ED Pathway for Evaluation/Treatment of Children with Sexual Abuse Concerns

Genital Examination with Attending/Fellow

Introitus

  • Discharge
  • Bleeding
  • Foul odor
  • Acute injuries
  • Bruising
  • Erythema
  • Mucosal abrasion
  • Laceration
  • Hymenal contour

Anus

  • Folds, Rugae
  • Laceration
  • Discharge

Pelvic
(if post-menarchal)

  • Use speculum at attending discretion if patient menstruating currently
  • Cervical motion tenderness
  • Adnexal tenderness

Bluemaxx Light

  • Identify areas to be swabbed and sent for semen analysis