Abuse, Sexual, Suspected — Team Assessment — Clinical Pathway: Emergency Department

Sexual Abuse Clinical Pathway — Emergency Department

Team Assessment/Huddle to Review Criteria for SART Activation

Team Members: Social Work, HP, RN, ED Attending

Criteria for SART Activation for Age < 18 yrs, Meets Criteria for Evidence Collection

  • When the decision to activate SART is not clear, proceed with activation to allow for full interview by SART Team to clarify decision for forensic collection, screening and associated medical treatment
  • SART can be activated at any time during the visit
  • Final decision is made by the ED Attending, SART-trained HP, and SART RN
  • Consult SCAN as needed for clarification
  • Consent is required for forensic evidence collection
Age < 18 yrs, female and male
Date, Time
of Assault
  • Pre-pubertal ≤ 24 hrs
  • Pubertal ≤ 72 hrs
  • Note:
    • Evidence collected from pre-pubertal children is mostly likely positive when collected within 24 hrs of assault
    • Clinical decision for the individual pre-pubertal child guides collection beyond 24 hrs
Perpetrator Age ≥ 10 yrs
History
  • Concern for assault
  • Referred by police for evidence collection
  • Pre-pubertal child with positive STI result
Signs, Symptoms
  • Abdominal, vaginal, rectal pain
  • Dysuria, hematuria
Documentation Use quotations to document any statement made by caretaker and/or child/adolescent during triage
Instructions
  • Remain dressed
  • Avoid eating, drinking, washing hands, going to the bathroom