| Treatment if Genital Injury Present |
- Stool softeners
- NSAIDS
- Peri bottle for hygiene
- Ice to perineum:
- On for 20 mins, then off for 20 mins for first 24 hrs
- Sitz baths:
- Warm or cool water, 4 times per day
- Tucks Hemorrhoidal Pads:
- Line pantiliner with pads 4 times a day or wipe after urinating or stooling
- Trauma consulted
- Review follow-up recommendations
|
| Early Post-assault Follow-up |
- ED discharge instructions:
- CARE Clinic staff will call you for all your follow-up needs within 72 hrs
- CARE Clinic Fellow/Attending will review SART Evaluation within 72 hrs of
ED disposition
- Based on individual patient needs, CARE Team will recommend one of the following
- CARE Clinic appointment
- Follow-up program, counseling
- Telephone care management
- Referral to PCP
- CARE Clinic number 215-590-4923
|
| Follow-up Testing and Treatment |
- HCG in 2-3 wks for post-pubertal females
- HIV test at 6 wks and 12 wks post-exposure
- Syphilis (RPR) testing at 4-6 wks and 12 wks post-exposure
- Consider:
- Repeating STI screening at 3 wks if not empirically treated
- If empirically treated, repeat STI testing at 3 mos as part of routine adolescent
STI screening
- Vaccination as indicated
- Hepatitis B vaccine at one 1 and 6 mos
- HPV 1-2 mos or 6-12 mos (2 dose regimen)
|
| HIV-PEP Follow-up |
- Discharge with a 4-day starter pack when outpatient pharmacy is closed
- Prescriptions
- 28-day HIV-PEP for all patients
- Ondansetron for side effects
- Recommend
- PCP follow-up in 3-5 days
- Lab Follow-up
- CBC and LFT testing in 2 wks
- HIV test 6 wks and 12 wks post-exposure
|
| Contact Numbers |
- Document in APP follow-up note
- Include 2 working phone numbers to contact child/adolescent/family
- Confirm name of PCP
|
| PEP Suggested Readings/Resources |
|