- Do collect clothing from severely injured children,
particularly if clothing has already been cut off during assessment.
- It is not necessary to collect clothing from every
abused child. However, if clothing is no longer wearable, and would
ordinarily be disposed of in the ED, it should be preserved for evidence.
- Do collect the clothing the child was wearing when
EMS arrived/when child arrived in the ED.
- Do place clothing in paper bags
- If clothing is wet, allow to dry as much as possible.
- Do seal and label the bag with the patient’s
- Do complete the City of Philadelphia Department of
Public Health Medical Report and attach to the paper bag with a staple.
Give the bag to police or security.
Forensic Evidence Collection for Suspected Bite Marks
- Open the Forensic Evidence Kit. Place the orange biohazard sticker
on the blank spot on the face of the box. Complete the top portion of
the box label.
- Select an envelope that contains swabs and a small cardboard box.
- Cross out the preprinted description (e.g. “rectal”) and
mark as “bite.” Place a patient label on the front of the
envelope. Mark the envelope “saliva” in large letters below
- Remove the cardboard box from the envelope. Place a patient sticker
on it. Mark as “bite.”
- Lightly moisten a swab with saline. Rub over bite mark, including both
peripheral bruised/abraded area and the area of central clearing.
- Rub a second, dry swab over bite mark in the same way.
- Allow swabs to dry. Use swab dryer if needed (in SART cart.)
- Place swabs in box and close. Place box in envelope and seal. Place
envelope(s) in kit and seal with 2 red security tapes.
- Complete the City of Philadelphia Department of Public Health Medical
Report and attach to the box with a rubber band. Be sure to note which
county/police department is involved.
- Give kit to police or security.