Emergency Department Clinical Pathway for Evaluation/Treatment
of Children with Sexual Abuse Concerns
- PHL ED
- Age ≥ 18 yrs
- PEM completes MSE
- Transfer to HUP ED
- Interfacility Transfer: CHOP PHL ED to Outside ED
- KOPH ED
- PEM completes MSE
- Transfer to Abington,
Bryn Mawr, or Paoli ED
- Age ≥ 18 yrs
- Expedite to ED Room as able
- Epic Chat ED SW
- Upon ED room arrival
- SW, SART RN, ED HP/Attending
- Review Criteria for SART Activation
- Team alert via PHL SART or KOPH SART
Non-acute Sexual Assault Cases
ED Team Evaluation
ED Team Evaluation
- SART activation not required
- Complete history and physical
- STI testing, treatment as indicated
- SW Evaluation, Reporting
- Multidisciplinary team interview
- Event history, acute symptoms
- Screen for Sex Trafficking
- Mental health assessment
- Obtaining Consent to Collect Forensic Evidence from Patients Who May Be Victims of Sexual Assault Job Aid
- PA Forensic Examination Consent Form
- Forensic Evidence Videos
- SART cart
- PSR label preparation
- Evidence collection kit
- Chain of custody
Child/Adolescent/Family Preparation
Child Life, analgesia, anxiolysis
Child Life, analgesia, anxiolysis
- Attending, ED HP, SART RN
- Exam, Photodocumentation Guidance
- Forensic Evidence Collection
Injuries associated with sexual assault
Laboratory Testing
- STIs
- Indications for STI Testing
- Recommended/Additional Tests
- Laboratory Testing
- HCG, screening labs for HIV-PEP
- Toxicology Testing, Drugscan
- Additional imaging, labs as indicated
Treatment
- STI Prophylaxis
- Syphilis, Vaccinations
- HIV Risk Assessment, HIV-PEP
- Emergency Contraception
- SW mental health assessment
- Psychiatry Consult as indicated
Discharge Planning
- Medical Follow-up
- Care Clinic vs. PCP
- SW, Psychological Support Follow-up
Evidence
- CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (PubMed)
- Antiretroviral PEP After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV
- AAP Committee on AIDS. PEP in Children and Adolescents for Nonoccupational Exposure to HIV
- NY SDOH. HIV Prophylaxis Following Non-occupational Exposure Including Sexual Assault
CHOP Program
Educational Media
- SART Module
- Primary Care Perspectives: Podcast for Pediatricians
Episode 76: Identifying Signs of Child Abuse and Neglect
Related Links
- CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (CDC.gov)
- National Clinician’s Post-Exposure Prophylaxis Hotline (PEPLine):
1-888-448-4911 - Enhancing the Identification of Commercial Sexual Exploitation Among a Population of High-Risk Youths
- A Public Health Approach to Global Child Sex Trafficking
- A Short Screening Tool to Identify Victims of Child Sex Trafficking
- Tindamax (Tinidazole) Prescribing Information