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

Indications for STI Screening

Pre-pubertal patients

Post-pubertal patients

All patients

STI Tests

Victims of acute assault should have the following tests done. The evaluating team will decide what testing is needed for other patients.

N. gonorrhoeae (GC) and C. trachomatis (Chlamydia)

Collect specimen from any site of possible, attempted, or confirmed penetration

Cervix / Vaginal First 20mL of “Dirty” urine, first-stream, no void in previous hour
Rectal, Pharyngeal Use Dacron swab, place in viral transport medium

Trichomonas – Rapid Trichomonas Antigen Test

For post-pubertal patients only after evidence collection completed
Red-topped culture swab placed in vagina for 30 seconds
Green-topped culture swab placed in male urethra for 30 seconds

HSV

Green-topped culture swab to un-roof lesion
Place in Viral Transport Medium

Serum for:

HIV
CBC, BMP, LFTs
RPR
Hepatitis B (if not fully immunized)

Other Tests as indicated:

Trauma Labs, radiographic studies